Chris Whitty appeared in my fb feed today and made me wish he had been on the small screen every day since last Feb, sharing his knowledge, instead of having to leave the stage to (whoever). And that is not to say, I agree with the slogan 'protect the NHS. As another service user said the other day: The NHS should be protecting us - not the other way round. The NHS should not be starved of capacity - and by that mean more than bed numbers und Consultants. - AS for vaccination roll-out: Wouldn't the grown-up message to get to the public be: Get your information from reliable sources, weigh risk and benefit and then decide for yourself if you take it? At least that would be taking the wind out of the sails of trolling anti-vaxxers. .PS Personally, I won't for the time being, - not least because I herd PHE's Dr Ramsay publicly deny there was evidence for the risk in Pfizer's. allowing people with allergies in with the argument 'we are standing by in case you have an anaphylactic shock' is in my view an example for the NHS lacking mental capacity to care for people.
Verbal abuse and even threat of violence toward NHS-workers is, of course, appalling but unless you look at what may be happening in a wider context it's not going to be resolved. I humbly submit the following thoughts for consideration: There is a surface level and a systemic level to confrontations, just as wars can't be understood while you are in the trenches. Here: The frontline workers are target of the pent-up frustration, mostly unaware, of people who may not have the education to differentiate, - frustration with a system that has been dysfunctional through denial and mismanagement for many years. Mostly in plain sight so. Of course this is no justification for insults or worse. I am talking about analysing what is going on: E.g. one scandal after the other, many patients dying at least prematurely (Gosport).If a boil is not surgically treated, it may break open and, at worst, pus may sink in deeper ... In 2018 Jeremy , then Secretary of State for Health no less, acknowledged 'systemic issues' in the NHS. Only then, for all I know, to return to his desk the next morning as if that had nothing to do with him, or as if the acknowledgment was enough. A sticking plaster on a boil. . Now, that in itself is a systemic issue...
The other day, one of those quotes showed up in my fb feed that come round to help people keep their spirits up - especially during the pandemic. This one began with more attention is being given to relationships (than to possessions). Fine by me. Only then it went on and ended more or less saying, it's only our nearest and dearest and their wellbeing that matters. Hold on: When you know how it feels to worry about a loved one being or getting sick - doesn't your heart almost automatically go out to all those in the same situation? Or try the other way round: What often helps when anxious is - knowing that I am not alone. I can be physically alone, but I am not alone in this. - The heart reaches out, and then the mind goes on to find allies to do something, SOME thing to improve whatever concerns most about the situation. NOT wanting to do THAT could be called defeatism or - depression. To overcome that type of reaction may be the first step...
My previous post was the letter to the Journal of Medical Ethics as first designed. Before I was able to get it to the correct editor, this happened and a paragraph was added:
letter to the Journal of Medical Ethics (part of the BMJ) sent Jan 11, 2021:
(So far my initial comment...)
... after I found the video interview where Dr Mary Ramsey for PHE declares the safety of vaccines, I felt prompted to do a little research and - surprise, surprise: The first academic paper I found, from 2016, states that allergies to PEG will most likely be underdiagnosed. (I can provide that link from a fb post later if required; today a follow-up reference: https://www.researchgate.net/publication/303372103_Immediate-type_hypersensitivity_to_polyethylene_glycols_PEGs_a_review).
Would it be fair to say that, given Dr Ramsay's position she could or even should have known of these findings? If at least one of those points is answered in the affirmative, then we have here a situation where, I am inclined to argue, an overcoming of epistemic injustice is actively prevented. Trustworthiness of a public authority rests on credibility, and that, like 'following the science' means in my understanding weighing the evidence one can reasonably have access to - not denying it.
