The following is a true story but, the names of those involved have been changed.
This story is part of the Euthanasia Prevention Coalition story contest (Contest link).
Here is the link to Doreen Blake's Story (Story link).
The author wishes to remain anonymous.
When Doreen was in Emergency Ward, soon after she entered hospital, her core TEMPERATURE was as low as 32.2 degrees or 32.1 degrees Celsius. So, she had hypothermia. Obviously, temperature was a particular concern for Doreen, which should have been continued to be a health issue to direct careful care towards. I’ve heard that a low body temperature likely contributes to drowsy sluggishness, which Doreen, D.E.B., continued to experience throughout her hospital stay. In Emergency, D.E.B. had an electric plastic blanket with air-filled sections, which gradually warmed D.E.B. above the ideal 37 degrees C. Then she was sent to 6th floor North, (6N), where there was no such blanket, or any electric blanket, or alternate warming system, (other than “too many” heavy normal blankets). Since the nurses thought the many normal blankets were too heavy, they kept removing some of them. D.E.B.’s temperature dropped as low as 34.6 degrees C., though at times it was 35.5 degrees or 35.4 degrees, & eventually even as high as 36.5 degrees. I told Bridgette, charge nurse, I did not want D.E.B. to be frozen to death &, since they had no electric blanket or heating pad on that floor, I’d like D.E.B. to go into the intensive care unit, (ICU), where they had such a blanket. But, Bridgette refused, under the circumstances. I suspect the circumstances were that D.E.B. had been slated for End of Life “Care”. Since Dr. Peadet suggested we buy a heating pad, & I recommended it, M. Crocket bought one & D.E.B. used it. But, she had little patience for it, (or for feeling too hot), & always soon threw off the upper part of her covers, exposing her arms, & demanded the heating pad be removed. So, I realized she seemed warm enough without the heating pad, despite the thermometer’s claims, and I no longer felt that temperature was a big concern for her while she was in the warm hospital. When she returned home to her cooler house, that may have been a concern though. There, on Jan. 21, 2016, C. Ann said they were no longer taking D.E.B.’s vitals. I think that stopping taking D.E.B.’s vitals was arranged to avoid “bothering the poor dear”.
But, in hospital, they took D.E.B.’s temperature daily. They used a rectal thermometer to get a good reading, since their mouth and armpit thermometers did not give good readings. Since D.E.B. had hemorrhoids, she screamed in pain when they checked her temperature. They had no ear thermometer, so I bought one and they used it. Screaming could have made D.E.B.’s voice more hoarse, which was already often difficult enough to understand.
Here is the link to Doreen Blake's Story (Story link).
(2)Doreen was given INTRAVENOUS liquid in Emergency Ward, where she slept for 2.5 days. She was moved to a room in 6 North, without her intravenous, and with no instruction to have her intravenous re-connected. By the time I reported her lack of intravenous, and then the nurse contacted Dr. Readair and got approval from her to re-connect it, and it was re-connected, a few hours had elapsed. Eventually, the intravenous “blew out”, and could no longer be used, since the veins in that arm could accept no more liquid. Since she still needed extra support on top of the liquid that she was awake enough to take by mouth, they gave her intravenous just under the skin in the other arm. Within a day or 2, that also was stopped due to water build-up, (edema) in her arms, etc., to the point that water was leaking back out of both arms.
Dr. Readair said, following the event, that she had not canceled D.E.B.’s intravenous for at the time when D.E.B. was moved from Emergency to 6 N. Due to Doreen’s drowsiness, the nurses were basically unwilling to feed her or give her any liquid by mouth. This they said was because she could choke if she was not fully alert. But, I suspect their instructions “to not themselves be involved in feeding her” came from staff members of higher rank, & resulted from D.E.B. being classed as “end of life palliative care”. In other words, I suspect this was part of the “plan to end D.E.B.’s life sooner rather than later”. I pointed out, (including to the charge nurse, I think), that if a baby is one of those drowsy-type babies who do a lot of their nursing, (drinking), while they are asleep, then their care-givers do not “completely avoid feeding them due to the risk of them choking”. Nor, I expect, are their feedings restricted to when they are highly alert, (as my Mom’s basically were, except when I was feeding her). So, in hospital, D.E.B. was basically completely dependent on her family to feed her. This could be a real problem for patients lacking families. Sadie, charge nurse, told me that if it was her relative being cared for, she’d be fighting hard for them too. But, should she have to? And, should the rest of us?
Since the rest of my family largely “avoided feeding or giving D.E.B. liquid except when she was highly alert, (following the nurses’ instructions)”, D.E.B’s intake was basically restricted to the limited time I was able to be with her. I told the charge nurse that when a baby has a delicate stomach and is often spitting up or chucking up what they are fed, they are not then deprived of being fed for 3 months. D.E.B. also chucked up an oral dose of antibiotics, before the re-hydration therapy.
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From the beginning of her hospital stay, Doreen was DEPRIVED OF the major NUTRIENTS which were essential for anyone’s maintenance of health, let alone Doreen’s, who was apparently already struggling with Congestive Heart Failure. I suspect that Congestive Heart Failure had a lot to do with D.E.B.’s “lack of exercise since Nov. 6, ’15”, plus her lack of vitamin and mineral supplements since then, even before entering hospital. That is all the more reason that D.E.B. should immediately have begun treatment with all the essential nutrients. Since we suspected D.E.B. might have pneumonia, hidden in the lower white area of her lung, shown in her x-ray, Dr. Readair kindly tried to arrange for 1,000 mg. of vitamin C to be included in the intravenous mix of vitamins which she did manage to have D.E.B. take while D.E.B. was in Emergency, (and perhaps soon once following that). But, the pharmacist refused to provide that much vitamin C. Please note that I believe that a daily dose as high as 100 mg. of vitamin B6 can be fatal if taken over an extended period. That is the quantity of vitamin B6 I have seen included in the individual capsules in some vitamin bottles.
