The Witch Doctor

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EARNING YOUR PHARMACIST AN HONEST CRUST

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3 Comments

Posted in Blogosphere, Communitarianism, Creep, Democracy, Hubris, The Third Way

Posted by: Witch Doctor | November 23, 2009

Goings-on in a cupboard

witchround

Wat Tyler had a fantastic time when he was lured into the pharmacist’s cupboard…….

a red apple ……………………

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MILITANT MEDICAL NURSE

Posted in Department of Health, Economy, Skills escalator, The Economy

Posted by: Witch Doctor | November 21, 2009

Nurse Anne is doing her nut!

witchround

And quite right too!

Nurse Anne, in the view of the witching community, is doing an essential service for patients, in bringing to the attention of the world, the way it really is in many wards in the UK during this wonderful age of “Change” and “Modernisation” and “Diversity” and “Talent” and “Leadership” and “Contestability” and “Plurality” and now “Polysystems” with “spokes” and all the other meaningless jargon that was ushered in by Tony Blair and his “Third Way” cronies that surrounded him and followed him and are still following him.

Nurse Anne is having a go at the doctors including The Witch Doctor.

In fact, The Witch Doctor agrees with most of what Nurse Anne says in her post apart from the implication that UK doctors are a cocaine snorting bunch, and The Witch Doctor’s views on apprenticeship. The Witch Doctor has a post on the topic of apprenticeship and the creep that will follow. This post is likely to appear sometime soon during The Witching Hour. The other thing is that, as a doctor, The Witch Doctor does not feel threatened by the “dumbing down” that the Skills Escalator is intended to produce. No. It is as a patient she feels threatened by this, not as a doctor.

So, why exactly do we witches feel that The Witch Doctor thinks Nurse Anne is quite right to do her nut about doctors?

Well, The Witch Doctor frequently does her nut about doctors too, albeit not in the same illustrative language of Nurse Anne.

If you are a hospital consultant, then we witches suggest that at some point over the weekend, you pour yourself a coffee, sit down by the fire and spend an hour or so reading through Nurse Anne’s blog.

We witches think every single hospital consultant in the land should read it.

We think every single hospital administrator should read it too.

We think every member of The Department of Health should read it.

No. Forget the last sentence. That would be counterproductive.

Consultants should read it because they should be supporting these nurses who are struggling against all odds in certain pockets of the NHS.

Consultants are not supporting them.

Ask yourself whether you have seen any of Nurse Anne’s accounts happening in your ward (if you have a ward that is – your patients are probably scattered all over the place nowadays, but that is a separate issue that you as consultants should have dealt with long ago).

And then ask yourself, does it bother you that patients lie in wet beds, are undernourished and don’t get their medications on time.

Well, Does it?

If it doesn’t worry you, then let me know who you are so that all the witches will avoid you like the plague when they are ill.

If it does worry you, have you asked yourself why it is happening?

Do you know the headcount of nurses in your unit?

Qualified nurses. Health Care Assistants. Cadets.

Have you watched them in a cluster talking about Big Brother instead of attending to patients? (Some do, Nurse Anne, I have watched closely. On the other hand, most don’t.) Most are excellent nurses who are run off their feet trying to nurse to the best of their ability but can’t. They are being asked to do an impossible task much of the time. The Witch Doctor has watched carefully and has done some simple arithmetic.

As a consultant do you trust your Trust Administration in not to squeeze the last ounce of flesh out of the nurses in your ward?

Come Monday morning, here is an exercise that all consultants could do for the benefit of their patients.

Get The Abacus out.

How many patients in your ward need help with toileting?

How long does it take to deal with each patient?

How long do patients in your ward (if your have one) wait for a bed-pan or commode?

How many patients in your ward need help with feeding?

How long does it take to feed a patient?

How long does it take to do the drug round?

How many times is the nurse in your ward interrupted when doing a drug round?

Do multiplication sums.

Lots of them.

Do the figures tie up with staff numbers that are appropriate to the level of expertise of each member of staff?

No?

Then what are you going to do about it?

Let me tell you.

You sit down with the nurse in charge of the ward. Not the one who is straddling the barbed wire fence between government administrator and nurse.

You say to him or her.

These are our patients. We have responsibility for them.

Together we will sort this out.

And do it.

That is what you are being paid a consultant salary to do. To ensure your patients are diagnosed, treated, and if possible cured. If that is not possible then you ensure your patients are cared for, comfortable and safe. You know that.

The medical and nursing professions need to work as one.

Together, both of you – the “hands on” senior medic and “hands on” senior nurse, with the help of The Abacus will carry great clout.

This government wants you divided.

They do not want you to have clout.

If you do not do this as consultants, you are letting nurses and patients down.

And for pities sake, if you are a hands-on consultant, don’t go bleating to your clinical director and medical director that “something will need to be done.” Ignore the hierarchy. As a consultant you can do this. You are an independent practitioner. These people are hindered because they have chosen to straddle the painful barbed wire fence.

See to it yourself.

Do you not know that you, the hands-on consultant, and the hands-on senior nurse, are The Leaders?

If you take on your rightful role together as The Leaders, this will never happen again.

a red apple ……………………

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DOES MEDICINE – AND MEDICAL ETHICS –HAVE A PRO-LIFE BIAS?

Posted in Blogosphere, Communitarianism, Consultant Delivered Service, Creep, Health Policies, Leadership, Medical workforce, National Practitioner, Skills escalator, The Third Way

Posted by: Witch Doctor | November 19, 2009

A message for Iain….

witchround

The Witch Doctor has just tried to post a comment on one of the BMJ blogs. However she was asked for a user name and password.

We witches treat User Names and Passwords with disdain and so I have posted my comment to Iain below.

Now, The Witch Doctor appreciates this is a weird comment, so you will have to put it into context by reading the original post.

“Dear Iain,

I suspect the comments in your blog over the past few weeks are providing you with interesting teaching material for the future.

For the first 15 years of The Witch Doctor’s life she asked “why?” many, many times. Following this was a ten year period of very deep thinking. After that first quarter century she made a decision to stop thinking deeply, because she recognised this could turn the brain into mince and furthermore it was counterproductive to the “projects” of her life and the lives of others. Instead she set about getting on with the mundane matters of life, like surviving, living, working, grabbing the occasional pleasure, and has done so ever since.

She regards this as a very clever philosophy indeed.

However, you have raised the question that as doctors, perhaps we should consider ourselves to be “underwriters of projects.” Are you suggesting, therefore, that part of our training should be to define the projects of life? To classify them? Having defined and classified them, do we then set about identifying and classifying our patients’ projects?

How do you propose we do that?

Even if we could define and classify an individual patient’s projects, do we then judge them?

How do we do that and is it wise?

If we judge them, to what end?

Mince…….

WD

Those readers of this blog may recollect that The Witch Doctor in the past had one of her comments dismissed as not suitable on a BMA blog.

The whole of the witching community were hopping mad!

P.S.

I notice, My Black Cat, that Dr No managed to post a comment. I wonder if he was required to submit a user name and password.

I doubt it.

Is the BMA just discriminating against witches?

a red apple ……………………

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CLARITY, THRUST AND BACKBONE

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10 Comments

Posted in -The right to live: The right to die, Creep, Death, Euthanasia, Medical Education, Suicide

Posted by: Witch Doctor | November 18, 2009

An antipodean missile!

witchround

“Gammon’s Law” In a bureaucratic system, increases in expenditure will be matched by fall in production. Such systems will act like black holes in the economic universe, simultaneously sucking in resources and shrinking in terms of emitted production”

Dr Max Gammon, British physician, 1960

The Ferret has posted that the medical profession down under has some backbone. Dr Grumble draws attention to it also in his daily readings.

Here is some evidence of the Antipodean medical backbone.

“1. Australian Medical standards must be maintained

2. Eroding confidence in the medical profession is not in the national interest

3. Medicine is a discipline where roles must be clearly defined and delineated

4. Workforce planning is not a science, it is at best speculation and guesswork

5. De-medicalisation (task substitution) has agendas other than productivity improvements

6. Productivity will improve if government gets out of the way of doctors and lets them get on with the job

7. Changes to Public patient financing will enhance productivity

8. Growing burden of compliance driven by government

9. The urban/rural imbalance will always be with us

10. Medical Education must be science based”

Much is notable about this document. For example there is no wishy washy polite committee speak as is the custom in the UK. This document is straight to the point. Australian doctors are learning how to say no.

The UK medical profession should join them with a second missile.

Eh, My Black Cat?

a red apple ……………………

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Posted in Health Policies, Healthcare

Posted by: Witch Doctor | November 17, 2009

The problem with bananas

witchround

The fact that all nurses will now require to have degrees, indicates that the major restructuring of staff planned within the NHS for some years now, is imminent.

Almost simultaneously it has been leaked that the Department of Health have proposed to cut central funding to hospitals to cover the salaries of junior doctors. Coincidence? Not on your life! They say it is to free up funding for nurse training. These proposals would have been made in the full knowledge of the likely outcome – that Trusts will cut the number of medical training posts.

The Witch Doctor’s interpretation of what is happening just now is very simple. Nurses NEED to have degrees so that The Skills Escalator becomes what it was always intended to be – a brutal cut in the numbers of expensive professionals (e.g. fully trained doctors and nurses), perched side by side, on the narrow upper echelons of The Skills Escalator, and a broad, broad base for a large workforce each of whom has clocked up a few simple competencies.

Those who have grabbed a fistful of “skills” will earn a place on the first few rungs of The Skills Escalator and most will go no further. This means, though, that the workforce will be “skilled.” It stands to reason. Hopefully patients will not know the difference between a professional worker and a skilled one. They certainly won’t know who is standing on each rung of The Skills Escalator. Eventually the skilled workers will regard themselves as “professionals” and The Skills Escalator will have done its job as one of societies‘ Great Levelers. Dumbing down will then be complete.

The Witch Doctor was made aware a couple of years back of a course being planned where a dietitian was to train staff in certain aspects of patient nutrition. Fair enough. Rightly, there was concern that patients were not eating their meals. The course was not really about nutrition at all. It was absurd. In one of the “modules” a banana featured. The skill required was to consider whether a patient was, or was not, able to peel a banana for herself. If the conclusion was that the patient was confused, had arthritis or couldn’t see etc, then that banana had to be peeled by the skilled worker and placed in an appropriate place that the patient could reach.

