Please add my name Paul
Mr Bill Bailey FRCS DA FFAEM
Clinical Director Emergency Care
Chesterfield Royal Hospital
----- Original Message -----
From: Howarth, Paul - RCHT <[log in to unmask]>
To: <[log in to unmask]>
Sent: Thursday, October 03, 2002 2:04 AM
Subject: An insult to A&E
> Dear All
>
> I know that this is not an acaedemic issue so forgive me if you think I am
> out of order in posting this to you.
>
> There was an editorial in yesterday's Telegraph which I believe undermines
> the integrity of all who work in A&E including paramedics who work so hard
> in the field to bring patients to us. My secretary has kindly typed the
> editorial out in full so that those of you who missed yesterday's paper
may
> have an opportunity of seeing it in full:
>
> Vampire powers
>
> The state sucking your blood is normally a metaphor applied to excessive
tax
> regimes. Now it's for real. As of yesterday, under the new Police Reform
> Act, doctors can take blood from incapacitated drivers without their
consent
> if asked to do so by the police. Doctors attending the scene of a car
crash
> may now be more interested in convicting you for drink-driving than trying
> to save your life.
>
> Even the doctors are worried. All that is needed to force blood from
> someone's veins is the untrained opinion of a policeman that a suspected
> drink-driver is either unconscious or incapable of fully understanding a
> request to take blood. The BMA is extremely concerned that the police
have
> received no guidance or training in how to assess capacity. It is
perfectly
> possible that an injured or shocked patient will express clear opposition
to
> having blood taken, albeit in an agitated way, and a policeman can use
that
> agitation to justify sticking a needle in his arm.
>
> There are some supposed safeguards. The blood sample can be tested only
at
> a later date, when the patient has given his consent. And the medical
> guidance for the procedure demands that collection of the blood samples
must
> not prejudice the proper care and treatment of the patient. But who can
> ever be sure that the seconds spent taking blood might not be better spent
> looking after a patient than trying to work out how much he's had to drink
> that evening? There can be no guarantee that there will never be a
conflict
> between the officious policeman, desperate for his phial of blood, and the
> ambulance driver who wants to get the patient to hospital.
>
> A doctor has, quite understandably, always been able to take a blood
sample
> without a patient's consent in order to do some good to him - say, to work
> out his blood group before a transfusion. It is putting doctors into a
> difficult position - and ptients into a possibly dangerous one - to allow
a
> procedure that could not only bring a criminal conviction, but also hinder
> medical attention. Hippocrates would not have been pleased.
>
> PAUL'S RESPONSE
>
> I am intending to send a letter of reply to the Editor for publication a
> copy of which is laid out below:
>
> If any of you feel the same way about this and wish to add your name to my
> letter please respond with your full name, position and any qualifications
> you may wish me to include.
>
> Sir,
>
> The suggestion that doctors attending the scene of a car crash may now be
> more interested in convicting you for drink-driving than trying to save
your
> life (editorial Oct.2) gravely underminds the integrity of doctors, nurses
> and paramedics in the front line specialties caring for victims of road
> traffic accidents. It has never been the case that the collection of
> forensic evidence of any description has taken precedence over the care of
> an injured person. The Police Reform Act now allows for a blood sample to
> be taken from a patient who is incapable of giving consent. Thereby
closing
> a loophole in the law which has in the past allowed drivers who have
caused
> accidents whilst under the influence of alcohol to escape conviction. It
is
> important that the collection of the blood sample is taken by a police
> surgeon in exactly the same way as it would from a person capable of
giving
> consent. This is essential in order that the Courts can rely on the
sample
> and to avoid any potential conflict of interest between the patient and
the
> emergency services caring for them. Doctors still have the right to
refuse
> the police surgeon access to the patient if they do indeed believe that
the
> circumstances would prejudice care and the public must understand that
this
> right will be exercised if the circumstances are appropriate. The
emergency
> services have always treated accident victims without discrimination and
to
> suggest that this might change prejudices the confidence that the public
> have in those who take great care in looking after them.
>
> Mr P A W Howarth MBBS FRCS FFAEM PGCE
> Consultant in Accident & Emergency Medicine
> Royal Cornwall Hospital, Truro
>
> Mr JP Wyatt MB ChB, B Med Sci, FRCS, FFAEM, MD
> Consultant in Accident & Emergency Medicine
> Royal Cornwall Hospital, Truro
>
>
>
> Obviously, if you disagree with me I would be happy to hear from you.
>
> Paul
>
>
>
>
>
>
>
>
>
>
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