Human Rights

well a warm welcome to this talk it's Monday the 8th of July now I want to bring you some of the concluding statements from the Scottish Co inquiry now this has been an excellent people's inquiry as far as I know the Scottish inquiry is the only one in the world to look at ordinary people's experience it really is a first class people's inquiry sort of groundup inquiry not politicians and not uh not governments refusing to have an inquiry at all and Scotland many aspects of what happened in Scotland in the pandemic don't come out well but we're not sort of uh going down on Scotland here because we believe well we don't know but this is likely to have happened in other places it's just that Scotland's had the guts to highlight it and talk about it now the particular mention of the Human Rights Act this is the UK version I've got here Human Rights Act 1998 and this is pretty hard-hitting stuff they're talking about potentially um contradiction of article two the Human Rights Act everyone's right to life shall be protected by law so we're actually talking about protection of life here no one shall be deprived of his life intentionally Sav in the execution of a sentence of a court following his conviction of a crime for which the penalty is provided by law and we don't have the death penalty in the United Kingdom and they're also talking about potential um contradiction of article three of the Human Rights Act which is prohibition of torture now this this is really quite uh quite extreme uh stuff they're talking about here no one shall be subject to torture or inhumane or degrading treatment or punishment now as You' expect it it identifies that the mortality rates were highest in the elderly and the frail but these people often weren't protected vulnerable people often weren't properly protected and there was an awful lot of excess deaths in Care Homes and there's a whole massive qualitative research here that researchers could be getting meaningful information out for years to come if they choose to look this inquire is not being covered by mainstream media um hardly at all I don't think I've ever seen anything in mainstream media about it uh it's not actually being covered that well on social media which of course is why we're covering it um now the inquiry is uh quite long there's a lot of uh long uh speeches and things in it rightly so to cover a lot of the detail and a lot of long witness statements so uh Dave independent research has actually put us together a very concise 10-minute clip which I'm going to play you in a minute so thanks for that Dave I know you spent many hours looking through this material um but but you've got some a good stuff to come out uh isolation is talked about had many knock on effects and Care Homes were isolated for longer they do not attempt resuscitation do not attempt cardiopulmonary resuscitation as we've said this is so often in interpreted Way Beyond just a restriction on cardiopulmonary resuscitation it means the care has changed to pallative very often it shouldn't but in practice it often does and of course we're talking about end of life medications as well how many lives were cut short by failing to provide a simple intervention such as oxygen or antibiotics how many lives were cut short by over intervention morphine and M mazalan we really need answers to this question if Scotland can lead the way and show other countries a methodology they could use to find out the same critical material that would be a noble thing for Scotland to do um the withdrawal of clinical care from from Care Homes ambulances refusing to attend Hospital doctors refusing to admit what is this what was what was happening the isolation I mean this time in 2020 um my my dad was actually in hospital for a couple of months during his last illness and um of course no one could is it and um um I don't think you understood I don't think you understood um and this has been common this has been commonly reported in the Scottish uh inquiry um effectively cut off from hospital care neglect um weakest and most vulnerable most affected you know what is a civilized society as I we said many times you can define a civilized society by how it protects its weakest members how do we protect children how do we protect the the people yet unborn how do we protect people when they're in a vulnerable phase of the life heck you or me could have an accident today and be being completely dependent on other people you know we want the reassurance that we're going to be protected old people not even that old sometimes weren't fully protected it would appear listen to the the summaries yourself and see what you think don't let me influence you and the blanket approach this this is May this is maybe the key thing there was a blanket approach DNA CPR do not attempt card resuscitation end of life protocols everyone the same it's the antithesis of healthcare Healthcare is individualized assessment planning implementation and evaluation this blanket approach and they compared that the blanket approach the converse of that would have been a human rights approach so links in the description as always uh do do give this video 10 minutes well worth it really quite hard-hitting stuff and um I'll probably see you at the end Dr Donald Masco CEO of Scottish care gave evidence about the impact isolation and social distancing had on residents particularly those with dementia for whom routine and physical touch is so important Alzheimer Scotland and others also spoke of cognitive decline that those with