Who knows, maybe there was a “banana box” to be ticked on a clipboard. However, it was The Witch Doctor’s view that if members of staff did not have the powers of observation or wit to work this out, then they were a liability and should not be allowed near patients at all.

Not everyone will agree with The Witch Doctor, but she is of the view that “dumbing down” does not save money. Indeed, from what she has seen it can be a pretty expensive exercise. For example, a trained nurse while peeling a patient’s banana will ask, “why am I having to peel this banana today for this patient when I didn’t need to yesterday?” Nurses will want to know why there has been a deterioration. They will ask about pain and discomfort. They will look for vital signs. They will check the drug cardex. In fact, they are multitasking while they peel the banana. A professional, multi-tasking while doing mundane jobs, saves money, time and lives. Similarly, as a junior, The Witch Doctor used to pick up many important problems about patients and dealt with them, while she multi-tasked during her “blood round” early every morning. Incidentally, this also taught her how to get blood out of a stone and put up difficult drips at amazing speed! It also primed her for the following year when she had to tackle tiny scalp veins on dehydrated babies as a matter of urgency. Nowadays, she would not acquire these “skills” so easily. Phlebotomists were a great blessing in many ways, but they were also one of the earliest symptoms of “dumbing down.”

The Witch Doctor could go on, and on, about her views on The Skills Escalator and how “dumbing down” is the expensive alternative. But won’t. Instead, the question she is asking herself is this:

How can dumbing down save money? Lots and lots of money…….

She thinks she knows the answer to this.

She might be wrong, of course.

But the signs are all there that she is correct.

a red apple ……………………

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NIGHTINGALE MUST BE TURNING IN HER GRAVE

Posted in Communitarianism, Competencies, Creep, Department of Health, Health Economics, Health Policies, Medical Education, Medical workforce, National Practitioner, Skills escalator, The Third Way, charity

Posted by: Witch Doctor | November 15, 2009

All going according to plan

witchround

The Department of Health announced last week that from 2013 all nurses in England would be educated to degree level.

The Times had their views:

DOCTORS AND NURSES

“The demand that all nurses have degrees will not increase the status of the profession very much. But it will worsen the shortage of nurses”

“There could scarcely be a worse moment to make becoming a nurse more difficult. Over the next ten years 180,000 nurses are set to retire. There are 100,000 nurses aged 50 and over and another 80,000 aged 55 and over. It is proving difficult enough to retain the current workforce. A third of nurses told the Royal College of Nursing in 2007 that they were thinking of quitting because of poor pay. The Department of Health has predicted a shortfall of 14,000 nurses by 2010. The increased cost is also likely to exacerbate the shortage.”

HospitalGeneral

Melanie Philips in The Spectator had much to say about it too:

“The news reported in the Times today that nursing in Britain is to become a degree-only qualification should strike a deep chill into every heart. Ostensibly to ‘improve patient care’ it will achieve precisely the opposite. That is because the real aim of such a move is to improve not patient care but the professional status of the nurse. The effect on patient care overall will be disastrous.”

Melanie Philips also quotes from an old article in the Telegraph by Harriet Sergeant.

THE TRUTH ABOUT NHS HOSPITALS: NURSES

“The catering staff slam the food down. No one bothers. Spooning food into a patient is just too demeaning for professional nurses, it seems. I always thought nurses were meant to care for patients. I might be wrong. I may have missed the plot somewhere.”

Another described the difficulty of trying to find a particular patient on a ward. Every patient is supposed to have his name above the bed. But, in some hospitals, they refuse to display the name “in case it infringes your autonomy”. So the consultant found himself wandering around, trying to find his patient. “There never seems to be anyone in charge who knows anything,” he said.

He would try to find the patient’s nurse. Then the patient’s notes. “I don’t often strike lucky with all three.” Finally, he had to translate the nurses’ diagnoses.

“They refuse to use hierarchical, male-dominated medical terms, so they will not say the patient is unconscious. No, the patient has to have ‘an altered state of awareness’.”

SkillsEscalator

From the medical blogosphere The Ferret Fancier had something to say about it too.

WHO WILL DO THE NURSING?

“This loss of the apprenticeship and the reduction of basic standards is a direct result of one thing, money, the government does not want broadly trained competent workers who have learnt the ropes adequately, they want to isolate individual competencies and shift work down to people who have had way less training than in years gone by. To see this in action all one has to do is see who does most of the basic nursing on wards, it is done by ‘health care assistants’ who have had very minimal levels of training, they are the modern day nurses.”

The Witch Doctor did not bat an eyelid when she heard the news that all nurses will require to have degrees.

For some time now, she has been waiting for this announcement.

This is just one part of The NHS Plan

The Skills Escalator will soon be in full force because some of the medical profession are actively complicit and others are letting it happen.

CAREER FRAMEWORK FOR THE NHS

“MORE SENIOR STAFF -LEVEL 9
More senior staff with the ultimate responsibility for clinical caseload decision-making and full on-call accountability

CONSULTANT PRACTITIONERS-LEVEL 8
‘Consultant Practitioners’ are staff working at a very high level of clinical expertise and/or have responsibility for planning of services 8

ADVANCED PRACTITIONERS-LEVEL 7
‘Advanced Practitioners’ are experienced clinical professionals who have developed their skills and theoretical knowledge to a very high standard. They are empowered to make high-level clinical decisions and will often have their own caseload. Non-clinical staff at Level 7 will typically be managing a number of service areas

SENIOR PRACTITIONERS/SPECIALIST PRACTITIONERS-LEVEL 6
‘Senior Practitioners/Specialist Practitioners’ who would have a higher degree of autonomy and responsibility than ‘Practitioners’ in the clinical environment, or who would be managing one or more service areas in the non-clinical environment.

PRACTITIONERS-LEVEL 5
‘Practitioners’ –most frequently registered practitioners in their first and second post-registration/professional qualification job

ASSISTANT PRACTITIONERS/ASSOCIATE PRACTITIONERS-LEVEL 4
‘Assistant Practitioner/Associate Practitioners’ –probably studying for Foundation degree, BTEC higher or HND. Someof their remit will involve them in delivering protocol-based clinical care that had previously been in the remit of registered professionals, under the direction and supervision of a state registered practitioner.

SENIOR HEALTHCARE ASSISTANTS/TECHNICIANS -LEVEL 3
‘Senior Healthcare Assistants/Technicians’ –this is a higher level of responsibility than support worker, probablystudying for or have attained NVQ level 3, or Assessment of Prior Experiential Learning (APEL).

SUPPORT WORKERS -LEVEL 2
Support Workers –frequently with the job title of ‘Healthcare Assistant’ or ‘Healthcare Technician’ –probably studyingfor or has attained NVQ Level 2.

INITIAL ENTRY LEVEL JOBS -LEVEL 1
Initial entry level jobs such as ‘Domestics’ or ‘Cadets’ requiring very little formal education or previous knowledge,skills or experience in delivering, or supporting the delivery of healthcare.”

THE SKILLS ESCALATOR NOW – WATCH HOW IT WILL CHANGE

The diagram below comes from a document:

“Who are the doctors of tomorrow and what will they do?”

This was presented at the 9th International Medical Workforce conference in Melbourne, in November 2005.

The paper was written by: Rob Webster, Debbie Mellor & Becca Spavin,
Department of Health, England.

The paper had the following disclaimer:

This is a discussion paper only. It is not a statement on Department of Health policy.

Nevertheless, the document gives clear insight into the thought processes behind MMC.

It is the first documentation The Witch Doctor has found that suggests the medical profession will be fully integrated at various levels into the “Practitioner” career framework for the NHS that underpins the structures and principles in “Agenda for Change”

Here is where the Doctors in the Grades they held in 2004 were placed.

LEVEL 9
Doctors: Consultants (27914), Directors of Public Health (228), Associate Specialists(2029).

LEVEL 8
Doctors: Registrar Group (8056)
Allied Health Professionals: Consultant Therapists (126)
Health Care Scientists: Consultant Clinical Scientist – Grade C (433)

LEVEL 7
Doctors: Registrar Group (8056), Staff Grade (4943)
Nurses: 5% of All Qualified Nursing, Midwifery and Health visitor Staff (20125)
Allied Health Professionals: Managers (265)

LEVEL 6
Doctors: Senior House Officer (20283), Hospital Practitioner/Clinical assistant (1164), Other CHS Staff (442), Other CDS Staff (1083).
Nurses: 30% of All Qualified Nursing, Midwifery and Health visitor Staff (120751)
Allied Health Professionals: Manager (2312), Manager (265), Instructor/teacher (4118), Tutor (89), Qualified Ambulance Staff (16587), Assisstant Practitioner (557)
Health Care Scientist Clinical Scientist – Grade A and B (2776), Advanced Practitioner Biomedical Scientist (342)
Admin Senior Manager (11365)

LEVEL 5
Doctors: House Officer/Dental House Officer (4259).
No Doctor appears below Level 5.
Nurses: 40% of all qualified Nursing, Midwifery and Health visitor staff….
etc etc…………..

The Witch Doctor has three questions:

1. Where do the doctors really sit on the Skills Escalator?

2. Who exactly will be doing what used to be called basic nursing care?

3. Is this, or is it not, a stupid government?

She thinks she knows the answer to all three questions.

Do You?

a red apple ……………………

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NASA’S MOON CRASH REVEALS LOTS OF WATER

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3 Comments

Posted in Creep, Department of Health, Health Economics, Health Policies, Independent medical practitioner, Medical UK, Medical workforce, NHS, National Practitioner, The Third Sector, The Third Way

Posted by: Witch Doctor | November 13, 2009

Bottled water from the moon?

BreakingNews

We witches are great lovers of the moon, the stars, milky way – in fact everything in the sky. We like the earth too, but its inhabitants drive us batty most of the time.

It was reported in September of this year that there might be water on the moon.

It was with great excitement that we heard the news today that they had indeed found water there. They confirmed there was a lot of it.

Holy moly! Who would have believed it!

moon

NASA FINDS WATER ON THE MOON

LCROSS IMPACT DATA INDICATES WATER ON MOON

a red apple ……………………

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Posted in BREAKING NEWS | Tags: water on the moon

Posted by: Witch Doctor | November 13, 2009

Judge, Jury and a victory for Gordon Brown?

witchround

My Black Cat and I have been interested in The Judge and his Jury Team for some time now.

The Witch Doctor does not know why she is interested. She just is.

My Black Cat, on the other hand, says she is interested because she smells a rat!