I also asked Dr. Readair to include the proper quantities of the “essential (for heart and other muscles) magnesium and calcium”. But, Dr. Readair said that changes in the medical profession are slow and, (although she seemed to recognize their value), there was no way she would be able to provide calcium and magnesium through intravenous. When D.E.B. was provided food instead of intravenous, adequate quantities of those nutrients were still apparently lacking. I gave them to her once or twice after her intravenous was finished. But her stomach was then so delicate, after sleeping and fasting for 2.5 days, that I think she threw much of that up. M. Crocket giving her mushroom, (to try to improve her kidneys), may not have helped much either.
A sputum test eventually showed that D.E.B. had some fungus growing in her lungs but that, (since it is unusual for fungus to cause pneumonia), it was very unlikely she had pneumonia. Dr. Readair said that fungus growing in older peoples’ lungs is not uncommon, and that she wouldn’t treat it. I got the impression that the fungus there was not a big deal. Or was she not treating it because she thought D.E.B. was going to die anyway? Dr. Readair told us when D.E.B. was in Emergency that she, (the Dr.), had begun being dizzy daily, so maybe she wasn’t feeling quite normal.
(This following youtube helps point out the importance of nutrients.)i
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Where there are FAMILY DYNAMICS, as was well-known by the charge nurses and doctors to be Doreen’s situation, and since one youtube said that in one country “one quarter of their elders are abused”, every effort should have been made to protect Doreen from any “anti-life” procedures and/or influence and/or location. Instead, M. Crocket “got his way” in having D.E.B. return home, where he knew I had not been comfortable in his presence. And, he knew that following C. Ann grabbing the water cup from my hand and telling me to leave the room, I had not felt comfortable enough to remain in D.E.B.’s room while C. Ann was in there.
I told charge nurse, Sadie, that in case M. Crocket had used his position as D.E.B.’s medical representative to sign any documents to allow D.E.B. to be released from hospital, (as I think he had), or in case he did so in future, I was using my position as D.E.B.’s medical representative to, at the time I spoke to her, cancel any past or future such “documentation or release”, without my consent. Sadie said, seriously, “you can’t do that”. I responded, “I just did”, and walked out.
(5)
Doreen had a REPRESENTATION AGREEMENT. It included me as one of her Representatives, for a reason. My lawyer told me that, legally, all three of Doreen’s medical representatives would need to agree before Doreen could be removed from the hospital. But, the hospital staff seemed to put themselves above the law. A charge nurse told me that “in the hospital, the staff would go by what two out of three of the medical representatives agreed on”. I believe I explained to Dr. Readair that, although the hospital was giving two out of three of D.E.B.’s medical representatives the power to “decide for all three and for D.E.B., while D.E.B. was in hospital”, the law would require all three representatives to agree at D.E.B.’s home and while transporting her there. I told her that if she had any questions about that, she could speak to my lawyer.
On Jan. 21, when I called the ambulance that evening to have them return D.E.B. to the hospital, three ambulance drivers followed four firemen, and were followed by two police women. The firemen soon left, but I think the ambulance drivers stayed over an hour, talking to Dr. Miran on the phone and to Dr. Dane, (supposedly the College of Physicians doctor), etc. Although the lead Paramedic/Ambulance driver said a College of Physicians and Surgeons doctor had then been consulted, I later learned there is no doctor representing the College of Physicians and Surgeons.
The Lead Ambulance driver, who said he’d go by the doctors’ decision, did so. He would not listen to any argument from me. The doctors decided that there was a part of the Representation Agreement which went above and beyond the question of whether to accept me or M. Crocket as Doreen’s main representative. (Emily was not at the house that evening). The part I am referring to is where it says D.E.B. is not to be resuscitated in the event of her heart stopping, and that certain other interventions are not to be taken under certain circumstances. Although I still felt there was hope for Doreen if she was treated properly, and although I had managed to convince Dr. Readair to (“give Doreen a chance” and allow her to “have intravenous about Dec. 29”), there was no convincing these men. Watch what you put in your Representation Agreement. Make sure you say in it whether your Representatives can act separately, or if a majority must agree first, or if they must all agree outside or inside the hospital because, even if the law may be clear on this, the doctors and lawyer involved may not be. And make sure your Representative is given the Right, within your Representation Agreement, to have control over “doctors’ decisions, who may more likely treat you as a number”.
In a situation where even only one of a patient’s medical representatives is requesting the patient to be treated in a “pro-life” rather than a palliative “care” manner, then I think the survival and health of the patient should be supported in every way possible. This way, not only may the patient live much longer in a reasonably healthy way, but that Representative will not have to live the rest of their life feeling as though their Dear One has been tortured and murdered.
Sadie, the charge nurse, led me to believe that if I filled out a Request Form, I would be able to “acquire D.E.B.’s medical records after D.E.B. left the hospital”, including D.E.B.’s geriatric psychiatrist’s assessment Report, if I submitted that form. But, after I submitted it, I was told that I would not be able to acquire my requested information unless all three of D.E.B.’s executors/trustees signed the Authorization Request Form.
