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SD

This is a scenario from an Ambulance forum and thought it was worthy of discussion here.

Scenario is you attend an address where you're met with a person who's takes an OD but is conscious. They hand you an Advanced Directive that appears genuine which states the person refuses any and all medical treatment. Paramedics turn out and whilst discussions are on going the person falls unconscious and medics refuse to step in and start treatment. What do you do?

A medic involved in a similar incident was threatened with arrest under the Suivide Act by a Sgt at the scene.

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Radman
2 minutes ago, SD said:

This is a scenario from an Ambulance forum and thought it was worthy of discussion here.

Scenario is you attend an address where you're met with a person who's takes an OD but is conscious. They hand you an Advanced Directive that appears genuine which states the person refuses any and all medical treatment. Paramedics turn out and whilst discussions are on going the person falls unconscious and medics refuse to step in and start treatment. What do you do?

A medic involved in a similar incident was threatened with arrest under the Suivide Act by a Sgt at the scene.

Save life and limb is a common law duty.

You treat the patient - we dont withdraw and let people get on with killing themselves.

"He wants to die and gave us a nice note telling us he doesnt want treatment so we'll leave him to it..."

If I was the Sergeant I likely would have done the same... What do we do when someone says they want to die and throw themselves infront of a train? We 136 them for their own safety and for an assessment.

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SD

Where does it say we have a common law duty to save life and limb. Often heard it never seen anything to support it.

What offence are you actually going to lock up for? Sec 2? It refers to doing an act, not failing to do one.

Also, even if you kept them alive till they got to A&E treatment wouldn't continue once the AD was disclosed. So all you've done is commit a load of criminal offences for which you've no defence. 

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chaos4122

Where does it say in the suicide act that's it's an offence to save a life when someone has attempted suicide?

Sent from my Moto G (4) using the Police Community App

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Sceptre

S25(3) Mental Capacity Act: An advance decision is not applicable to the treatment in question if at the material time P has capacity to give or refuse consent to it.

So if the paramedics believe the patient P has mental capacity then the document can be disregarded, and they should continue as per any cogent patient who refuses treatment. If not then there are criteria the document needs to meet to be a binding refusal of life-sustaining treatment but if the paramedics are satisfied it is up to scratch then who are the police to question it? Where there are doubts, from S26 a person does not incur liability for carrying out or continuing the treatment unless, at the time, he is satisfied that an advance decision exists which is valid and applicable to the treatment, and nothing in an apparent advance decision stops a person...providing life-sustaining treatment...while a decision as respects any relevant issue is sought from the court. 

This is not an easy pill to swallow but it's a medical scenario which the police frankly have no business getting involved in, far less contradicting people with a far better understanding of consent and capacity. Threatening to arrest a paramedic under the Suicide Act is beyond belief. 

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SD

Double post

Edited by SD

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Indiana Jones
9 minutes ago, Sceptre said:

Threatening to arrest a paramedic under the Suicide Act is beyond belief. 

I'd like to see what necessity criteria the sgt would have applied.

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SD
1 hour ago, chaos4122 said:

Where does it say in the suicide act that's it's an offence to save a life when someone has attempted suicide?

Sent from my Moto G (4) using the Police Community App
 

It doesn't. But the medics were refusing to treat them. Hence the threat. 

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chaos4122
It doesn't. But the medics were refusing to treat them. Hence the threat. 



Arghh... Apologies... RTFQ.... The threat of arrest was made due to the fact the paramedics refused treatment becouse of the advanced notice..

Got it...

Doesn't the paramedics first duty as well as a police officer is to preserve life?

Other than that, start filling out the form 97!

Sent from my Moto G (4) using the Police Community App

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SD
12 minutes ago, chaos4122 said:

 

 


Arghh... Apologies... RTFQ.... The threat of arrest was made due to the fact the paramedics refused treatment becouse of the advanced notice..

Got it...

Doesn't the paramedics first duty as well as a police officer is to preserve life?

Other than that, start filling out the form 97!

Sent from my Moto G (4) using the Police Community App
 

 

 

They've a duty alright but can't break the law to do so. 

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Burnie

A properly written Advanced Decision (ADRT) is a refusal of treatment. In order to be valid it must be witnessed by another person.

 

At the time of signing it the person to whom it relates MUST have mental capacity to make the decision and its purpose is to instruct responders what to do and what treatments the patient refuses for when the patient is either unable to communicate them or if the person no longer has capacity to make that decision.

 

Where an ADRT has been properly made it is LEGALLY BINDING.

 

To act against the ADRT would be assault.

Abiding by the instructions in an ADRT which state treatment is not to be given is NOT assisting a suicide.

 

The Sergeant was wrong.

 

The difference between an ADRT and an acutely suicidal person is that the suicidal person has made their decision to end their life at a time when their mental health is compromised and they do not have capacity. In an ADRT the person has capacity at the time at which they make the instruction not to provide life saving care.

 

This is the official NHS page on ADRTs

http://www.nhs.uk/Planners/end-of-life-care/Pages/advance-decision-to-refuse-treatment.aspx

 

"Deciding to refuse a treatment is not the same as asking someone to end your life or to help you end your life."

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BlueBob

In the practical world many/ most would attempt "first aid" or other treatment despite any scribbled note they are given, and consider the consequences later.  When we hear of how courts approach the cessation of treatment, their tendency is on continue to preserve life come hat may, even if it may be against a persons wishes.

having said that, we protect so many and such diverse personal rights, why not accept the one that allows a person to stop their life ,  but that leads us to assisted suicide which is a whole new post.

Edited by BlueBob

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Lone Wolf

At least the Sgt has got some great evidence for his Inspector's board.

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SD
On 18/05/2017 at 09:12, BlueBob said:

In the practical world many/ most would attempt "first aid" or other treatment despite any scribbled note they are given, and consider the consequences later.  When we hear of how courts approach the cessation of treatment, their tendency is on continue to preserve life come hat may, even if it may be against a persons wishes.

having said that, we protect so many and such diverse personal rights, why not accept the one that allows a person to stop their life ,  but that leads us to assisted suicide which is a whole new post.

What courts? I can think of only 1 where they forced treatment on someone with capacity to choose and they were under 18. 

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BlueBob
2 hours ago, SD said:

What courts? I can think of only 1 where they forced treatment on someone with capacity to choose and they were under 18. 

So the media reports of court decisions - high or Supreme Court presumably.   There have been quite a few where the decision had been to continue treatment.     The point was giving rather than withholding for most occasions would be the norm and would be seen that way by most.  We in the uk are fortunate to having the principle of Good Samaritan and I'd suggest that would be a fair result even if they held up a piece of paper at the roadside or as a result of a call most people might attend

ate you suggesting waving a bit of paper would be sufficient to have people step back?

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