Now, you should never take My Black Cat’s rats too seriously, nevertheless you should not put them on the back burner of your mind either.

Yesterday there was a by-election in Scotland due to the vacation of the seat by Michael Martin, the former speaker of the House of Commons.

A high proportion of the residents of Glasgow North East carry the “ma faither and grandfaither a’ voted Labour” gene in their DNA, and so when Labour won the seat as it has done for 74 years, it was no surprise. Willie Bain, the successful candidate exclaimed:

“This is a resounding victory for Gordon Brown and for Labour”

RedCross

Wrong, Mr Bain. Don’t get too excited. The turnout was 32.97% a record low for a Scottish by-election. Since many of the 67.03% who didn’t vote will also carry historical Labour gene, they may well have decided it is time for a mutation, and yet they couldn’t quite yet stomach the idea of voting for another party. And who was there to vote for anyway?

You could say 67.03% of the population have voted with their feet.

Did The Jury Team think that, in John Smeaton, they had a candidate, a celebrity who might tap into that 67.03%.

Russell Grant, television presenter and astrologer supported him.

“When I spoke to John, he was everything I wanted from a politician. He is a good man. His enthusiasm, energy and passion for Glasgow North East shone through. He’s certainly someone I would vote for if I could.”

So did Martin Bell, former television war correspondent who entered Westminster in 1997 after standing as an independent against Neil Hamilton.

“I believe that a victory by John Smeaton will strike a blow for honest politics that will be heard throughout the country.”

It was no victory.

John Smeaton collected a meagre 258 votes.

Sir Paul Judge, you got this wrong. Glasgow folk may seem gullible to you, but they are not swayed by world celebrity status even if he is one on their own.

It is not a good idea to experiment with Glaswegians.

You probably don’t understand them.

a red apple ……………………

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THE END OF THE GREAT DECEPTION

Posted in Democracy, The Jury Team | Tags: Sir Paul Judge, The Jury Team

Posted by: Witch Doctor | November 11, 2009

Mangling democracy!

witchround

So, My Black Cat, you’re at it again trying to scare the wits out of every one with your conspiracy theories.

You are getting very excited because it is reaching mainstream newspapers!

What is?

Democracy is being put through a mangle.

It is being flattened into something beyond all recognition.

What have you found now?

A columnist in The Telegraph.

I thought it was a blogger.

That was yesterday.

Is this somebody different?

MangleOld

“So the trap has snapped shut. It was somehow apt that the politician who finally let the EU get the constitution it has craved so long should have been President Vaclav Klaus, the veteran anti-Communist who predicted, just before the Czech Republic joined the EU in 2004, that it would mean the end of his country as “an independent sovereign state”. And what a delightful irony that Pravda, of all newspapers, greeted the news last week with the headline: “Twenty years after the fall of the Berlin Wall, the EU is now a reincarnation of the Soviet Union”.

A blogger. A columnist. Different people. Same newspaper.

The columnist article has 201 comments?

You want me to read all the comments too?

OK, I might read it all.

When I get round to it…….

But we witches don’t really understand all this stuff about the European Union, My Black Cat.

And for that matter, you understand it even less!

In fact, probably nobody understands it.

And that is bad.

Very bad.

a red apple ……………………

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BERLIN WALL – BROWN MARKS 20TH ANNIVERSARY OF ITS FALL

Posted in Common Purpose, Communitarianism, Creep, Democracy, European Union, Freedom, Freedom of speech, Leadership, The Third Way, charity, conspiracy theories

Posted by: Witch Doctor | November 10, 2009

Pay attention!

blackcatmatt

I suppose you are all busy getting on with your mundane day as you meander into oblivion, you stupid feeble “citizens” of The Humankind.

In much the same way, The Witch Doctor is dabbling about in The Spell Pantry in total denial that there could possibly be a conspiracy of gigantic proportions going on.

“Creep” she calls it.

Creep.

What the devil is “Creep?”

Anyway, witches cats are not alone with our conspiracy theories.

It now seems to be seeping into that corner of the blogosphere occupied by the mainstream media.

FUNERAL OF FREEDOM

About time too!

And Gordon Brown is using his habitual throw–away term “common purpose” in a speech once more!

As he has done in the past.

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© Dlundin | Dreamstime.com

ESTIMATING DRUG HARMS

Posted in Common Purpose, Communitarianism, Creep, Democracy, European Union, Freedom, My Black Cat, The Third Way, charity, conspiracy theories

Posted by: Witch Doctor | November 8, 2009

Hold on! This is about freedom!

witchround

It is difficult to take time off from blogging to do other things, because there is always some important drama or another going on in our society that seems to make the computer keyboard beckon.

Sometimes, My Black Cat asks me why these dramas happen.

Presumably she thinks they are part of The Great Big Conspiracy.

I just tell her I don’t know why, but it is probably connected to the complexity of a society that no longer gains from the healthy exhaustion that comes from hard physical graft required in earning a living from the land.

She thinks I’m nuts.

FreedomofSpeech

Anyway, this drama is about Professor Nutt.

Professor Nutt was sacked as a government advisor.

FACTUAL ERRORS

CRIME AND JUSTICE

AUDIENCE WITH DAVID NUTT

JOHNSON “MISLED PARLIAMENT” OVER NUTT SACKING, LIB DEMS CLAIM

KNEED IN THE NUTS OR A SHOT IN THE FOOT

Everyone knows he was advising on something to do with drugs. Now, My Black Cat, on the matter of drugs, I have my views and you have yours. Your views and mine may be sensible, or they may not. You and I may disagree or we may not. You and I may agree with David Nutt. We may not. His committee may disagree with each other, they may not. The government seems to disagree with Professor Nutt, and his committee of experts. You may feel that you may want to be free to express your views if you want to, particularly when there is a disagreement. I certainly want to live in a country where I have that freedom. David Nutt may feel the same way.

Drug addiction is a difficult and emotive subject.

But that, My Black Cat, is not the point!

It does not matter what a Professor and his advisory team were advising on. It might have been education, finance, or whether it was good for everyone to drink bottled water umpteen times a day to “wash out their kidneys” and consequently boost the economy by increasing the sale of plastic.

It just does not matter!!!

An expert in his field, whatever that field might be, not employed by the government but chosen by government, to head a team all of whom gave their own time to use their expertise to try to help with a difficult problem, was sacked.

Why?

He had hard facts gathered over many years that informed his opinion. He voiced these facts and opinion as a professional, to professionals, in a professional journal and at a professional meeting.

SpeakersCorner

He did not stand at Speakers Corner or wander about the streets of London with a billboard, although in a free country he should have been free to do so.

It appears that the government did not like him behaving as if he lived in a democracy where freedom of speech is sacrosanct.

His opinion might lose votes perhaps?

His opinion might upset the alcohol mega-industry perhaps?

It seems as if it needed to be demonstrated that the state dictated what he was and was not allowed to say.

Do we now live in a country where independent expert advisors need to be sacked if they cannot be gagged?

Is this government making it clear that it only wants expert advisors who are creeping “yes men” who know their place as subordinates of the state, and are not free to speak out?

This appears to The Witch Doctor to be a deliberate attempt to destroy freedom of speech.

And you know where that can creep!

Don’t you, My Black Cat?

That is why we witches do not believe in gagging of any kind unless it is in very exceptional circumstances such as a genuine threat to national security or for example, where free speech might temporarily be detrimental to delicate negotiations which might free a hostage.

Assuming Alan Johnson regards the UK as a democracy, he was wrong to sack Nutt. If he did not intend to curtail free speech in the UK, if he did not fully understand the importance of the neutrality of The Scientific Method in a free society, then he should immediately ask Professor Nutt to resume his position.

Alan Johnson should apologise to Professor Nutt. There is nothing wrong with making a mistake. Once reinstated, whether or not he chooses to take the advice is a separate debate.

On the other hand, If Alan Johnson does not want experts to advise on difficult matters………..

If Alan Johnson does not regard freedom of speech as important……………

If Alan Johnson before he sacked him anticipated there would be an outcry …………….

If somebody was pulling Alan Johnson’s strings.…………..

Then, My Black Cat, I will begin to listen to all the rubbish you talk about conspiracies.

However, it may well just have been an error of judgement.

a red apple ……………………

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Posted in Creep, Democracy, Department of Health, Freedom, Freedom of speech | Tags: Alan Johnson, Professor David Nutt

Posted by: Witch Doctor | November 6, 2009

“The Good Death”

witchround

INTOVERTED, SELFISH, TIDY, CONFUSED, NAVAL-GAZERS, OR VICTIMS OF A NEW WORLD PHILOSOPHY?

The colourful language used by the Dr Rants of the world may disgust some people.

We witches are not disgusted by it even although we ourselves choose to express ourselves in a different way.

Where is Dr Rant anyway, My Black Cat?

There are some words that disgust us though.

A “healthy” husband and wife recently committed suicide together because they wanted a “good death.”

We are disgusted by the words “Good Death”

All witches loathe this term.

It is like a sick joke.

No. It’s worse than a sick joke. It is sinister. It is intrusive.

Dettol

Believe this witch, who is well qualified to talk about death – there is no such thing as a “Good Death.” It is just that some deaths are less bad, less painful and less sad than others.

“Good Death” is a hygienic term for the unthinkable. It is a play upon words. Worse still, it is play upon ideas. It is a formula for the future. It is a seed that is being sown that will de-stablise the thought processes of many troubled, elderly and dependent people. Particularly the naval-gazers, the ones who think too much about themselves, those who focus on their fears rather than enjoying what they have and getting on with life.

It is a term that will add confusion to muddled minds.

It is a term that will encourage the selfish folk.

It is a term used that will encourage the organised, tidy folk of the world who plan every life event.

Even death.

You should also believe this witch when she talks about planning your life, and death. The witch doctor has lived by the philosophy of only doing a minimal amount of planning, but a maximum amount of adapting to circumstance.

“The best laid schemes o’ mice an’ men gang aft agley……”

For The Witch doctor, like Rabbie Burns, knows that there is always a wicked uncle chuckling in the background when you make your plans.

She has a lot of experience of foiled plans, death and “Chuckling Wicked Uncles.”

Incidentally, we witches also loathe the other sanitizing words “Ethnic Cleansing” We consider it to be one of the most offensive terms in the English language. It is, however, used by television commentators and newsreaders without them batting an eyelid.

Perhaps they will stop using it now.

“Good Death”

“Ethnic Cleansing”

They are both subliminal intrusions of the mind.