Upon seeing an article in a journal on Medical Ethics@BMJ, I felt compelled to write to the editor Dear Editor,
having scanned the article by Julian S, philosopher in Oxford no less, in your journal's edition from Nov 2020 as I became aware of it just now, I feel I need to comment: The mandate to prevent harm from others requires a reasonable amount of knowledge what the risk to self is. To use a narrative extract from an autoethnographic case study as example:
"... what those people who experienced serious reaction to the covid vaccine are believed to have reacted to is an emulsifier called PEG -polyethylenglycol which sounds harmless enough. I was tested for allergies comprehensively by a very thorough specialist in Ger in 1996 and that because of a series of very light reactions to at that point unknown substances (potentially skin creams). I dare to assert that in the UK where I have lived for 20 years and worked in multidisciplinary health settings the first thing people would know about such an allergy would be if they suffered an anaphylactic shock. Prior to that most people would only/at best have been prescribed cortisone. I believe here enters what M. Fricker, UK philosopher in NY, calls epistemic injustice inherent in a system of health inequalities as prevalent in the UK and an approach to behaviourism in clinical practice I politely call blinkered. ":
As a Social Care Consultant, I remain available for Consultation to assist clients' self management and professionals' training to that end.
My own lived experience stems from surviving persistent emotional abuse in childhood - with a deep sense of meaning. I have always believed that humans are intrinsically good and that we all have the innate resources to recover. Psychodrama with a truly client-centred coach brought this to the fore some 35 years ago. Since then, I have done considerable research into intuition and insight facilitating presence to self as a process - and, yet more importantly, as a social worker I have shown how this approach helped clients who were all but written-off by the typical mainstream services. The greatest praise: One such client said to me 'I can talk to you because you are not afraid.' The greatest challenge: The conscientious decision to see through a legal case for defamation after Whistleblowing in NHS Mental Health Safeguarding: 'Better a break in your career than in your spine.'
I look forward to hearing from you.
P.S. One key moment connecting insights was ca 2007 hearing Jacqui Dillon, now Dr. JD, say at a Conference: We are all on the spectrum of human experience.
Force feeding not in anorexia patient's best interests - UK Human Rights Blog, (Northamptonshire Healthcare NHS Foundation Trust v AB  EWCOP 40)
Force feeding not in anorexia patient's best interests - UK Human Rights...Patient suffering from extreme eating disorder found not to have capacity, but further gastro-nasal feeding was ...
One commentator on the Human Rights Blog argues the case had been about whether the patient had the mental capacity to decide against force-feeding..With respect, this kind of reducing matters to fine legal points in my eyes means removing substance and context from the case. Formally they may have been right. But what is Justice for if not decide real-life cases:The Trust would not have argued that the patient did not have capacity if it was not for the fact they, the Doctors, thought they knew what was best for the patient (in her best interest). It would be interesting to see whether the Judge did consider that these were Doctors who had been unable to treat the patient with any success for years, and if so in what light:. Commonly, under prevalent psychiatric concepts the patient is seen as the problem and as resisting therapy. Increasingly, and rightly in my view, survivors of such treatment who found other means to get better, argue that instead of asking 'what's wrong with you' - the question 'what happened to you' should be asked. In-depth psycho-social and cultural investigation would at least have the chance to enable the patient to see her stuckness as socially constructed.
While the Judgment may be preferred over the alternative in this case (which would have been to allow force-feeding) it seems to me, ultimately, the Judge may still have failed to address the causes and the context: The Trust, the doctors, in this case seem already far removed from thinking about the patient's best interest. Justice, perhaps with the help of expert witnesses, looking deeply at the reality of either application in this case might have contributed to reversing that, might have applied human wisdom:
The Doctors would not need to be force-fed, only encouraged to seek treatment options the patient could agree on. Since it can be assumed that they have the capacity to do so, it seems to be negligent not to do so. I do not know what if any psycho-social interventions were tried in the case at hand. However, I deduct from the fact that the Doctors (and the Trust) arrived the view they did (about force-feeding being in the patient's best interest) and also from my own experience working with Psychiatrists and other medically oriented mental health professionals: Where the investigation how to help a human in their care does not cast a wide net reaching all their life circumstances and human reasons for those, the ethical roots of do not reach deep enough to be nourished by the desire to truly support a valued independent life and vice versa.
I have met one exception - a young female Doctor who maintained a deeply human approach even while the system in which she worked did not give her any tools to apply it. She, of course, too ended up feeding a system that worked against her. deepest intentions.
I wished I was more optimistic about what ca can achieve. I attended one local once on social care and the facilitators chosen (by whom?) were clearly afraid to be open and honest about critical issues as perceived by service users. I saw one trembling as she had to take notes. She was an NHS employee, if I remember. Let's hope I am wrong.