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Informed consent; not
Betty Tucker, a middle-aged woman on the Radio 4 programme The Archers,
was given a heart attack just before Christmas because the person
playing her is emigrating to New Zealand so Betty needed to be written
out of the script. I happened to hear the episode and it's bothered me
ever since.
Her husband, returning home to find her unwell and gasping that she had
chest pain, called for an ambulance. One of the paramedics who arrived
asked Betty a few questions about her medication, allergies and
bleeding tendencies. His diagnosis of a heart attack was confirmed by
staff at the hospital to which he relayed her ECG. He gave her an
aspirin to chew and then said that he wanted to give her a clot-busting
drug intravenously. This would ease her pain and reduce the severity of
the heart attack but it did have a low risk of causing internal
bleeding. To be effective it had to be given as soon as possible;
however, he needed her permission to give it. Did she want him to give
it? It had to be her choice.
By this time Betty was more distressed, saying she was frightened and
thought she was going to die. She was in no state to make any decision,
let alone one about which she had almost no information.
I was left wondering if paramedics really say what the chap in the programme said.
Thought for the day
Politicians are often transient: yesterday's Transport Secretary is
today's Health Minister and tomorrow's Secretary of State for Defence
or, if things go badly, embittered back-bencher. The workforce the
Secretary of State faces is more or less permanent. Not unexpectedly
they will have a deeper knowledge and understanding of the real
business of medicine than a Minister appointed at a few days' notice.
Raymond Tallis, Hippocratic Oaths
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