These terms and the “hygienic” ideas behind them disgust us.

a red apple ……………………

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BEN NEEDS A NEW HOME. FIND OUT ABOUT HIM AND OTHERS AT THE OLDIES CLUB

Posted in -The right to live: The right to die, Euthanasia, Suicide | Tags: Assisted suicide, Ethnic cleansing, Euthanasia, Suicide

Posted by: Witch Doctor | November 2, 2009

Interlude: The Oldies Club

WitchSpell

SOME MAGIC FOR BEN

Although we witches are usually associated with our Black Cats, it is often not appreciated that we are soft on all animals and are usually surrounded by a veritable menagerie in addition to our feline helpers.

Being one of the most ancient of witches, The Witch doctor was interested to discover that there is a club for dogs that are also past their prime who would like a home where they can get peace and quiet and lots of nice titbits and comforting things.

Wouldn’t we all?

This is Ben.

He is a “Golden Oldie” – well really a “Black and White Oldie” that maybe could be made happy somewhere.

Calling all witches with a spare kennel in their back yard. No. A doggie bed in the spell pantry, a comfy couch in the sitting room, or a king sized bed….

If Ben can’t find a witch, a human would do………

I suppose.

Posted in The Oldies Club | Tags: Dog Rescue

Posted by: Witch Doctor | November 2, 2009

Going, going……

Pumpkin2

GONE!

The Witch Doctor and My Black Cat are wending our way home after The Great Big Party!

Two days and two nights it went on!

We didn’t think we were in a fit state to be in charge of The Old Rickety Broomstick! (The Broomstick Maker is still trying to mend the new one which has an autopilot).

So we’re having to walk.

We feel shattered!

But we have a Very Important Spell to do so we will need to pull ourselves together!

So we will take a little break from blogging.

We will be gone for quite a while since we need to rack our brains about this one!

And we need to gather many strange ingredients too…..

But who knows, when we return refreshed, you might even see The Fruits of our Labour!

a red apple ……………………

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Posted in Spells

Posted by: Witch Doctor | November 1, 2009

The Witch Doctor offends the BMJ!

appleredhand

Well, My Black Cat, the time has come for The Great All Hallows’ Witching Party.

We have to report that it is now The Witching Hour and the moderators and philosophers have not accepted our offering on the BMJ Blog. As promised, we will now reveal to all of cyberspace the deeply profound things that The Witch Doctor said that offended so much.

The comment referred to the opening paragraph of a post by John Coggon. He wrote:

“If I asked a physiologist to show me where her conscience is, I’m fairly sure she’d not be able to.”

As it happens, The Witch Doctor agrees totally with this utterance.

Consequently, it seemed appropriate to expand the theme.

So The Witch Doctor said:

“If I’d asked William Shakespeare to show me where his genius was, I’m fairly sure he’d not have been able to.”

If I’d asked Joseph Mallord William Turner to show me where his genius was, I’m fairly sure he’d not have been able to.”

If I’d asked Ludwig van Beethoven to show me where………….

Etc. etc. etc.”

Was that offensive?

That was the very first comment they received.

And if you’ll forgive me for saying so, very erudite for a witch it was too!

A conversation stopper maybe….

Anyway, it was consigned to the trash can!

Just like that!

Truly!

No matter, soon after, another blogger crash-landed into the BMJ corner of blogosphere.

Nothing meek and mild about this blogger!

Bet they wish now they’d stuck with The Witch Doctor!

Eh, My Black Cat?

a red apple ……………………

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Posted in -The right to live: The right to die, Suicide | Tags: Assisted suicide, Ethanasia, Suicide

Posted by: Witch Doctor | October 30, 2009

Physician assisted suicide – an open letter

witchround

The Witch Doctor finds it remarkable that she was so busy getting through the days that she was oblivious to the clever footwork that seemed to be going on at the BMA annual conference in 2005 when a spurious vote was taken which effectively moved the pendulum from “Against” to “Neutral” regarding the BMA’s position on assisted suicide.

Yes “neutral.”

The “D’oh!” moment!

Doctor’s have no view on whether they should help kill or not!

I suppose The Witch Doctor was not alone in having her head in the sand at that time.

Some of the medical profession were awake, however.

Below is an open letter that was sent later that year to MP’s and Peers regarding these activities.

Note particularly para 3 where it is alleged there was some attempt to persuade medical students and young doctors to drop their opposition to euthanasia.

“Open Letter to MPs and Peers about the BMA ARM
Open Letter to MPs and Peers about what happened at the BMA ARM in June 2005

“Just before the summer recess parliamentarians were sent a statement from Ms Sue Marks, Head of the Parliamentary Unit of the British Medical Association, regarding the Association’s change in policy, making it now neutral on physician-assisted suicide.

As two BMA members present at the Annual Representatives’ Meeting where this took place we consider Ms Marks’ description of the event to be highly misleading. It is vital that parliamentarians understand that the whole process was highly questionable and the pro-euthanasia group achieved their vote – by a small majority of only 93 for and 82 against – through clever manipulation of procedure.

In the year 2000 it became clear at a BMA Consensus Conference on Physician Assisted Suicide that, contrary to the majority opinion of grass roots BMA members, a significant number of BMA Ethics Committee Members – including chairman Dr Michael Wilks – determinedly supported both euthanasia and physician assisted suicide. Their campaign has been strengthened by the input of ‘expert’ members co-opted (not elected) to the Committee from the political and academic liberal elite, three of whom gave evidence to the Lords’ Select Committee on behalf of the Voluntary Euthanasia Society last autumn. Dr Michael Wilks, has made a number of attempts to change the Association’s policy and in particular earlier this year used his position to try to persuade the Students’ and Young Doctors’ Divisions to drop their opposition to euthanasia – a move which was singularly unsuccessful.

This summer, however, things were different. As well as being chairman of the Ethics Committee providing ‘expert input’, Dr Wilks was made Chairman of the Annual Representatives’ Meeting which was to consider the issue of euthanasia, and was also appointed Chairman of the Agenda Committee (which ultimately became responsible for framing motions to be considered). At the start of the Representative meeting, Dr Wilks used his position as chairman to introduce a new procedure for deciding the issue. In a departure from past protocol none of the motions submitted by BMA divisions were to be voted on. Instead, on the Tuesday there was a debate for half an hour on draft motions submitted to the conference by councils and divisions from around the country. The Agenda Committee was then deputed to submit a Motion based on the debate in which a majority of speakers (six of eleven) were strongly opposed to any change in BMA policy: the motion would be voted upon two days after the original debate at the end of the Conference! However, instead of one Motion based on the debate, the Agenda Committee submitted three Motions. The first opposed euthanasia and assisted suicide; the second supported a neutral stand on physician-assisted suicide; and the third Motion supported the adoption of a policy in favour of the legalisation of euthanasia and physician assisted suicide. These were not voted upon until one hour before the end of the meeting when more than half of the delegates had left. Furthermore, delegates were not given written copies of the motions until just before the vote – so many delegates did not even see the Motions which – furthermore – had never been discussed by grass roots members and divisions.

The manipulations did not end there. As Chairman of the Conference Dr Wilks sought permission for the order of voting on the Motions to be reversed – so that the motion in favour of legalised euthanasia came first with the motion in favour of the BMA taking a neutral stand on physician assisted suicide second and the motion in favour of retaining the current policy third. In the event, the last motion was never voted on because the second motion won a majority. Thus 93 delegates were enabled to reach a decision for 133,000 grass roots members on a Motion the latter had never seen – let alone discussed. Such anti-democratic procedures to force through a Bill in Parliament would cause a public uproar and we urge you to take these matters into account if the BMA’s new position is used in debate to support any attempts to legalise euthanasia and physician-assisted suicide.”

Peter Saunders, General Secretary, Christian Medical Fellowship
Tony Cole, Chairman, Medical Ethics Alliance”

a red apple ……………………

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Posted in -The right to live: The right to die, Euthanasia | Tags: Assisted suicide, BMA, British Medical Association, Euthanasia, involuntary euthanasia, Suicide

Posted by: Witch Doctor | October 30, 2009

Spit it out, Mr Einstein!

witchround

You could say The Witch Doctor grew up in a nutty environment. Her mother loved nuts and she ate some nearly every day. Not the mamsy-pamsy shelled nuts you buy nowadays in little packets. She would buy big paper bags full of almonds, hazelnuts, walnuts and brazil nuts with their shells still on and crack them open with The Old Nutcracker.

And there were peanuts of course.

Peanuts were they easy ones to crack. The reason they were easy is that they are not nuts at all. They live in pods, not shells. This is because peanuts are of the pea, bean, lentil and lupin family. The Witch Doctor didn’t know that then. Her mother didn’t know that either. We just thought they were nuts with fragile shells.

NutsAlmond

Sometimes The Old Nutcracker was misplaced in our untidy house and then the nuts were wrapped in a newspaper and broken with a hammer.

A more interesting way, though, was to find a door to break them.

If you don’t know how to break a nut in a door, then I’m not going to tell you. Just work it out! The Witch Doctor has been doing it since she was five years old!

If you don’t know how to break a nut in a door, it is probably because you were brought up in a tidy house where doors were not to be meddled with, and there was a place for everything and everything was in its place.

Poor thing!

NutWalnut

Although The Witch Doctor became an expert at cracking nuts at a very young age, she never ate them.

Absolutely never!

She hated nuts.

She still does.

Mark you, she will happily eat nuts concealed in cooking or baking as long as the are well ground up and well hidden, but she would never dream of eating a whole nut (or a peanut for that matter).

She wouldn’t even eat a chocolate bar with whole nuts in it!

Honestly!

Well, she might eat all the chocolate round about the nuts and leave the nuts in an unhygienic pile somewhere.

Or feed them to the birds.

The reason The Witch Doctor avoids nuts is simple. It’s nothing to do with the taste. In fact, she quite likes the taste. Once she has chewed, and chewed, and chewed a nut it seems to float around inside her mouth and never seems to reach a consistency that is suitable for swallowing.

So she spits it out!

Since spitting is frowned upon nowadays, she refrains from eating nuts.

We witches never demonstrate bad manners!

peanutsMatt

It is at this point, The Witch Doctor feels she must confidently disagree with Albert Einstein.

“When I read philosophy I have the feeling of chewing on something that is not there to swallow.

ALBERT EINSTEIN”

Philosophy, Mr Einstein, is more like a great big nut. It’s there all right, and you can if you want indulge yourelf in an awful lot of chewing, but it never reaches the correct consistency to swallow.