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Doreen got a blister on each heel, which were called BEDSORES. Could they have been prevented? Which locations on the body are most common for bedsores? I’ve heard that once these bedsores become infected, they can take a long time to heal. My Dad sat in his chair for four years, waiting for a hole in his heel to heal. I think if Doreen had been mobilized soon after she awoke from her 2.5 days sleep, bedsores would have been less likely to occur. And, maybe silk sheets rather than rougher sheets would have been less likely to cause bedsores. And, once bedsores form, are sticky bandages the best way to protect the skin? Because D.E.B. had bedsores, she was picked up in a lift while she slept, and her mattress was exchanged for a special one to prevent more bedsores. It had a machine attached to its end, which I think blew air through the airways in the mattress to keep it dry.
Before D.E.B. returned home, I wanted all the important equipment to be in place at her home before D.E.B. was transported to there. That type of mattress, with the machine at its end, is part of that equipment I wanted there. When I told M. Crocket that, I believe he reassured me that not only was there a hospital bed, but also that type of machine at its end at the house. But, when I visited the house on Jan. 19 and 21, I saw no such machine there.
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After sleeping 2 1/2 days, and thus being on at least a 2.5 days fast, Doreen’s DIGESTIVE SYSTEM was very delicate and needed special care.
I think at that point the kitchen often repeatedly sent her nothing but containers of various types of thickened fruit juice, likely non-organic. They repeatedly came as a pair of the same type of juice, as in 2 orange or 2 cranberry or apple, rather than providing variety within the pair. And, those were the only 3 types. They were very often 2 orange, & I felt both the orange and cranberry were too acidic for a delicate stomach. Doreen drank water instead of the juices a lot. Then, when the meal trays came, they were a strange mix of pudding, meat, potatoes, fruit, juice and vegetables. I believe that delicate stomachs are best fed fruit first, and separate from other foods. Then, the important protein can be introduced, likely best as clear liquid, and separate from (the big serving of starchy mashed potatos, which was typically served daily). In other words, there is a “best system”, which needs to be taken into account for each individual, and provided for. Without being properly guided in this, I over enthusiastically over-fed my Mom at least once with a mixture of foods. Then I had to back right off, and then tried giving her “world-renouned re-hydration therapy of sugar, salt and water, which I think has saved millions of people world-wide, annually. Unfortunately, I was not instructed how much to give her, so I gave her 7/8 cup, which was too much, and she didn’t manage to hold it down. I think it was the next morning when Dr. Readair approved her drinking one eighth cup per hour of that re-hydration therapy. So I did that until one p.m., at which time she brought that up too. Then we were back to one teaspoon per hour of water for the rest of that day and starting the next day. I think that was the day she was slowly transitioned to diluted apple juice at one teaspoon per hour, with a little extra water. All this was occurring when D.E.B.’s body needed “significant quantities of liquid”. That was the day my family was told by Dr. Miran that, (due to Doreen being given palliative “comfort ” care), we were welcome to give her “anything she wanted to eat”. When I “objected” to the charge nurse, Sadie, (since “any quantity” of any food type, or mixture, could have brought us back to square one, or worse, with feeding D.E.B.), she confirmed that if D.E.B. alertly said she wanted ANY thing, such as ice cream for example, then we could give it to her! Instead, D.E.B. had a little beef broth that evening and the next morning.
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Doreen was treated as though she was a vegetable, LEFT IMMOBILE. One of the youtubes says that patients should be mobilized regularly. They turned Doreen over at pampers-changing time, and that was about it. Shortly after she awoke from her 2.5 days slumber, I started asking almost daily for help with moving her. The geriatric psychiatrist visited my Mom briefly twice. My Mom told her, Dr. Chase, that she, D.E.B., wanted to go home. But, Dr. Chase determined that D.E.B. was too drowsy to properly complete her mental capacity assessment. But, Dr. Chase assumed that since D.E.B. was competent enough to say she wanted to go home, then she must be competent enough to make her own decisions such as that, and thus go home. It seemed in a discussion with Dr. Chase, and then one with the social worker, I had to try to convince them that “now” was not the time for her to go home, until all the necessary equipment, etc. was in place. That was when the social worker, Leslie, assured me D.E.B. would not be sent home without all the equipment, etc. in place first. But, I heard the story many times that D.E.B. wanted to go home, from the charge nurses, etc., and that D.E.B. was “capable of making that decision”. Sadie also told me that their operation was based on discharges. But, when D.E.B. asked, (a hundred times?), to get up and use the washroom, commode or toilet, she was denied that privilege. She asked, “Are you out of your mind?’. She was told she needed to get stronger first. And, how was that supposed to happen when she was left lying there? When I asked a nurse to help me move Doreen, she said she was busy and would leave it for the nurse of the next shift, which was a night shift. The night shift nurse said, to maintain the normal body rhythm of the biological clock, it was best to let D.E.B. sleep at night, and wait for the day shift nurse. In the morning, the nurses are very busy with other things and patients. Then I was told that, since it was the weekend, the sling which should probably be used, was being used on the other side of the hall and would not be available until the weekend was over. Then I was told the physiotherapist would need to assess D.E.B. before she was moved. A week may have elapsed before the physiotherapist assessed D.E.B. while D.E.B. was awake. The very small woman physiotherapist determined it was best to use a sling to move D.E.B. for the first time. After D.E.B. had been in hospital for nearly 3 weeks, a nurse told me D.E.B. was not being moved because the care-givers risked being sued if D.E.B.’s body was damaged while being moved. I suspect they were told not to move her so she’d degrade and die. But, I have little doubt she was moved with a sling when sent home.
