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Author Topic: Forced to have dialysis  (Read 3925 times)
MooseMom
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« on: May 30, 2012, 12:10:37 PM »

What do you all think of this?

From the Daily Telegraph (UK)

Kidney failure patient forced to have dialysis

 Doctors have been given the power by a court to force a man dying of kidney failure to have dialysis against his will.
 

By Stephen Adams, Medical Correspondent

10:00PM BST 29 May 2012


The man, who cannot be identified for legal reasons, had resisted dialysis and doctors believe that without it he will die within weeks.
 

Managers at the hospital where he is being treated applied to the Court of Protection for legal permission to use proportionate restraint, if necessary, to force him to have the life saving treatment.
 

Lawyers acting for the English hospital trust, which cannot be named to protect his identity, argued that he lacked the capacity to make decisions about his medical care.
 

The man, referred to in court as Mr S, did not want to die, emphasised Vikram Sachdeva, acting for the trust.
 

About 10 days ago he told a doctor that he did not believe his condition was bad enough to warrant dialysis.
 
Mr Sachdeva told the court: "He said, 'I don't believe I've got a life threatening illness."
 
However, over the next week his condition deteriorated significantly.

"The consequences of no treatment were potentially extremely serious," said the barrister.
 
On Friday Mrs Justice Parker granted the trust an order enabling clinical staff to restrain Mr S during dialysis, if necessary. In the event, he complied with treatment and received dialysis over the weekend, noted Mr Sachdeva.
 
Yesterday (Tuesday), the judge agreed to extend the order indefinitely, after accepting that Mr S did lack the capacity to make decisions about his care. She noted Mr S's relatives supported the trust's application.
 
However, she said clinicians needed to be very careful about the degree of restraint needed.
 
She said: "Nobody is suggesting that the gentleman is restrained in a straight-jacket or anything like that, it has to be proportionate. Restraint may exacerbate the medical difficulties."
 
She continued: "What is intended is that he should be gently restrained by having a hand held by each nurse so it is possible to put in a catheter."
 
If he became so agitated that he removed lines from the dialysis machine during treatment, which lasted three hours, that could trigger a potentially fatal embolism, she said. The stress of such an episode could also kill him due to a serious heart condition.
 
She said: "A balance needs to be struck ... between saving his life and subjecting him week-in and week-out to invasive treatment that has a capacity to be cruel to him."
 
http://www.telegraph.co.uk/health/healthnews/9298215/Kidney-failure-patient-forced-to-have-dialysis.html
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smcd23
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« Reply #1 on: May 30, 2012, 05:53:42 PM »

It sounds like he is really sick in more ways than one. I don't agree with restraint per say, but it does sound like he needs a guardian or someone to make medical decisions for him. And I am thinking, or at least hoping, that once he gets some dialysis and cleaned out a bit, his delusions that he isn't that sick and his physical aversion to the treatment will lessen. They say people who have untreated kidney failure do lose some of their marbles due to the toxic build up in their bodies...
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Caregiver to Husband with ESRD.

1995 - Diagnosed with vesicoureteral reflux and had surgery to repair at age 11. Post surgery left side still had Stage I VUR, right side was okay. Both sides were underdeveloped.
2005 - Discovered renal function was declining, causing HBP. Regular monitoring began.

March 2008 - Started transplant evaluation for preemptive transplant due to declining function.

September 16, 2008 - Transplanted with my kidney.
September 18, 2008 - Kidney was removed due to thrombosis in the vessels in and leading to the kidney.

October 2008 - Listed in Region I

May 2009 - Started in Center Hemo
January 2010 - Started CCPD on Liberty Cycler

June 15, 2012 - Kidney transplant from a 43 year old deceased donor
June 22, 2012 - Major acute rejection episode and hospitalization began
June 27, 2012 - Nephrectomy to remove kidney after complete HLA antibody rejection. Possibly not eligible for another transplant, ever again.

Now what?
YLGuy
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« Reply #2 on: May 30, 2012, 06:00:42 PM »

I do not know enough to make an opinion about this either way. 
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Rerun
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« Reply #3 on: May 30, 2012, 06:22:20 PM »

The JUDGE needs to sit and and observe the entire session with him on the machine.  I bet by the end she would have a different judgement.
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Poppylicious
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« Reply #4 on: May 31, 2012, 02:32:12 AM »

I'm with Marc ... we don't know enough to make a valid judgement.  His age and his medical (particularly mental) history could be a big factor in this, I would think.  I couldn't imagine any other reason why the Trust would have applied for permission to use moderate restraint without very good cause. 
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« Reply #5 on: May 31, 2012, 08:42:17 AM »

I wonder how old he is. I would hope my family never supports this treatment!
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Desert Dancer
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« Reply #6 on: May 31, 2012, 09:05:10 AM »

They made this judgement because the poor man does not have the mental capacity to make his own decisions. Well, that's just great. He already can't understand what's going on, so let's just strap him to a chair and torture him. He may be terrified and he's sure to be in pain but gee, don't we feel all righteous for fooling death again? What's next? Chemo at gunpoint? Obviously anyone who chooses to retain their dignity and bodily integrity and declines dialysis or chemo must - by definition - be out of their minds. Let's just strap 'em all down and run them through the gauntlet of infiltrations, infections and crashes. It's 'for their own good', after all.

People in general - medical personnel in particular - need to stop cramming their fear of death down everyone's throats. Life at all or any cost - why? Sometimes Death is the kindliest visitor one will ever receive.
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MooseMom
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« Reply #7 on: May 31, 2012, 02:17:05 PM »

I agree that we probably don't have ALL the information, but then again, what sort of information is missing that would suddenly make this decision incontrovertible?  For this to have gone to court at all must mean that there was/is an ethical dilemma that I thought might be interesting to discuss.

It's just that dialysis is such a hard treatment, so invasive and so easily done wrong as we all know.  It can be torture for someone who does not want it.
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lmunchkin
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« Reply #8 on: May 31, 2012, 05:54:40 PM »

They made this judgement because the poor man does not have the mental capacity to make his own decisions. Well, that's just great. He already can't understand what's going on, so let's just strap him to a chair and torture him. He may be terrified and he's sure to be in pain but gee, don't we feel all righteous for fooling death again? What's next? Chemo at gunpoint? Obviously anyone who chooses to retain their dignity and bodily integrity and declines dialysis or chemo must - by definition - be out of their minds. Let's just strap 'em all down and run them through the gauntlet of infiltrations, infections and crashes. It's 'for their own good', after all.

People in general - medical personnel in particular - need to stop cramming their fear of death down everyone's throats. Life at all or any cost - why? Sometimes Death is the kindliest visitor one will ever receive.

I could not have said it better!!!!!

lmunchkin
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