Best to spit it out!

Or, if mannerly, don’t put it in your mouth in the first place!

Yes, My Black Cat, philosophy and nuts have much in common.

a red apple ……………………

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CAN A CONSCIENCE DICTATE?

Posted in -The right to live: The right to die, Euthanasia | Tags: Albert Einstein, Medical ethics, nuts, Philosophy

Posted by: Witch Doctor | October 29, 2009

A twitching witch

witchround

The BMJ group has a number of blogs relating to individual journals.

Two bloggers were very quick off their mark to comment on the Kerry Wooltorton case.

The first was a lawyer, Professor Sheila McLean who is a distinguished academic with a particular expertise in medical law. She provided a summary in the BMJ blog of the legal situation regarding the outcome of the inquiry but did not enter into any discussion in the comments that followed the post.

According to the books and papers she has written it appears that Professor McLean is not only a distinguished member of The Humanist Society and also appears to be strongly in favour of voluntary euthanasia becoming legalised.

Dr McLean is a member of the ethics committee of the BMA.

The second to put pen to paper on the BMJ Group Blogs was Dr Iain Brassington. His post was in the Journal of Medical Ethics. There is quite a discussion in the comments section, some of it in the foreign language of philosophy.

If you scroll down the comments section to October 12, you reach a very short comment that seemed rather odd to The Witch Doctor.

“Forgive the intervention – I’m delighted to see Iain finding support in case law and statute.

John Coggon”

More recently the name John Coggon appears again, in a post of his own, this time in the BMJ blogs.

FreedomsSpeechCat

Here is the opening gambit of his post:

“If I asked a physiologist to show me where her conscience is, I’m fairly sure she’d not be able to. Yet, it seems, a great many doctors appeal directly to their consciences, or at least wish to be free to do so. This is a little strange. If a patient says “God makes me do it” suspicions arise. So why should a doctor be at liberty to appeal to something beyond the empirically demonstrable?”

Now, The Witch Doctor has no idea who John Coggon is, but she was quite taken by his smiling face, so in order to say “Hi” the way we witches do, she placed a little comment at the end of his blog.

She saw it in print, but it indicated it was waiting for moderation:

There it sat, and sat, and sat………

Waiting, waiting, waiting……….

Then……

It vanished. Just like that!!!

My Black Cat and I fear the moderators didn’t like it!!!

Perhaps John Coggon didn’t like it?

So, it seems the BMJ does not allow witches to express themselves freely in the comments section of their blogs.

The Philosphical Folk – yes.

The Ethical Folk – yes.

The Witches – no.

No free speech for witches.!

Probably everyone reading this is now worried sick about what The Witch Doctor could possibly have said to cause such offence.

Well, the witch just gave a little twitch.

That’s all.

Surely they could have published a little twitch?

From a witch……..

N.B. If the comment has not appeared on the BMJ blog by Halloween, then The Witch Doctor will let you know exactly what she said as a little trick and treat before she flies off to The Big Party on the All Hallows’ Eve Holiday.

a red apple ……………………

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5 Comments

Posted in -The right to live: The right to die, BMA, Blogosphere, Euthanasia, Freedom, Freedom of speech

Posted by: Witch Doctor | October 27, 2009

A rigged vote?

witchround

So, 2005 was the year that it has been said there was some kind of rigging of a vote at the annual meeting of the British Medical Association.

The vote did not concern a trivial matter. There is a view that it was the most significant vote in the history of the BMA.

TickSymbol

“A 30-minute open debate on euthanasia took place on Tuesday, June 28. Most of the speakers opposed euthanasia. But in a striking departure from past procedures, no vote was taken. This was not the only departure: Liberal Democrat Evan Harris — also a member of the ethics committee — was allowed to speak, even though he was not a delegate. But the tenor of the debate confirmed what everyone knew: that British doctors are opposed to euthanasia by a margin of about 2 to 1.

Based on the issues raised in the debate, the apparatchiks of the agenda committee drafted three motions. These were voted on two days later, on Thursday, only minutes before the end of the four-day meeting. Most of the nearly 450 delegates had already left. Only 174 actually voted.

Critics of the BMA’s decision claim that there had been a gentleman’s agreement to vote first on whether the status quo should be preserved. This would almost surely have passed. Instead, the first motion put to the meeting was whether the BMA should support euthanasia. Unsurprisingly, this failed by 101 to 73. Next came a vote on whether the BMA should withdraw its long-standing opposition. This carried by a vote of 92 to 82. Whether British doctors should uphold the status quo was never voted upon at all.

In short, a rigged vote by a fraction of delegates to the annual representative meeting made what is probably the most significant decision in the BMA’s history.

Doctors who oppose euthanasia have every right to feel outraged and to demand a referendum of all members on this vital issue. Controlling an agenda, breaking unwritten agreements and manipulating a quorum have been standard fare in shady trade union ballots. But it beggars belief that professors of ethics should use these Leninist tactics to engineer a change in the BMA’s euthanasia policy and very soon, perhaps, a change in the law. It is a chilling start to Britain’s debate on Lord Joffe’s Assisted Dying for the Terminally Ill Bill.”

RedCross

Now, those who do not attend national medical meetings may not be aware that the audience dwindles substantially on the last hours of the last day of any meeting. Always. This is because delegates have come from far and wide and have planes and trains to catch or a long drive ahead of them. Every delegate knows this, every speaker knows this and every organiser knows this.

Everyone knows.

So, this vote was taken at a time that it was known there would have been many vacant seats.

a red apple ……………………

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Posted in -The right to live: The right to die, Creep, Death, Euthanasia, Freedom, Health Policies, Medicine, NHS, Patient Choice, Patient Experience, Suicide | Tags: Assisted suicide, BMA, British Medical Association, Euthanasia, Voluntary euthanasia

Posted by: Witch Doctor | October 26, 2009

D’oh! Double-D’oh! And a Byzantine plot!

witchround

It seems the British Medical Association had a Homer Simpson moment a few years ago.

Round about the same time The Royal College of General Practitioners had a double dose of Homer Simpson moments.

Apparently.

What about?

Euthanasia.

BMA_House-1

The following was written after an event that happened a few years ago ie the annual meetng of the British Medical Association:

“June 30 was a Homer Simpson moment for the British Medical Association. At the end of its annual representative meeting, delegates voted to withdraw the BMA’s firm and long-standing opposition to euthanasia and assisted suicide. This leaves the world’s most prestigious gathering of medical professionals in the absurd position of having no opinion on whether killing their patients is good or bad. Doh!

Admittedly, this is an advance on the double-Doh position of the Royal College of General Practitioners. At the moment this august body has a policy of total ignorance: it doesn’t support euthanasia; it doesn’t condemn euthanasia; and it is not neutral.

MA for moral agnostic is not a qualification that most people want on their doctor’s brass plaque. If their teenaged son wants steroids so that he can have a body like Arnold Schwarzegger, they expect their GP to say No. If their teenaged daughter has anorexia nervosa, they expect their GP not to tell her that it is a lifestyle choice. And if the aged parent is depressed and wants to die, they expect cheery advice and a pat on the hand, not a needle.”

In view of the Kerry Wooltorton suicide case and the subsequent myriad of convoluted ideas emerging regarding the right to live and the right to die, it might be worth revisiting what happened at that meeting of the BMA in June 2005.

“Neutrality on euthanasia is so daft a policy for doctors that only two things can account for it: monumental stupidity on the part of the profession or a Byzantine plot to legalise it. Perhaps fortunately for the health of the nation, the latter is the case. Here is what happened in June 2005”

THE BYZANTINE PLOT

The D’oh! moment proved to be a wake-up call for some members of the medical profession. But for others, they missed the moment, and the significance of the whole incident passed them by as they busied themselves in their respective mundane daily doctoring tasks.

My Black Cat’s advice to all medical practitioners is to resign from one committee that you sleep through and use all that valuable time to keep at least one eye open for D’oh! moments.

a red apple ……………………

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There is a view that an omission is by definition not an act.

Posted in -The right to live: The right to die, Creep, Euthanasia, conspiracy theories | Tags: Assisted suicide, Euthanasia, Suicide

Posted by: Witch Doctor | October 23, 2009

The Kerry Wooltorton debate

witchyounground

The fiery debate about the Kerry Wooltorton case has been rekindled over at Dr Grumble’s blog:

There, a lawyer (Marjorie) has entered the informal discussion. This is welcome, because this suicide has opened up a whole supermarket of cans containing legal, ethical, clinical and moral worms. These worms, having been set loose following the rare and complex circumstances surrounding this case, are liable to be found wriggling around in more straightforward and common situations, if the conclusion reached in the Wooltorton inquiry sets a legal precedent for doctors regarding the future management of patients who have attempted suicide.

This case has several facets.

Three of the most important are the role of (1) The Advance Directive, (2) The interplay between Consent, Capacity and Self Determination, and (3) The legal relationship between the Mental Capacity Act and the Suicide Act.

EmergencyRedAbstract

THE ADVANCE DIRECTIVE

The fact KW carried an advance directive indicating that she did not want to be treated, but only to be made comfortable while she died, has been raised in some of the discussions.

However the KW case was not about advance directives. The AD was irrelevant since the patient was conscious. She was in a position to refuse treatment. The case is about imposing treatment on an un-consenting adult patient and whether if so doing would render the doctor in charge guilty of assault.

That is what the lawyers say.

The Witch Doctor can grasp that.

So, forget about the AD. That is another debate for another day.

THE INTERPLAY BETWEEN CONSENT, CAPACITY AND SELF DETERMINATION

This is crucial but extremely complex. Ignore it for the moment.

THE LEGAL RELATIONSHIP BETWEEN THE MENTAL CAPACTY ACT AND THE SUICIDE ACT.

It seemed to The Witch Doctor that a legal error may have been made, because of a clause in the Mental Capacity Act. There appears to be a conflict between the MCA and Suicide Act. On Page 6 of The Mental Capacity Act 2005 there is something called a “declaratory provision” which specifically says:

“Scope of the Act

For the avoidance of doubt, it is hereby declared that nothing in this Act is to be taken to affect the law relating to murder or manslaughter or the operation of section 2 of the Suicide Act 1961 (c. 60) (assisting suicide).”

It seems to me “The Scope of the Act” is the attempt of the law to avoid a situation such as happened in Norwich. i.e. The Suicide Act over-rides the Mental Capacity Act.