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Doreen was SENT HOME WITHOUT AN ASPIRATOR. I was told by the man nurse named, “Blair”, that “aspirators are not provided to patients when they go home because aspirators can cause patients to have a reduced amount of oxygen”. And, I think that, “patients with lung difficulties could be even more sensitive to that oxygen reduction”. I then asked charge nurse, Bridgette, about it. She said that she’d had an awful experience watching her uncle in pain when he used an aspirator. I responded that I understood that if an aspirator is used improperly and the patient closes their mouth on it, the aspirator could suction the air out of their lungs causing a collapsed lung and their death. But, I said, that if the aspirator is used properly, by putting a finger in their mouth, preventing the patient from making a seal with their lips, then there should be no problem. “Besides”, I said, “there are aspirators all over this 6N floor level, for a reason”. She seemed to have no response to that.
The aspirator seemed like an essential piece of equipment for D.E.B., considering her coughing, drowsiness, new transition to eating food , and it had been used for her in hospital. So, after I heard D.E.B. had been “cut off of all food and drink on Jan.21 morning” by the doctor, (Miran, I believe), I rented an aspirator and delivered it to my Mom. I was hoping that, “if the doctor realized D.E.B. had an aspirator to help her in case she choked”, then he would allow her to eat and drink again. But, when I said that to M. Crocket, he said, “He won’t”. The next day, about 1:15 p.m., when Dr. Miran finally returned my call, (after the ambulance failed to return D.E.B. to hospital Jan. 21), I explained that I’d rented an aspirator in hopes he’d again allow D.E.B. to eat and drink. He responded, “Doreen can eat anything she wants ! But, if someone puts any food or drink in her mouth” (and, I think, “she has any resulting problem), then that serving person can be charged legally”. Dr. Miran tried to convince me with a serious voice that “Doreen is dying”. When I resisted, I think pointing out that the risk of dying from not drinking is greater than from choking, he said, “We’ve had this conversation before”. Of course I think he was “between important meetings”, so there was little time for discussion. When nurse, Blair, said that “aspirators are not recommended for home use”, he added, “unless oxygen is available there in a tank”. My Dad’s may still be there. At the hospital the nurses DISCONTINUED BEING WILLING, (or permitted) TO SERVE D.E.B. WATER, liquid or food, because if she choked they could be held legally responsible.
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I hear the HOSPITAL staff are well-unionized, and WON’T ALLOW VOLUNTEERS to help out there. But, Doreen needed very much care to be provided by her family, since the nurses were far too busy to attend fully to her needs. Patients without families would need even more “other help”. If the nurses are too busy, volunteers should be allowed to help. This includes people who offer to pray for the patient. I never saw any unfamiliar people doing this in the 3 weeks D.E.B. was in hospital, although I have seen them doing this in the past.
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Doreen was very OFTEN OFFERED PAIN-KILLER drugs, although she was basically at peace. A doctor in a youtube said that “life” and health may be supported at times with calcium, rather than drugs. But, he didn’t mention magnesium, although it is critical calcium and magnesium are in proper balance. In fact, magnesium has been called the natural pain-killer. I am of the impression that, since nurses are so busy, their system encourages them to give their patients pain-killing drugs at the slightest hint of any discomfort so that they can walk away without even asking what the discomfort is caused by. The arguments for alternative natural therapies rather than pharmaceutical drug therapies are generally well known to exist, so I needn’t go over them here. But, it seems to be time to create institutions based more, if not completely, on non-drug therapies. The pharmaceutical drug companies seem to have a tight grip on our hospitals at present. In fact, I am of the impression those drug companies have influenced the hospitals and druggists to omit calcium and magnesium from patients’ diets so that their pain-killers are substituted. The nurses seem convinced that the small amount of pain-killer they offered was entirely harmless, including to the liver. That may be relatively true for a basically strong, healthy person. But, I expect it is not true for a patient who drinks only small amounts of (liquid which can dilute it). And, when a patient has a delicate stomach, then taking drugs orally can risk causing them to vomit or choke. I had to convince a nurse not to administer them rectally as the alternative to orally. I told that nurse that, with D.E.B.’s hemorrhoids, when she was given a suppository, I’d heard her screaming.
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I was apparently GIVEN MIS-INFORMATION by Dr. Peadet, the palliative “care” doctor. She told me that the platelets of D.E.B.’s liver had a problem. The other doctors later assured me that there had been no such, or other, problem with D.E.B.’s liver. I think Dr. Peadet also told me that D.E.B.’s kidneys also seemed to be lacking proper functioning, (I think she said “both organ problems are likely due to damage from the congestive heart failure”). I believe D.E.B.’s kidneys later proved to be functioning just fine. So, was D.E.B. wrongly classified as “End of Life Palliative Care Patient” for these inaccurate reasons? A clear document, showing factual health details, should be given to the patients’ medical representative(s) regularly throughout the patient’s treatment. M. Crocket said a nurse told him in hospital that Doreen’s urine outflow would soon decrease to zero milliliters.
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FALSE PREDICTIONS WERE GIVEN by the doctor. I heard Dr. Readair being told in Emergency by Emily that Doreen had had “spirit visitors in her room, while Doreen was at home, who told Doreen she would soon be going to pass on”.
(see death and near-death accounts of visions, dreams and presentiments of death)ii
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The ambulance driver SPOKE OF D.E.B.’S EXPECTED DEATH WITHIN HER HEARING.
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Dr. Readair SPOKE ABOUT D.E.B.’S HEART “NOT WORKING AS WELL as in previous days”, IN D.E.B.’S PRESENCE. I responded that her heart rate had been recorded as normal. She then responded that that was “the way she had interpreted the data”, again within D.E.B.’s hearing.
