[Magdalen] RIP Sir Terry Pratchett

[sally.davies at gmail.com]

Oh, and another interesting aspect of palliative care in our town, the
Hospice doctor who goes by the beautiful name of Nan Jolly (something Terry
Pratchett could have invented!) is also a much respected and loved
Breastfeeding and post-natal consultant. She's very aware of the parallels
between beginning and end of life, when it comes to medical assistance aka
interference!

Sally D
On Fri, 13 Mar 2015 at 01:46 Roger Stokes <r.s.stokes.65 at cantab.net> wrote:

> ------ Original Message ------
> From: "ME Michaud" <michaudme at gmail.com>
> To: "magdalen at herberthouse.org" <magdalen at herberthouse.org>
> Sent: 12/03/2015 22:43:23
> Subject: Re: [Magdalen] RIP Sir Terry Pratchett
>
> >My nderstanding (and I could be wrong) is that the British are
> >much better at end-of-life care than we are. We've talked about
> >DNR orders being routinely ignored here. And I think we talked
> >about the pacemaker conundrum here also.
>
> The concept of Hospice care started in Britain with Dame Ciceley
> Saunders in the 1950's who qualified, in succession, as a nurse, social
> worker and doctor.  The first dedicated hospice opened in London in
> 1967.  The aim is to give holistic care, including emotional and
> spiritual care alongside the medical.  The aim is to allow the
> individual the best possible quality of life at every stage of a
> life-limiting condition. Hospices, both for day-care and for inpatients,
> are now a part of British life but they still rely heavily on voluntary
> fund-raising to complement what the government funds.
>
> I do not claim for one moment that we have end-of-life care sorted out.
> Until a few years ago we had what was called the Liverpool Pathway (Joan
> was put on it, and I believe it was appropriate for her) where purely
> palliative care to keep the patient comfortable as nature takes its
> course.  That was stopped after concerns that it was being used
> inappropriately in some cases where the condition was not necessarily
> terminal.  A few weeks ago the local hospital chaplain spoke to our
> clergy chapter and said that discussing end-of-life plans is still
> something that many doctors feel uncomfortable about and will not
> address directly.  She and I believe that is wrong.  We all have the one
> condition with 100% mortality - it's called life.
>
> As you imply we have considered before situations where medical
> intervention is basically futile and, I would add, depriving the patient
> of their intrinsic human dignity.  I believe the hospice philosophy has
> much to offer to medicine in its recognition of reality and affirming
> the dignity of the patient at all times, providing emotional support to
> their loved ones as well.  On this list we have (at least) one person
> receiving hospice care (Brud Jon) and the husband of another (Jim).
> Jon's post today about his retirement epitomises for me the essence of
> appropriate care - recognizing his calling as a deacon even when he can
> no longer exercise it in any active way.  Jim's Marcy's condition
> strikes me as being particularly hard as her body refuses to do what she
> wants it to do and so she has to rely on others for intimate care.  I
> pray that while Jim is away in Hawaii Marcy receives a more holistic
> care away from the memories of how their home has had to be adapted
> (very well in my view having seen it) and the inevitable rebalancing of
> the husband-wife relationship.
>
> Roger
> >
>
>