Looking at the wording of the Suicide Act 1961 (c.60)

“2 Criminal liability for complicity in another’s suicide

(1)A person who aids, abets, counsels or procures the suicide of another, or an attempt by another to commit suicide, shall be liable on conviction on indictment to imprisonment for a term not exceeding fourteen years.”

The words used seem to have many shades of grey. These are complicity, aids, abets, counsels, procures.

The greyness means that individuals may have different ways of interpreting these two acts. For The Witch Doctor, it seems clear that the Suicide Act always trumps The Mental Capacity Act. i.e. the Mental Capacity Act was not addressing suicide and to assume it did do so was not only misinterpreting its intention, but was placing it at odds with The Suicide Act.

In the initial article by Sheila McLean, The Suicide Act seemed to have been ignored. In fact even the very word suicide was avoided in her summary of the legal situation. Check it out for yourself. I wondered if this omission was intentional.

There is also the debate as to whether omitting to do something is a positive act or whether it is an act at all.

The Witch Doctor disagrees with this.

Marjorie (the lawyer) contributing to the discussion in Dr Grumble’s post states that omission is an act. It is an act of omission as opposed to an act of commission.

The Witch Doctor agrees.

However, Marjorie disagrees with The Witch Doctor’s suggestion that there may have been a legal error or oversight regarding the content of The Suicide Act over-riding The Mental Capacity Act in the KW case.

The following seems to be the key to the reason for the view it is not a legal oversight and could be the reason why most lawyers who have commented on the case seem to be in agreement.

“As a general rule, our legal system does not treat acts of omission as criminal acts”.

However, The Witch Doctor is still of the opinion that if she omits to treat a patient in order to save a life, and she knows that her intervention will save the life or has a high chance of doing so, then choosing not to intervene is a positive act following a definite, deliberate decision for which the doctor must take full responsibility. This responsibility takes on a particular prominence if The Witch Doctor, her medical peers, her patients, and society at large are of the view that one of the main roles of a doctor is to save life. If the outcome is death, she must take full responsibility for that. The Witch Doctor would then be complicit in ensuring the fatal outcome, because she knew how to avoid it, had the facilities to do so, and in addition was the consultant responsible for the care of the patient. The circumstances in a suicide case such as this are quite different from those surrounding a terminally ill patient where a doctor does not have the advantage of knowledge or capability of ensuring the patient does not die.

So, regardless of the law, regardless of the stance taken by philosophers and medical ethicists, The Witch Doctor believes that she would have been responsible for her death because she was responsible for her care. Of that she has no doubt. She therefore believes she would have been complicit in the death.

It is the word – play surrounding “complicit” that is important.

It is likely that someone cleverer that The Witch Doctor could find a way of trying to relieve the Witch Doctor of this burden of responsibility and complicity by introducing a different meaning to the vocabulary above.

But it won’t wash. The Witch Doctor will regard this simply as a facile play upon words.

So, believing herself to be complicit in the suicide, she would consider herself in breach of The Suicide Law.

And she would have to plead guilty.

But it seems she would not have been charged on this particular act of omission because legally the word “complicit” seems to have a different meaning within the legal profession to the other word “complicit” that The Witch Doctor uses on a day to day basis.

(It is interesting that if The Witch Doctor’s act of omission had been not to disclose the driver of her car when an offence was committed, she would have been charged and probably found guilty).

Conversely, if she had not allowed the patient to die, she may have been charged with assault.

But she would have pled innocent because the Mental Capacity Act was not drawn up with this situation in mind but The Suicide Act was, and she did not breach it.

Would she then have been found guilty?

And if so, what would have been the likely sentence?

a red apple ……………………

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Quote from the comment on The BMJ Group –Journal of Medical Ethics Blog October 21 2009 at 9.59am:

Posted in -The right to live: The right to die, Death, Euthanasia, Freedom, Health Policies, Medical UK, Suicide | Tags: Assisted suicide, Kerry Wooltorton, Medical ethics, Suicide

Posted by: Witch Doctor | October 21, 2009

What are doctors for?

witchyounground

What happened in Norwich in the Kerry Wooltorton suicide case concerns me a great deal as a doctor, but it concerns me even more as a patient or as the relative of a patient.

There is a conversation going on at a BMA website just now about this. I was going to post the comment in full below, but it would have been too long so I have posted here and the comments section in the BMA post should pick it up as a track-back.

It does not require membership of the BMA or a password to access the the original post and the discussion. I have closed comments here so that if there are any, they can take place at the site of the original post.

COMMENT:

A doctor’s clinical role is normally to diagnose with a view to saving life and make it as comfortable as possible for the patient. That is his job almost all of the time. Occasionally it may be his job to let a life go, but that is not the norm. The way to let a life go may be by a deliberate act of doing nothing. Before a doctor deviates from his normal role of saving life, i.e. what he was trained to do, and what is expected of him, there has to be a definite, carefully considered decision made taking many aspects into account. These aspects will be unique to the patient and the situation. The decision may lead to the act of ensuring the patient is comfortable, but otherwise the act may be one of masterly inactivity.

And yes, when the patient dies, the doctor is complicit in the death. How can he not be?

It was however, an act. He behaved in a specified way, contrary to the norm, following a decision. The doctor was not a passer-by who didn’t quite notice something was amiss or did not have the confidence to intervene or was in a hurry somewhere. The doctor was in charge and responsible for the patient’s management. It was a decision, an act, a behavior to allow death because the doctor knows how to save life. And that is his normal role.

“In the Wooltorton case, I’m not sure that there was anything too blameable about not intervening.”

I agree. But note the word “too” before “blameable.”

It is the “I am not sure” that is important. Uncertainly is rife in medicine. It is that kind of job. You have to live with the consequences of making a wrong decision and often there are several possible decisions. Consultants are paid a lot of money to make difficult decisions. However, if you are “not sure” life will take precedence over death. To make a decision to end life rather than save it when you are unsure is not the way to practice medicine. It is as simple as that.

It seems the problem was that the consultant who was looking after KW, sought advice. He sought advice because he was unsure. But who could be sure? It was always going to be a decision that dealt with an uncertainty. In seeking advice, he likely set off a chain reaction which eventually put the problem into the hands of lawyers who tossed about words and ideas and difficult interpretations so much that they forgot to draw the legal link between the Mental Capacity Act and The Suicide Act. At least, that is how it seems to me and to several other members of the medical profession.

It also seems that lawyers and ethics committees need to get their heads together again soon, because what has happened in Norwich has set a legal precedent that is at odds with the code of practice of most doctors. Indeed, most doctors that I know, placed in similar circumstances would break the law as it now stands.

What is to be done when that happens?”

a red apple ……………………

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Posted in -The right to live: The right to die, Suicide | Tags: Kerry Wooltorton, sucide

Posted by: Witch Doctor | October 20, 2009

Bad boys?

witchround

Is silliness politically incorrect?

Why do you want to know, My Black Cat?

You are worried about Dr Grumble and Dr No?

Why?

They have been caught up with a couple of silly girls.

Don’t worry, My Black Cat, they are both mature, streetwise male versions of The Human Kind. They will have had lots of experience of silly girls. Lots and lots. They will be able to handle anything that the fairer sex throws at them, for sure.

They can cope with any female.

Don’t worry about them.

manYoungJumping

But they are calling them “silly girls.”

Uh Huh?

You think they might get themselves carted off to The Tower or something for using politically incorrect terminology.

No they won’t, My Black Cat. Don’t be stupid! The country is not quite at that stage yet.

ManYoungJumping2

Once people start to get locked up for being paternalistic, then they will have to worry about calling people silly.

But no, the country is not quite there yet.

They are not being politically incorrect.

Yet.

And anyway, even if they were, we witches quite like people who are politically incorrect. We find many of them are particularly un-gushing, freethinking, independent, challenging individuals who don’t creep. We find also that they are often the caring ones.

Not the ones who go around with clip-boards “releasing time to care”

I mean the ones who care but they don’t talk about caring when they care, so the silly folks who have a need to listen to “nice” caring self-indulgent drivel can’t work out they are being cared for and who is doing the caring.

And there are plenty of silly folks wandering about amongst The Humankind.

OK. That’s “silly girls” dealt with. Now you want to know if the term “bad boys” is politically correct or not.

Go away, My Black Cat.

You’re doing this old witch’s head in.

a red apple ……………………

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CAMERON WILL IMPOSE ALL WOMEN LISTS

Posted in Death, Healthcare, Independent medical practitioner, Medical UK, Patient Choice, Suicide

Posted by: Witch Doctor | October 20, 2009

Cloned politicians?

witchround

You think David Cameron is a clone of Harriet Harman, My Black Cat?

“David Cameron has indicated he is ready to force Conservative associations to adopt female candidates to fight the next general election.

In a move which will anger sections of his party, the Tory leader said he was now prepared to impose all-women shortlists for the first time.”

He may indeed be part of the banal clone of politicians who are hell bent on demeaning merit, ability, education, intelligence, and knowledge in this country of ours, My Black Cat.

Who knows what is going through the minds of our politicians nowadays?

Who knows who is pulling their strings?

WitchRedHair

We witches would not allow ourselves to be patronised in this way.

We would not allow our names to appear on a trite shortlist.

We would not be so insulted.

We are as good as any man.

We can compete with the best of them.

And win.

If we wanted to.

Often we don’t want to.

However, as we have said before, it is possible to turn a crazy notion into an advantage. It indicates we might soon have all-male shortlists for applicants to medical schools so the balance can be restored there.

We witches would have hated to attend a medical school where we outnumbered the male students. What kind of fun would there have been then?

Listen, My Black Cat, see if you can find out if red-headed witches are well enough represented in the conservative party?

Or whether we are being discriminated against.

a red apple ……………………

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Posted in sexual discrimination | Tags: David Cameron, Harriet Harman

Posted by: Witch Doctor | October 19, 2009

Suicide, Capacity, Self-determination, Paternalism, Persuasion

witchround

It could be argued that when an individual grabs a gun and shoots himself (usually himself) then the intention was to commit suicide.

It could be argued that when an individual hangs himself or herself by the neck, then the intention was to commit suicide.

When the deeds are done, these people are usually not in a position to withhold consent for treatment. They have chosen a Fast Death. This is much easier than a Slow Death where onlookers have the opportunity to debate whether the conscious individual really means what they say they mean, followed by another debate on whether it is legally or morally correct to try to save a life, taking into account the right of self determination.