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I told Sadie, the charge nurse for the 6 North floor, as well as Leslie, the social worker, that C. Ann had “grabbed a cup of water out of my hand and given me a stern lecture, telling me to get out of the room”. I have read that such an action is an assault. But, Sadie REFUSED TO “PROTECT ME by blocking C. Ann from being in D.E.B.’s room”, or “getting involved in the family dynamics”. Leslie left Friday afternoon, just after hearing my story, but said she’d return Monday, when we could continue our discussion. But, I heard no more from her. The Security Team later told me that they would remove anyone from the hospital who commits such an act as C. Ann did, (of grabbing the water cup , etc.), if they were notified. I suspect Leslie was instructed from “higher up” to avoid me.
The day following Doreen’s discharge from the hospital, I returned to the 6N phone at the hospital to try to contact Dr. Miran, etc. Bridgette, the charge nurse, questioned me as to why I was there. Later, Gina showed up with 3 Security Guards and, (saying that Bridgette had asked me to leave, which I denied), Gina then asked me to leave. The guards escorted me to the nearest exit, informing me that if I’m not a patient or visiting a patient, then I’m trespassing in the hospital.
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Sadie said she’d tried to contact the Geriatric Psychiatrist who’d tried to assess D.E.B.’s mental capacity, (Dr. Chase). Sadie said she’d get back to me with Dr. Chase’s response, but I have not heard from Sadie. The Fraser Health has a policy of NOT PROVIDING “RELEASES OF PATIENTS’ INFORMATION” to those who fill out a Request Form and Request it, UNTIL AFTER THE PATIENT HAS LEFT THE HOSPITAL. As in D.E.B.’s case, it could be critical to determine while the patient is Still In The Hospital whether that patient indeed has the mental capacity to determine important decisions for themselves, (such as whether it is time for them to return home or stay in the hospital), not to mention conducting important legal or financial transactions.
As it was, I’d asked Sadie to ask Dr. Chase if Dr. Chase would be willing to support my Committee of D.E.B. by signing an affidavit I provide.
I heard there was only one Geriatric psychiatrist, (or Dr.) in that hospital which could assess a patient’;s mental capacity. This helps deny the patient the second assessment required (by the Private Committee office), in order to get a Committee.
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One youtube emphasized the tragedy that can occur as a result of LONG, EXHAUSTING 12 HOUR SHIFTS of nurses. I’ve heard this also takes years off of these nurse’s lives. And, it disrupts their family life.
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We’ve all heard that HOSPITAL FOOD IS LOUSY.
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M. Crocket’s friends SAT AROUND DOREEN at the hospital, TALKING ABOUT FUNERALS.
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I heard that a few hours before Doreen passed on, she sounded like she was gurgling quite a bit, with congestion in her lungs. So, rather than turn her over, which had normally been done regularly, it was decided that it could cause her to cough, so SHE WAS NOT TURNED.
I think I heard that turning such a person with congested lungs is beneficial, as it helps to clear the lungs.
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M. Crocket made a big deal out of the type of thickener provided at the hospital for thickening water, etc. He said all 3 of its ingredients were poison. Its main ingredient was cornstarch, which was likely non-organic, and possibly GMO. I believe that twice M. CROCKET REMOVED NEARLY FULL CONTAINERS FROM THE HOSPITAL OF THEIR THICKENER, which was meant for the whole floor, rather than just Doreen. This left Doreen, and possibly others, with absolutely no thickener. The hospital required “that no liquid be given to Doreen unless it was thickened”, and she needed her liquid. This was reported to the nurse and charge nurse. They responded by ordering more from downstairs. But, rather than wait for that order to arrive, I bought a supply from the store. M. Crocket made a couple of stabs at providing alternate thickener for Doreen. Once he brought a bottle of agar agar, and he brought another bottle of a different thickener. But, his attempts were not consistent, and when she finished those bottles, I was left to rely on the hospital’s thickener again. C. Ann complained about the styrofoam cups D.E.B. was using, which the hospital provided.
I suggested that M. Crocket could bring a glass cup for Doreen and organic cornstarch as a substitute thickener. But, although he seemed to have plenty of time to accomplish this, it did not happen. The thickener was provided in order to make Doreen’s liquid easier to swallow, without choking.
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Dr. Readair called me and the others to a meeting, LEAVING DOREEN RELATIVELY UNATTENDED during the meeting. I left earlier than the others so I could get back to tending Doreen’s almost constant needs, which the nurses could not keep up with. During this meeting, Dr. Readair let C. Ann, M. Crocket, & Emily, (my competitors) know that I had reported Dr. Readair to the College of Physicians and Surgeons and that I had wanted to become Doreen’s Committee. This may well have contributed to M. Crocket’s interest in having D.E.B. return home, where he could regain his controlling position. Emily was one of Dr. Readair’s patients, as was D.E.B. when not in hospital. When there was a disagreement between me and M. Crocket, Dr. Readair relied on Emily’s decision. But, I don’t think Dr. Readair properly accounted for the influence on Emily’s decisions that M. Crocket had.
(24) (video: Chasing Zero Winning the War on Healthcare) iii
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C. Ann COUGHED occasionally IN D.E.B.’S CLOSE PRESENCE throughout D.E.B.’s hospital stay, making me wonder if she was exposing D.E.B. to a contagious disease. She also put her fingers in Doreen’s mouth.
