Death becomes her

As a locum GP I think I am getting better at spotting money making opportunities when they turn up. I note that the public seems to be changing its opinion on assisted suicide, or active euthanasia to give it its proper term. No doubt this will eventually be made law as politicians have an annoying habit of passing populist laws based on opinion rather than fact or worst still hiring experts and then firing when they don’t agree with them. It does seem a curious vote winner but we live in curious times I guess.

Anyway, back to my first point, how can you (or the NHS) make money out of assisted suicide? It seems clear that this will eventually become law so I suggest brushing up on ways to kill your patients. No doubt the Shipman Guidelines will need to be drawn up to decide what drugs are best at bumping patients off. I’ll hazard a guess and say that not every doctor is entirely keen on the idea of euthanasia or variants of it. Well, its no time to be displaying a backbone or relying on your moral guidance.

As a large number of doctors will not want to take part in the selective reduction of vulnerable patients it could mean a big cash bonus for those of willing to wield the scythe. I’m sure you can think of a number of your elderly patients who don’t want to be seen as a burden or make a fuss, well now you could finally have the opportunity to help them shuffle off this mortal coil. You no longer have to worry about such trivialities as palliative care and all those fiddly drugs. A quick consent form, needle in the arm or pills in a cup and hey presto, one assisted suicide cash bonus and perhaps even a cremation form fee if you are lucky.

Its only a matter of time before it becomes part of the QOF targets. Just think of all the money it could save the NHS! ICU bed numbers could be slashed, hospices could close and we’d have another treatment option for our severely depressed or heartsink patients. Hopefully the money saved will be reinvested in other areas of the NHS but don’t hold your breath. The Government is pretty short of cash at the moment and needs every penny.

If you became a Specialist in Regulated Euthanasia Assisting the Passage to Everlasting Rest (R.E.A.P.E.R) you can forget about the need for basic life support skills (unless you ‘assist’ the wrong patient!). I would expect that it would be unlikely the patient complains but its possible that the family might if their dear relative didn’t die peacefully or if you declined to ‘assist’ their granny who lives in mansion that’s far too big for her.

Seems like a win-win situation to me, what could possibly go wrong?

To jab or not to jab?

A patient came to see me the other week and asked me about the swine flu jab for her children. Should she get her children vaccinated?

She had two healthy children under five with no pre-existing illnesses. The media had helpfully pointed out that the children who had died from swine flu had pre-existing illnesses, although rather more unhelpfully no one was saying what these illnesses were.

Being a locum, I thought I had missed the official information to give to parents about the jab. I checked in with Dr Google but couldn’t find a thing. A few papers here and there, but nothing that had meaningful numbers in it. I was surprised as there is a wealth of very good information for parents about other vaccines but nothing that I could find for swine flu.

Eventually she decided that she wasn’t going to bother as she thought it was all rubbish. Not exactly the informed choice I was hoping for, but it’s her choice nonetheless.

Then the invite came through for our children, I was faced with the same choice: to jab or not to jab? I won’t bore you with medical papers that I read to see if was really necessary to vaccinate an otherwise healthy child for a mild illness (in most) that she may have already had or may not even catch.
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But what I wasn’t prepared for was the amount of hand wringing and floor pacing about the decision to potentially stick a needle in my child’s arm. Previously the wife had taken the children to their jabs so she had to endure the sight of a needle piercing their flesh, the looks of betrayal on their cherub-like faces and the inevitable ear piercing shriek that followed.

The daughter was sick the other day, and three weeks later she is still harping on about how she puked – God knows who taught her that word. Would I be prepared for her constant whining about how Daddy let the nurse hurt her and the years of counselling she would no doubt need afterwards? Not to mention the fact that it’s not nice to see your child in pain. Would I get emotional? I couldn’t blame it on the hayfever as it was winter. Perhaps blaming the dusty environment might help.

It made me realise that what we might regard as trivial – a quick jab, or a blood test - can be very upsetting for the child and parent and that might discourage them from attending or going along with the management plan. How do you explain to a 3-year-old what is about to happen? It's no wonder children bawl their eyes out when they attend the doctors.

I’ve asked colleagues and friends about the swine flu jab and it's been more or less a 50:50 split over whether their children have had it or not. The uptake is poor in the otherwise healthy, which has got me wondering whether it was worth offering in the first place?

The government wasted million on Tamiflu, which was largely useless. Have they done the same for the swine flu vaccine?