This ~~decision-making~~ lack of decision-making must be painful for those watching The Slow Death.

The Law in England assumes that capacity is present until proven otherwise, that a depressed person is not necessarily lacking in capacity, and that the right to self-determination in the individual who has capacity is paramount.

So, in England, if you see a conscious person pointing a loaded gun to their head with their finger on the trigger, the default position is that they have capacity and since they are also holding the trump card of self-determination in one hand and a gun in the other, then let them shoot.

Keep it simple.

Keep within the law.

Let them shoot!

As long as you can be sure that they are only going to shoot themselves of course.

So maybe that’s a bit of a conundrum.

Not a good example.

ArrowDown

Anyway, ignoring the conundrum, the paternalistic ones of the human race may shout, “Don’t shoot! Come and talk with me and I will help you!”

i.e. you will intervene to try to change that person’s will using the technique of persuasion.

Paternalism, although not yet illegal, is frowned upon in England.

Father figures are not welcome.

However, persuasion is OK. Think of the adverts on billboards and everywhere you look. Think junk mail. Think sales talk. Think alternative medicine. Think bottled water……

Persuasion is hallowed in England.

It has to be.

We have a nation of people employed one way or another in the tactics of persuasion.

So don’t call your intervention “Paternalism.” Call it “Persuasion.”

For goodness sake!

Here is another example with less of a conundrum.

In England, if you see a young woman with a noose around her neck and she is about to jump down into a stairwell, then if you are paternalistic, by all means shout a fatherly “Don’t jump!” You could even talk in a gentle hypnotic voice to her as you climb the stair to be beside her.

Remember, you might be criticised because you are intervening with her right to self-determination, but in England it is still within the law to be paternalistic.

Paternalism is bad, though. Very bad. But at the moment you can safely assume you won’t go to jail for it. But you can conceal the fact you are using paternalism by calling it persuasion. Then you won’t be an outcast.

JellyBabyOneOrange

The law, however, seems to be on your side if you just stand by and watch.

But don’t shout, “Go on – Jump.”

Because then you would be aiding and abetting.

Mark you, if you shouted very loudly “don’t jump” then that might give her a terrible fright and she might lose her balance.

Maybe somebody would then accuse you of aiding and abetting.

No. The intention was to prevent rather than facilitate.

But who can prove that?

Perhaps you just chose your aiding and abetting words carefully. It was the volume you used to shout them that had the desired effect of suicide facilitation.

Aiding and abetting in the context of suicide is bad. It is illegal and carries with it a prison sentence.

WarningBlank

Watching and allowing is good.

Three words: “Go on – Jump” make you a criminal.

Two words “Don’t jump” might make you criminal too, but you probably won’t get caught because everyone will believe the words, not the scary way you used the words.

But the outcome for the individual with the noose around her neck is the same.

Death.

In suicide, The Outcome is not important.

But The Pathway is.

So they say………

By doing nothing you have acknowledged the prime and noble positions legally and morally of “capacity by default” and “self-determination” in a conscious patient.

You have not aided and abetted.

But you have allowed.

This play upon words means that at night you can sleep the sleep of the righteous with The Book of Law under your pillow.

While you cuddle into your pacifier blanket enchantingly embroidered with the nursery rhyme called : “The Alternative Moral Code of the State”

a red apple ……………………

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Posted in -The right to live: The right to die, BMA, Creep, Freedom, Suicide | Tags: Autonomy, Capacity, Medical ethics, Paternalism, Persuasion, Philosophy, Self-determination, Suicide

Posted by: Witch Doctor | October 17, 2009

WD Apology (39) – What’s wrong with the Dutch?

witchyounground

One of The Witch Children stayed and worked in Holland for a while, so The Witch Doctor had the opportunity to visit this country from time to time, not so much to see the sites but to absorb the way of life there in a small town. She liked the place and the people. And the flowers. She supposed in time she would have missed the mountains, hills and glens. Or maybe, being an adaptable witch she would have grown used to the flatness. She was intrigued how almost everyone in The Netherlands has a symbiosis with their bicycles in much the same way as we witches have with our broomsticks.

They seemed a tall nation and since all witches have big feet, The Witch Doctor quickly spread the news to the witching community that this little Dutch town is a place where witches could find shoes that fit.

There were very few fat people in this little town. Presumably this was related to their daily cycling habit.

TulipsAllium

There was something about the Dutch personality that The Witch Doctor liked but she didn’t know quite how to describe it. They seemed polite and friendly but not gushing or demanding. They were a sensible lot who would not be intrusive or stick their noses into other peoples’ business but nevertheless be helpful if the need arose.

We witches like that.

The Witch Doctor also recollects that this is one of the few countries of the world where MRSA is not a problem due to the good common sense of the Health Service there when this irksome little organism first appeared on the scene.

With all of this in mind, The Witch Doctor was recently a bit surprised to read this on a Common Purpose Website. (Category A2 information)

“In the Netherlands, where there is little or no tradition of citizenship, Common Purpose has a difficult job: to engage individuals from all parts of the community, and inspire them to transform society.”

Els Swaab, Amsterdam Municipal Theatre; Dutch National Bank

In what way exactly would Common Purpose want to transform the society of this country. And why?

Why does Common Purpose, which started off as a small a UK charity, feel it is required there? Do the Dutch people feel a need in their country for CP’s charitable acts ? Did they ask them to come? What are these charitable acts costing the Dutch people and do they see a gain?

Would someone from The Netherlands please inform The Witch Doctor if her judgment is becoming impaired and whether The Dutch need themselves transformed using the Common Purpose leadership agenda?

After all, the Common Purpose Folk say they are having a difficult job there with you all. You don’t seem to be conforming to their matrix.

Would it not be fairer to them if you just told them to go home?

Or something?

Back sometime……..

a red apple ……………………

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Posted in - THE WITCH DOCTOR'S APOLOGY, Common Purpose, Creep, Leadership, MRSA, The Third Sector, charity, conspiracy theories

Posted by: Witch Doctor | October 17, 2009

Death With Dignity Acts

witchround

The Euthanasia Society of America was founded way back in 1938. The theme of full blown euthanasia was too radical to be accepted and instead the accent was placed on the concept of informed consent and a patient’s right to refuse unwanted treatment. Although renamed “The Right to Die Movement” it is likely that euthanasia remains the ultimate aim and is being achieved by gradual social engineering over many decades.

Somewhere The Witch Doctor came across the view recently that The Death with Dignity Act allowed physicians in Oregon to administer a lethal injection. This is not the case. The patient is responsible for the self administration of lethal doses of oral drugs which have been prescribed by a physician and dispensed by a pharmacist.

The safeguards relating to The Death with Dignity Acts in both Oregon and Washington are outlined below.

Notice Section 16.

1. The patient must be a competent adult (age 18 or over).

2. The patient must be a resident of the state of Oregon or Washington.

3. The patient must be capable of self-administration (only the patient can take the medication him or herself).

4. The patient must be terminally ill, defined as someone with an incurable illness who is expected to die within six-months or less.

5. A second physician must confirm the terminal diagnosis.

6. If either physician suspects the request for aid in dying is motivated by depression or coercion, a third examination by a psychologist or psychiatrist is required.

7. Only the patient himself or herself can initiate the request.

8. The patient must make two oral requests for the medication, separated by a minimum 15-day waiting period.

9. The patient must make a third written request witnessed by two people who know the patient and who can testify, if necessary, that the request was an informed and rational once.

10. Witnesses cannot stand to gain financially from the patient’s death.

11. Prior to writing the prescription, the physician must confirm that the patient is both still competent and capable of self administration.

12. The physician is required by law to counsel the patient on alternatives to a hastened death, including hospice, palliative care and pain management.

13. The physician must recommend, but not require, that the patient inform his or her family of the decision to hasten death.

14. No insurance policy or contract can be made invalid if a patient uses the law to hasten death.

15. The patient can change his or her mind at any time.

16. Any physician, pharmacist or medical facility opposed to aid in dying does not have to participate.

17. If a death occurs under the law the physician is immune from any civil or criminal liability.

In the UK, as a result of the “allowed” suicide in Norwich, there is now a precedent set that may result in doctors in the UK having no choice LEGALLY but to ALLOW suicide to occur in the context of this recent interpretation of the MCA. ie by doing nothing, they are participating in that death and therefore have no option but to opt in or abandon their patient in an emergency situation. ie unlike in Oregon and Washington, they cannot opt out.

Although the circumstances are different by a hairsbreadth, it could be argued that the UK has now moved further down the euthanasia road compared to Oregon and Washington.

Unlike the USA, if the recent precedent in the UK is now accepted, the wings both of doctors and the institutions they work in have been well and truly clipped.

Enter The Will of the State.

a red apple ……………………

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Posted in -The right to live: The right to die, Creep, Death, Suicide | Tags: Assisted suicide, Euthanasia, Suicide, Voluntary euthanasia

Posted by: Witch Doctor | October 15, 2009

Beyond reasonable doubt

witchround

Andy Cowper made a comment on one of Dr Grumble’s recent posts.

He introduced a term usually heard in legal context.

“Beyond reasonable doubt.”

This concept seems to The Witch Doctor to be important in the allowed suicide of Kerry Wooltorton.

The Witch Doctor wonders how many doctors, if faced with the decision to allow this young woman’s life to end, could say to themselves that it was “beyond reasonable doubt” that suicide was really intended at the time the decision not to treat was made.

Furthermore, even if it seemed it was “beyond reasonable doubt” then, how many doctors could say “it was beyond reasonable doubt” that she would be sure she wanted to die a week onward, a month onward, a year onward, five years onward, a lifetime onward.

None, probably.

ZenBeach

So, are patients to be allowed to die nowadays when the criteria of “beyond reasonable doubt” is not satisfied?

Is that what medical students are now going to be taught?

Is this how the next generation of doctors will be expected to behave?

Can this term ever be satisfied longitudinally in the context of suicide?

I think not.

This week, it was reported that a widow received a settlement following the death of her husband in a hospice.

Why?

It was because the controversial Liverpool Care Pathway was initiated.

However, it is reported that the patient was “cured” of his “terminal” cancer and was in fact was suffering from a treatable pneumonia.

Presumably though, the consultant concerned who decided on the terminal “treatment” felt it was “beyond reasonable doubt” that the patient would die soon from recurrent cancer.

This brings to mind a lesson that The Witch Doctor remembers way back as a medical student.

“Never diagnose cancer without histology.”

Maybe The God Doctors among us don’t need histology.

