{"id":4752,"date":"2016-10-02T14:34:36","date_gmt":"2016-10-02T14:34:36","guid":{"rendered":"https:\/\/damesnet.com\/?p=4752"},"modified":"2016-10-02T14:34:36","modified_gmt":"2016-10-02T14:34:36","slug":"inside-the-ethics-comittee","status":"publish","type":"post","link":"https:\/\/damesnet.com\/?p=4752","title":{"rendered":"Inside the Ethics Comittee"},"content":{"rendered":"<div id=\"attachment_4766\" style=\"width: 287px\" class=\"wp-caption alignright\"><a href=\"https:\/\/damesnet.com\/wp-content\/uploads\/2016\/10\/rod-of-asclepius.jpg\"><img aria-describedby=\"caption-attachment-4766\" decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-4766\" src=\"https:\/\/damesnet.com\/wp-content\/uploads\/2016\/10\/rod-of-asclepius.jpg\" alt=\"Rod of Asclepius\/Mark Morgan\/flickr\" width=\"277\" height=\"277\" srcset=\"https:\/\/damesnet.com\/wp-content\/uploads\/2016\/10\/rod-of-asclepius.jpg 277w, https:\/\/damesnet.com\/wp-content\/uploads\/2016\/10\/rod-of-asclepius-150x150.jpg 150w, https:\/\/damesnet.com\/wp-content\/uploads\/2016\/10\/rod-of-asclepius-203x203.jpg 203w, https:\/\/damesnet.com\/wp-content\/uploads\/2016\/10\/rod-of-asclepius-60x60.jpg 60w, https:\/\/damesnet.com\/wp-content\/uploads\/2016\/10\/rod-of-asclepius-147x147.jpg 147w, https:\/\/damesnet.com\/wp-content\/uploads\/2016\/10\/rod-of-asclepius-184x184.jpg 184w\" sizes=\"(max-width: 277px) 100vw, 277px\" \/><\/a><p id=\"caption-attachment-4766\" class=\"wp-caption-text\">Rod of Asclepius\/Mark Morgan\/flickr<\/p><\/div>\n<p>Apologies if what follows seems like a post-Brexit paean of praise to Blighty \u2013 I\u2019ve actually been mulling this blog over since long before the fateful 23 June.<\/p>\n<p>It\u2019s just that one of the things that makes me grateful to live in this country is Radio 4\u2019s <em>Inside the Ethics Committee<\/em>, the programme in which a panel of experts examines the issues brought up by real-life cases presented to medical ethics committees, and it makes me grateful for the following reasons:<\/p>\n<ul>\n<li>We have a National Health Service (still, just about, against all the odds) that despite the pressures on it takes the individual needs of patients seriously. (Can I still call them patients as opposed to customers, clients or service users?)<\/li>\n<li>There are skilled and dedicated people, both specialists and lay members, who are prepared to take the time, often alongside their day jobs and often for no remuneration, to sit on ethics committees and confront some of the most profound, and even distressing, questions of right and wrong in the hope of adhering to the doctor\u2019s guiding principle of doing no harm.<\/li>\n<li>We have a national broadcaster that that pays us the compliment of assuming that we will find the proceedings of medical ethics committees and the minutiae behind their decisions interesting.<\/li>\n<\/ul>\n<p>Oh, and the presenter is an octogenarian woman (Joan Bakewell). I rest my case.<\/p>\n<p>The first time I heard the programme it made a deep impression on me. The case under discussion was that of a middle-aged man, David, with learning difficulties, who, from a purely clinical standpoint, needed treatment for cancer. On the face of it, it was a cut-and-dried issue: the usual course of action for a patient with this condition was a course of chemotherapy and David\u2019s disability was neither here nor there: he was as entitled to treatment as anyone else.<\/p>\n<p>But it wasn\u2019t as simple as that. David\u2019s learning difficulty was so severe that he would not be able to understand why he needed treatment, and therefore could not give consent for it. This issue of capacity \u2013 the ability to understand and make a decision based on that understanding \u2013 was explored in great detail.<\/p>\n<p>The manager of David\u2019s care home described very vividly how traumatic the exploratory CT scan had been for David, and the degree to which it had compromised his trust in his carers: he could not understand why those whom he trusted had taken him to be subjected to a frightening ordeal.<\/p>\n<p>Establishing what would be genuinely in his best interests entailed assessing the relative merits of a number of factors, including the extent to which potentially painful and frightening chemotherapy would further damage his relationship with his carers, and the fact that this treatment only offered a 50 per cent chance of success. In the end, the panel in the studio arrived at the same conclusion\u00a0as the ethics committee at the hospital: they had\u00a0decided that to maintain David\u2019s current quality of life, he should receive palliative care only. He died five months later.<\/p>\n<p>The programme recently completed its 12th series, and <a href=\"http:\/\/www.bbc.co.uk\/programmes\/b07nrxd4\">all 36 episodes<\/a> are available on iPlayer. It covers an impressive range of topics, including assisted conception, persistent vegetative state, religious objections to treatment . . . Everyone is likely to have personal experience of at least one of the issues discussed, or to know someone facing them.<\/p>\n<p>I now view <em>Inside the Ethics Committee<\/em> as being like the ravens at the Tower of London: as long as it\u2019s either on or scheduled to return, there is hope. Should it ever disappear we are well and truly\u00a0 done for.<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>If it disappears we are done for.<\/p>\n","protected":false},"author":4,"featured_media":4766,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[2,55],"tags":[],"_links":{"self":[{"href":"https:\/\/damesnet.com\/index.php?rest_route=\/wp\/v2\/posts\/4752"}],"collection":[{"href":"https:\/\/damesnet.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/damesnet.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/damesnet.com\/index.php?rest_route=\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/damesnet.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=4752"}],"version-history":[{"count":15,"href":"https:\/\/damesnet.com\/index.php?rest_route=\/wp\/v2\/posts\/4752\/revisions"}],"predecessor-version":[{"id":4783,"href":"https:\/\/damesnet.com\/index.php?rest_route=\/wp\/v2\/posts\/4752\/revisions\/4783"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/damesnet.com\/index.php?rest_route=\/wp\/v2\/media\/4766"}],"wp:attachment":[{"href":"https:\/\/damesnet.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=4752"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/damesnet.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=4752"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/damesnet.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=4752"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}