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(Baroness Ilora Finlay reports that one in 32 of all deaths in Holland are from euthanasia and that 46% of the euthanasia cases are not reported.)iv
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If I’d played my cards right, knowing all that I now know, I expect I could have
(1) First, reported “M. Crocket’s threat to physically assault me, (while Doreen was still in Emergency), to Security”, and I expect they would have removed him from the hospital. This is not to mention M. Crocket’s threat to “Charge me, (legally)” he made in hospital. And
(2) Reported “C. Ann’s assault of me” to Security, and I expect they would have removed her from the hospital.
Did Sadie’s policy to “ignore getting involved with any family dynamics, (including assault)”, come from higher staff member(s), including Dr. Readair? In any case, there are obviously far more issues to address here than just family dynamics.
(28)
A couple is charged with failing to provide the necessities of life for their son.v But palliative care-givers & doctors are permitted to deny patients, or counsel care-givers and family to deny patients such necessities? Is this not “the norm” in palliative “Care”?
So, on one hand, I think I was basically told by the palliative care doctor that if a care-giver fed a patient or gave them a drink which the patient ended up choking and dying on, or had other complications from, then the care-giver could be charged with harming the patient.
On the other hand, if a care-giver can be charged with harming the patient as a result of denying the patient his or her necessities of life, how is a care-giver to know which activity is safest for the patient and the care-giver?
I think that a risk of the patient choking, & even dying may exist from being given food & drink by mouth, though less with a handy aspirator in the hands of a trained user.
But, I think the risk of death is higher when the patient is denied the basic necessity of fluid intake, not to mention food in the longer run. And so, any care-giver in their sincere attempt to give care by providing healthy food and/or healthy fluid by mouth, should be protected by law from negative consequences of the patient being harmed by choking or vomiting or the like, as a result of that eating or drinking. I think the following case indicates that is true.vi
(29)
July 6, ’16 I managed to hear back from the Patient Care Quality Office representative of Doreen’s hospital. That representative told me they could not do a formal investigation of the circumstances involved in Doreen Blake’s Story, because to do so they would need my co-executors’ permission to obtain, or allow that office to use, Doreen’s medical records. That office is willing to do “Feedback” though, which means that office will give the hospital members involved my perspective, but I will receive no feedback from them.
And, on June 27, ’16, I received the Final Response from the College of Physicians and Surgeons regarding Dr. Readair. But, all my concerns regarding her were not fully addressed. And, that College would not allow “further investigation by them with response regarding her”.
In any case, I am coming to the conclusion myself that Doreen’s Representation Agreement was misinterpreted by the doctor(s). Even if Doreen’s condition was considered terminal by them, and her Representation Agreement allowed for no “artificial feeding” under those circumstances, then it was no one’s proper place to thus deprive her.vii
Below are two decisions rendered under the Health Professionals Actviii, followed by a response to that decision:
HPA Judgment:
“2016-HPA-142(a) re: The College of Physicians and Surgeons of British Columbia Stage 1 hearing of an application for review of a complaint Inquiry Committee (IC) disposition under s. 50.6 HPA – disposition confirmed. The Complainant complained to the college about the Registrant concerning his refusal to assess her mother’s mental capacity so she could attempt to create a private committee for the care of her mother. Her mother had previously provided instructions for her care to her children holding powers of attorney. The Complainant disagreed with her siblings and wished to pursue more aggressive intervention to prolong her mother’s life. The IC investigated and concluded without criticism of the Registrant for declining to perform an assessment of the mother without the siblings’ knowledge. The Review Board noted that the evidence showed that the Complainant’s mother, who died at the age of 102, had very clear ideas on how she wanted to be treated in her final time and her express wishes were set out in a Representation Agreement. The Review Board found that the IC conducted an investigation that was appropriate for the facts in this case and as such the investigation was adequate. Further with respect to the disposition the Review Board concluded that the IC presented a history of the case that aligned with the evidence, provided a clear line of reasoning and reached a conclusion consistent with the facts and the law. It was a reasonable disposition. January 17, 2017 ( Posted February 3, 2017).
and
Stage 1 hearing of an application for review of an inquiry committee (IC) disposition under s.50.6 Health Professions Act (HPA) – disposition confirmed.
The Complainant alleged to the College that her 102-year-old mother had not been at the end of her life when she indicated her wish to be discharged from hospital to return home “to live”, and the Registrants did not comply with the mother’s wishes concerning end of life care in her Representation Agreement. Contrary to the medical opinions, the Complainant believed that her mother would recover if the Registrants had kept her in hospital. Following the College’s investigation, the IC concluded that the Registrants had each acted appropriately and that no regulatory criticism was warranted regarding the mother’s passing. The Record reflects that the College obtained the Registrants’ responses to the complaint and the Complainant’s responses to them, in addition to medical records from two hospitals, the community home health care agency and BC Ambulance. The Registrants and the other two Representatives agreed on the mother’s end of life condition. There was no evidence that the Representation Agreement was not valid. The Panel determined that the investigation was thorough, comprehensive and complete. The disposition clearly sets out the IC’s reasoning and draws a clear line between the evidence and their decision for each Registrant. The investigation was adequate and the disposition reasonable.
September 27, 2018 (Posted October 12, 2018)
Response to the above HPRB decision of Sept. 27, ’18.
I – Introduction
[1] CPS decision was Oct. 11, ’17.
[2] DEB’s Representation Agreement, (Rep. Agr.), says the representatives may act separately. There is no mechanism set out in the Representation Agreement for decision making in the event of a disagreement between the representatives. But, there should not need to be, since the law states that unless all representatives agree, then their opinion or wishes are ineffective. This however, does not give anyone, including doctors, the right to with-hold life-sustaining help from “a person without capacity”, despite whatever that person has written previously in an advance directive, within a Representation Agreement or not. If instead a person does have capacity, my understanding is they must go through an involved process of filling out multiple documents, etc., in order to purposefully end their life. However, since there is such a lack of education in the medical & legal professionals, it would be best to state within the Medical Representative Agreement exactly what is to occur if the representatives disagree.