The Witch Doctors, however, are not so clever.

a red apple ……………………

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Posted in -The right to live: The right to die, Creep, Death, Euthanasia, Health Policies, Healthcare | Tags: involuntary euthanasia, Voluntary euthanasia

Posted by: Witch Doctor | October 13, 2009

Here is the evidence!

witchround

During the witching hour, we witches were all saying how much we despair of The Humankind.

We ration our contacts with The Humankind.

They drive us batty!

We think they are like a flock of daft sheep!

Here is the evidence.

Watch this first:

MUSIC MADE FOR WITCHES

MORE MUSIC TO MAKE WITCHES WEEP

Now, when you’re emotionally stable again, read this and watch the videos.

SOMEWHERE ELSE

Proof of daftness!

If ever there was!

Eh, My Black Cat?

a red apple ……………………

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Posted in Classical music | Tags: Joshua Bell, Last night of the Proms

Posted by: Witch Doctor | October 13, 2009

Creeping “Choice”

witchround

The Witch Doctor remembers reading some time ago that an insurance company in the USA had sent out letters to cancer patients telling them that a particular expensive palliative chemotherapy prescribed for them by medical staff would not be funded. However, in the same letter they gave them the good news – they would, however, be happy to fund a prescription for assisted suicide.

Apparently this benevolence caused a bit of a stir in the USA and the company concerned back-peddled and said it was a clumsy administrative error.

Clumsy?

Sure.

Apparently it was such a clumsy error that the establishment concerned will no longer put this in writing. Instead, someone will phone the patient and discuss the options with them.

We would agree a positive, sympathetic voice is always less clumsy than factual, chilling text at times of great anxiety.

Wouldn’t we, My Black Cat?

The right kind of voice, at the right time, can be very reassuring and persuasive.

And comforting.

Can’t it, My Black Cat?

HotWaterBottle

REASSURING COMFORT

The Witch Doctor couldn’t find where she first read about this information that had found its way into the depths of her brain. However, last Saturday, by magic, a second diet of the information fluttered from cyberspace on to her computer screen.

This time it was from a different source.

So, now she has read about it twice. Therefore, this serious matter might well be true and therefore requires equally serious consideration.

The epicentre of these events was that corner of the world where Qalys were born.

Oregon.

It seems it that those from Oregan Health Plan (OHP) wrote to patients with the bad news followed by the ultimate, dignified, but irreversible good news.

Some years before, Oregon voters approved a new act. They say some voters thought they were voting for compassionate care and better pain control towards the end of their lives. They say some thought they were voting for the right of self-determination in the sense that their opinion would always be sought before embarking on rigorous treatment in an attempt to prolong a life that was ending.

Choice.

It seems reasonable to vote for Choice.

It is understandable that, if asked, most of The Human Kind will vote for Choice.

Just as, if asked, they would vote for Liberty.

After all, this act had a name that gave great comfort.

It was called the “DEATH WITH DIGNITY ACT”

The beginning of Creep always seems reasonable and rational and right.

That is why only witches notice the beginning of Creep.

That is why witches in the UK are right now questioning the meaning of the word “Choice.”

Just as they are questioning the meaning of the word “Change”

Just as they are questioning the meaning of the word “Leadership”

Just as they are questioning the meaning of the word “Democracy.”

Change, Choice, Leadership, Democracy

They are all words that are reasonable and rational and right.

Eh, My Black Cat?

a red apple ……………………

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Posted in -The right to live: The right to die, Creep, Democracy, Euthanasia, Freedom, Health Policies, Qalys | Tags: Assisted suicide, Death with Dignity Act, Oregon Health Plan, Suicide

Posted by: Witch Doctor | October 12, 2009

The Hemlock Society

witchround

The Hemlock Society is no longer in existence.

It has been renamed. This is probably just as well because “The Hemlock Society” seems to conjure up thoughts of a tragic yet romantic nature.

There is nothing romantic about suicide.

It is probably no coincidence, nevertheless, that there is a strong link with Oregon.

Hemlock

Oregon, I understand, is where Derek Humphry now lives.

Derek Humphry, an American journalist born in the UK founded the Hemlock Society in 1980 in a garage in Santa Monica, California. He was perhaps strongly influenced by his own personal tragedy. This right-to-die movement fought for “voluntary euthanasia and physician-assisted suicide to be made legal for terminally and hopelessly ill adults.” This work continues.

It is of interest though, that in 2006, Derek Humphry said the following:

“For the 25 years that I have been campaigning for the right to choose to die, and get help with it, I have kept my arguments confined to the terminally ill and the hopelessly ill competent adult. People are always asking me why don’t I include the mentally ill in the struggle.”

He gave nine reasons for this.

This was his 9th reason:

“I gently tell such troubled people that I don’t think anybody is going to help them to die — it’s just too much to ask — and if they are still determined to leave this world they must handle it themselves. Some do, most don’t so far as I can tell, at least, not until later on.”

It is just too much to ask…….

a red apple ……………………

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Posted in -The right to live: The right to die, Euthanasia, Suicide

Posted by: Witch Doctor | October 11, 2009

How are health choices affordable?

witchround

The Witch Doctor has, for many years, kept an eye on Oregon USA.

Why is this?

Well, she first heard of Oregon when she was spirited away by the NHS many years ago for a ~~brainwashing~~ management course. This took place in a posh hotel by the seaside. It was compulsory.

It was there that The Witch Doctor first heard about Qalys.

Oregon is the home of Qalys.

The details regarding what she learned and what she thought about Qalys are for another day.

However, she was unusually vocal at this meeting regarding Qalys. She said Oregon would become the epicentre for voluntary euthanasia.

“Just wait and see,” she said.

In fact she said much more than this. But that too is for another day.

Some present at the meeting thought The Witch Doctor had lost the plot.

But then, nobody there was aware they were in the presence of a witch of considerable stature within the witching community. If they had known that the might have listened to what she had to say.

AppleGreen

Here is what this witch is saying now, to all of those who attended that meeting:

I told you so!

The Creep is now well on its way and the Oregon way of death has spawned into Washington State too.

In addition, there is an Act floating about on the other side of the Atlantic just now called:

“AMERICA’S AFFORDABLE HEALTH CARE CHOICES ACT 2009 (HR3200)”

The intent of this legislative proposal is:

“To provide affordable, quality health care for all Americans and reduce the growth of heath care spending and for other purposes.”

Note: “for other purposes”

What purposes do you suppose they might be?

Eh, My Black Cat?

a red apple ……………………

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Posted in Euthanasia, Qalys, Suicide | Tags: Euthanasia

Posted by: Witch Doctor | October 11, 2009

Witching Hour in The Spell Pantry

witchround

THE CASTING OF A WICKED SPELL

We are recovering from a busy night in The Spell Pantry, My Black Cat and I.

ChocOrange11

The Big Jar

ChocOrange15

Powdered Magic

ChocOrangeButter

Exceedingly dangerous butter

ChocOrangePeel

Orange peel, not carrot

ChocOrange14

Crystals of Sweetness

Sticky Liquid Sweetness

Ready for the Magic

ChocOrange12

A view in side The Big Cauldron

ChocOrange13

A Flattened Spell

Two slabs of The Ultimate Magic Sweetness

ChocOrange8

A view inside The Small Cauldron

ChocOrange9

After The Incantation

ChocOrange10

A Bloggers Helping of Magic

a red apple ……………………

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Posted in Spells

Posted by: Witch Doctor | October 5, 2009

The Tories are pottering about with eBay

witchround

Mr Cameron, I hear you are entering the eBay scene late in the day!

(Or is it Mr Lansley, My Black Cat? Who cares – lets go straight to the top man!)

Now, Mr Cameron, you may find this difficult to believe, but this ancient witch is The Witch Queen of eBay!

She was probably buying and selling stuff on eBay when you were just a boy in short pants.

Because The Witch Doctor has bought and sold lots of stuff on eBay, she has lots and lots of feedback.

WitchPrime2

The Witch Doctor has 100% feedback.

Do you know what this means?

It means that this witch has learned to work the system so nobody ever gives her bad feedback.

That’s right. The Witch Doctor NEVER gets bad feedback.

She has never had less than 100% feedback for any transaction.

Not Ever.

Let me tell you, Mr Cameron, just a few ways how to work the system so you get 100% feedback.

ebay_logo

AS A SELLER

1. Your little corner of the eBay world should look either clean and business-like or beautifully artistic but in an understated way. Unless you are very clever and know exactly what you’re doing don’t use Flash or any form of animation. There should be nothing tacky about the design even if you are selling tacky goods. THIS MAKES YOU SEEM PROFESSIONAL.

2. You need a decent digital camera. Lots of excellent quality photographs of the wares you are selling are essential. Any flaw in the goods you are selling should be demonstrated in a close up photograph. You should describe the flaw in detail. If there is no flaw just pretend there is one. THIS MAKES YOU SEEM HONEST.

3. Start the bids at a low price. THIS MAKES YOU SEEM FAIR

4. Wrap the goods up beautifully as if it is a birthday present for someone very special. THIS MAKES YOU SEEM CARING

5. Post them to the buyer the day after the auction ends. THIS MAKES YOU SEEM PUNCTUAL

Now, The Witch Queen of eBay may the most unprofessional, dishonest, unfair, uncaring and always late eBayer in the world, but nobody will know.

If you keep up this act until you have say 1000 positive feedbacks, each one 100% then everyone will be thronging around your auctions willing to buy.

Then, if you are crooked you can strike! You sell a ruby that belonged to Queen Elizabeth 1, or a piece of moon rock or a genuine Cezanne and everyone will believe you!

People can act the part Mr Cameron.

Even dangerous people.

Patients were keen to have Dr Shipman as their GP.

He would have had excellent patient feedback.

And Mr Cameron, just a whisper in your ear…….

Both sellers and buyers give feedback on eBay.

It works both ways.

Patients about individual doctors.

Doctors about individual patients.

Both ways….

Eh? Mr Cameron.

PS In case you have nothing to sell but instead you want tips on how you can get 100% feedback as a BUYER then just drop My Black Cat a line, Mr Cameron.

She may or may not reply.

(Actually, My Black Cat, eBay sellers and buyers are much more sensible than we are making out, but since Mr Cameron and Mr Lansley are turning somersaults in the political circus ring in an attempt to attract votes, they won’t listen to proper advice about how patients with any wits are quite able to make their own judgments about doctors without the machinations of politicians)

a red apple ……………………

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