16 July 2014
Personally, I prefer the Compassion in Dying
form (plus accompanying guidance notes) to the Alzheimer’s Society form. The main reason for this is that the triggering condition for the refusal (i.e. when the refusal is to become effective) is rather strange in the Alzheimer’s Society form. It’s when ‘the gravity of my condition/suffering is such that treatment seems to be causing distress beyond any possible benefit’. The goal of an ADRT is to refuse treatment which others would or might think is in your best interests (otherwise there’s little point – if everyone agrees the treatment is not in your best interests then it would not be lawful to give it under the Mental Capacity Act 2005). This triggering condition doesn’t seem to me to leave much (if any) scope for this. If the treatment causes distress beyond any possible benefit then it is hard to see how it could be given as it would not be in your best interests. The balancing of burdens against benefits is exactly what the courts (and the Mental Capacity Act Code of Practice) require in order to reach a decision on your best interests.
You can contrast this with the triggering conditions (there is a choice) in the Compassion in Dying form
, the most relevant one of which is: ‘I suffer serious impairment of the mind or brain with little or no prospect of recovery together with a physical need for life-sustaining treatment/interventions’. Here it is quite possible that different people will have different views on whether life-sustaining treatment is in your best interests as the ADRT will be triggered (in dementia patients) once their condition constitutes a serious impairment and there is little or no prospect of recovery. So the ADRT will have a role to play.
Compassion in Dying also have a free phone line you can call to get help in filling out the form; details are provided within the form as well as on their website.
NB: Compassion in Dying has a relationship
with Dignity in Dying. They are separate organisations but they work out of the same offices.
18 March 2010
From the Today programme this morning: “More than two thirds of primary care trusts in England are unable to say if or how they spent money allocated to them under the National Dementia Strategy for England. Jeremy Wright, Conservative MP for Rugby and Kenilworth who chairs the APPG [All-Party Parliamentary Group on Dementia], and Nigel Edwards, director of public policy at the NHS Confederation in England, debate the spending of dementia care funds.“
5 November 2009
Wednesday 18 November 2009
The Royal Society of Medicine, 1 Wimpole Street, London, W1G 0AE
Registration required in advance.
||Registration and tea
|Chair: Chair: Professor Peter Bartlett, Professor of Mental Health Law, Nottingham University
|| Is facilitated Self Harm “Actual” Harm?
||Ms Kerry Gutridge, Wellcome PhD Student, Bristol University
|| Palliative care dilemmas in dementia
||Dr Adrian Treloar, Lecturer in Psycho geriatrics, King’s College London
||Completion of evaluation forms
||End of meeting
||Members of the committee will be going for a meal at a local venue afterwards and delegates are welcome to join
29 June 2009
As recently reported in the BMJ, following the partially successful appeal by the pharmaceutical company Eisai in R (on the application of Eisai Limited) v National Institute for Health and Clinical Excellence  EWCA Civ 438, a further review process was instituted. As ordered by the Court of Appeal, Eisai was given a fully executable form of the economic model used by NICE for determining the drugs’ cost effectiveness. Both Eisai and the Alzheimer’s Society made further representations. Despite these, NICE has now reaffirmed its original guidance that the drug Aricept is not cost-effective for patients with mild Alzheimer’s Disease. Eisai and the Alzheimer’s Society may now appeal against this decision.