[3] Even if DEB’s “advance directive” within her Rep. Agr. set out explicit direction for her end of life care, it was still “Just an Advance Directive”. And, even if in her advance directive she “assigned significant decision-making authority to her physician”, it was still “Just an Advance Directive” which can not over-ride a named medical representative, (which the doctor was NOT), in order to practice any system which did not support life. DEB’s Medical Representation Agreement even said her Medical Representative could allow medical treatments which she might herself refuse at the time they were available for use. This seems like the kind of contradiction within DEB’s Medical Representation Agreement that would make it conflicting enough for the judge of “Bentley vs. Maplewood” to determine, on that basis alone, that DEB’s advance directive gave no one the right to deprive her of life-saving measures. A doctor who is not a relative of their patient can not be a medical representative of their patient. None of DEB’s doctors were her relatives.
[4] DEB’s Medical Representatives disagreed with each other.
[5] Dr. Miran determined that, in the weeks prior to her death, DEB had entered into the end of life phase. Even if DEB had suddenly changed for the worse on her last day in hospital, (and her temperature was low then), certainly her medical records show she was NOT in an end of life phase.
[6] Lorne Borgal, of HPRB, argued that “Bentley vs. Maplewood, 2014 BCSC 165” did not provide the support which I believed it did.
[7] Lorne Borgal concludes that the College of Physicians & Surgeons, (CPS), Inquiry Committee conducted an adequate investigation & he confirmed their disposition. He said that the matters reviewed in this decision touch on many important aspects of, & considerations for, the natural end of life & for those who are left behind.
[8] Lorne Borgal offers sympathy.
II – Review Board
[9]
[10] Lorne Borgal determined this matter at stage one.
III – Background
[13] DEB’s Rep. Agreement “Expressed Wishes”, including re: coma.
[14] DEB said, “I want to go home to LIVE”.
[15] Dr. Chase, (psychiatrist), said DEB was too weak for a capacity assessment.
[16] On Jan. 6, ’16, Dr. Peadet found DEB unable to answer simple yes/no questions.
[17] On Jan.15, ’16, Dr. Chase found DEB too weak for assessment, though DEB repeatedly asked to go home.
[18] Dr. Miran assumed responsibility for DEB, noted Jan. 19, ’16.
[19] Dr. Miran stated DEB has no rehabilitation potential, etc. On Jan. 19, ’16, he confirmed his Jan. 13 statement that there was no treatment to prolong life that can be offered, and DEB had severe frailty, etc.
[20] The risk/legal department determined DEB’s Rep. Agr. was valid. DEB’s Family Dr. & doctors Miran, Peadet, & Chase were declared to state DEB is “at End of Life”, etc., on Jan. 19, ’16.
[21] I did not attend Jan. 19, ’16 meeting, but told Dr. Miran I believed DEB had rehabilitation potential.
[22] Dr. Miran found DEB at ease & looking comfortable Jan. 21, ’16. Dr. Miran said that DEB’s only discomfort occurred when the family gave her water on a spoon at her home. (I think this meant the coughing that occurred afterward). This contradicts Lorne Borgal’s statement that DEB was not being offered water on a spoon, & that she needed intravenous instead. Dr. Miran said giving liquids is unsafe.
[23] I called ambulance & Dr. Miran spoke to Dr. Dane .
[24] “Power of Attorney” is incorrectly referred to, rather than “legal (medical) representative”. I referred to decision-making when representatives disagree.
[25] CPS ruled the care of all the doctors was standard & appropriate.
[26] Since my siblings did not properly complete their sections of DEB’s Medical Representation Agreement forms, I questioned whether they could validly claim medical representative status.
[27] states I said the Frailty Scale score for DEB on Dec. 30, ’15 didn’t meet the test to be classed “terminally ill”. It didn’t mention that I found DEB’s medical records showed she did not meet any test for her to be classed as “terminally ill” before she left hospital.
[28] to [31] – Governance of Review Board.
[32] refers to a case law example which says that administrative tribunals do not have to consider & comment on every issue raised. But….
[33] But, is Lorne Borgal a tribunal?
[34] Lorne Borgal says it is not his role to untangle the legal issues related to these submissions. If not his, then whose?
[35] The Representation Agreement Act, (RAA) S. 16 (2) says, “When helping the adult make decisions, or making decisions on the adult’s behalf, a representative must (a) consult with the adult to determine their current wishes, (to the extent reasonable) & (b) comply with them if reasonable.” Aside from my opinion that killing people or oneself is not reasonable, it seems that the other part of the law, & the judge of “Bentley vs. Maplewood” over-rides this S. 16 (2) part of the law. In other words, if a patient is incapacitated, then they can not legally try to end their life, and neither can their representative. And, if an adult patient is not incapacitated, then they must go through a specific involved process to try to end their life legally. So, the law saying a representative must try to comply with the patient’s current reasonable wishes appears to be regarding more minor issues.
[36] Since RAA S. 16(3) says (a medical representative who can not determine a patient’s current wishes must comply with any “instructions or wishes the adult expressed while capable”), it must mean, “any (REASONABLE instructions or wishes) the adult expressed while capable”. Again, see [35] above, which shows the other part of the law over-rides “RAA S.16(3)” regarding ending life. Also, Doreen’s representation agreement stated that her representative was welcome to allow Doreen to be given treatments, even if Doreen refused them.
[37] Doreen’s expressed wishes allowing her doctor to determine her treatments, (at end of life), were over-ridden by Doreen’s expressed wishes allowing her medical representative to determine her treatments. Nevertheless, Doreen’s expressed wishes (that the doctor thought gave the doctor top authority) were misinterpreted by the doctor.
[38] It was reasonable to assume Doreen was not at end of life when there was no proof that she was, right up until (she died, with the aid of the medical team). Even though I was not given her medical records in a timely enough fashion to allow me to prove my point, when I did finally receive them after her death, the proof was apparent.
[39] Bentley was helpful, partly in showing that feeding with a spoon is essential personal care, rather than health care.
[40] Although Doreen set out her expressed wishes in one document, Doreen giving authority to her medical representative opposed, (but over-rode), the authority she gave “her doctor (in the case Doreen was in an end of life state)”.
[41] In addition to intravenous, Doreen was deciding to accept nourishment and liquid by opening her mouth on the day she left hospital, as well as afterward when she was at home.
[42] The whole of Doreen’s medical team was wrong in saying that Doreen was in an end of life phase on the day she left hospital. Her medical records show she was an “8” on the relevant scale. To be classed as “end of life”, she would have needed to be a “9”. Relevant documentation also shows that frailty is never to be considered a reason to determine a person is at end of life.
[43] I agree that the Representation Agreement is valid. I was indeed questioning the absence of a properly executed Certificate of Representative by each of the 2 siblings. I think it is a further complication that not only were such properly executed certificates absent, but improperly executed certificates were presented, which could be considered as “misrepresentation”. I have since learned from Nidus that a completed Certificate of Representative is no longer required by law. But it concerns me that Lorne Borgal seems unaware of that new ruling. Instead, he seems to have “found inconsequential the authority of all signed agreements & statements” by making out that (these certificates were “as good as witnessed” just because they “could have been witnessed”). Further, it is of great concern that the government has removed the important “protections against elder, etc. abuse”, (by removing the previous requirements), in order to make Representation Agreements available to more people.
[44] See [2] & [3], above. At first I was concerned that since all 3 of us medical representatives did not agree on DEB’s care, then that disqualified our representation entirely. So, I thought that may have given her care-takers, (her doctors), the right to choose others, (such as my 2 siblings) to become DEB’s alternate representatives. But, I learned the law does not give doctors that authority in respect of making decisions which do not support life. Bentley refers to “the laws”. Nidus defines the law as, “A doctor’s order does not constitute consent”. A representative can over-ride an advance directive of an incapacitated adult, including in DEB’s case. To direct toward or order or allow death, then ALL representatives must agree. Greyall J. judged Bentley & concluded, “5. Even if Margot was found incapable of making the decision to accept oral nutrition & hydration, I am not satisfied that the B.C. legislature intended to allow reference to previously expressed wishes or substitute decision makers to be relied on to refuse basic personal care that is necessary to preserve life”.
[48] Home Health provided records, but CPS didn’t release them to me.
[49] “A doctor’s order does not amount to consent”, says Nidus. An advance directive can NOT direct a decision to end life. All representatives must agree first. A doctor can not be a medical representative.
[50] The Representation Agreement does NOT bind the representatives to the wishes of the incapacitated Doreen regarding direction to cease life-supporting practice(s).
[51] I disagree with Lorne that the CPS investigation was adequate.
[52] Lorne says the reader should be able to understand the factual and legal foundation for the CPS Inquiry Committee’s conclusion. But there is no such proper legal foundation.
[53] I don’t agree that the CPS reached its conclusion consistent with the facts and the law.
[54] I believe I have given a reasonable challenge to the legal foundations of the decision of the CPS.
[55] I wasn’t ready to accept end of life for Doreen under the circumstances. And I have offered evidence to invalidate the Disposition.
[56] Lorne should not have confirmed the CPS decision, since it was not justified.
[58] Contrary to Lorne’s conclusion, the investigation of my complaint was not adequate, & the Disposition of the CPS was not reasonable.
Notes:
1. Italian baby raised on a vegan diet is hospitalized for severe malnutrition, removed from parents (Link) (Link)
2. I See Dead People: Dreams and Visions of the Dying | Dr. Christopher Kerr | At 4 minutes and 12 seconds TEDxBuffalo (Link).
Peter Fenwick on “Experiences surrounding near-death and dying” at 34 minutes and 52 seconds begins Peter Fenwick’s claim that Spirits in Visions can be negotiated with, although he seems to suggest there may be a limit to what may be allowed (Link).
Nurse Shares 30 Years Of Spiritual Experiences With Death & Dying: at 36 minutes & 49 seconds Becky tells about her brother who lived for a year after he saw his mother (Link).
3. CHASING ZERO…….. Chasing Zero Winning the War on Healthcare Harm (Link).
4. Care Not Killing – euthanasia interviews – a palliative care professor speaks (Link).
5. https://ca.news.yahoo.com/jury-deliberations-resume-case-alberta-couple-accused-childs-080012765.html (article unfortunately removed subsequent to Canadian law on internet content)
6. SUPREME COURT OF BRITISH COLUMBIA (Link).
7. this case indicates SPOON FEEDING IS not considered to be “health care”, [which includes artificial feeding], but is instead ESSENTIAL PERSONAL CARE) (Link).
8. 2017-HPA-158(a); 2017-HPA-159(a); 2017-HPA-160(a); 2017-HPA-161(a) re: The College of Physicians and Surgeons of British Columbia (Link).
(Group File 2017-HPA-G09) (Link).
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