dementia experienced during the pandemic turning to consider the impacts of withdrawal of healthcare services from Care Homes Scottish care has provided evidence of the sense of clinical abandonment experienced by staff when GPS and other health professionals ceased to visit Care Homes social care providers have also given evidence about the impact of the lack of physical assessment had on residents as a result of primary health carees services transferring to telephone appointments guidance issued by the Scottish government also created an impression that there was a blanket ban on residents who were covid positive being transferred to hospital which persisted even after the guidance was clarified Witnesses have spoken of ambulance refusing to take care home residents to hospital care homes unlike nursing homes are not designed to provide clinical care it submitted that it was foreseeable that withdrawal of healthcare services for residents would increased pressure in staff and lead to deterioration in the health of residents the impact of the response to the pandemic on those who had loved ones in Care Homes and those who worked there was profound each individual who's given evidence to the inquiry recounted their own personal story but what is striking is the commonality of their experiences and the foreseeability of many of these outcomes the inquiry heard some witnesses speak of concerns around the apparent misuse of do not attempt CPR notices this directly engages Article 2 of the European convention and is a matter of grave concern in addition although in a pandemic some excess deaths are to be anticipated what was not anticipated and what was not inevitable were the sheer numbers of EX deaths in Care Homes the inquiries heard about conditions in some of the Care Homes Witnesses described the neglect of residents and their environment the inquiries heard concerns about the lack of basic hygiene issues around food safety residents being injured as a result of being left unattended well of course it is understood that there were pressures on Care Home providers resulting from the pandemic including Staffing in our submission the extent of the deterioration of conditions may have breached the article 3 rights of residents no less serious than these Article 2 and article 3 issues was the impact of the lockdown and the accompanying visiting bans and restrictions residents were suddenly cut off from family and friends who play an integral part in their care the effect particularly on those with dementia of this isolation as well as the removal of their personal items cannot be overstated the approach to lockdown was nothing short of a callous disregard of people's right to Family Life the impact on residents mental health and physical well-being was devastating the unilateral nature of the relationship was emphasized when Care Homes sought to admit residents to hospital staff would phone ambulances who would refuse to convey residents those who were taken to hospital found that Consultants refused to admit them because they had come from a care home the inquiry has committed to taking a human rights based approach the refusal of hospital treatment for care home residents is a stark example of the denial of what should be fundamental rights in any modern society turning to DNA CPR requests which are a normal part of Care Home practice during the pandemic the perception was that there was a push from the NHS to get more of these decisions in place concerns were raised that conversations between GPS residents and residents families were not happening restricted visiting caused stress and tension between residents family members and staff with the latter placed into enforcing roles which they had no prior experience of it is an issue which could have been minimize with a better approach to the relaxation of rules and Care Homes when they were relaxed for the rest of society there was poor communication or a complete lack of communication with family members in relation to the treatment for and the well-being of individuals in hospitals this was particularly keenly felt in relation to the use of the do not um attempt CPR notices in his submission yesterday Mr Gail said that this is an area that will be subject to thorough investigation the SCB are concerned that the DNA CPR decisions were made on flimsy and irrelevant clinical information in some instances we understand our members were concerned that their relatives didn't have the capacity to make such decisions especially when they were denied the opportunity to discuss matters with them it should not have come a surprise to our politicians that when problems arise in society it is the weakest and the most vulnerable who are the most likely to be badly affected it is submitted that those in hospitals or Care Homes clearly fall Within These categories yet time and time again the inquiry was presented with evidence which made it clear there had been no special consideration given to vulnerable groups as a and this was perhaps most vividly Illustrated when it came to the end of Life Care there appeared to have been a blanket approach taken towards many Elderly Care home residents rather than a human rights-based approach in some cases especially within Care Homes many had reached a point where quality of life was more important than duration whilst lockdown was initially understandable as an effort to keep these vulnerable individual safe as time went on other fundamental rights became equally as important the inquiry has ear evidence that dying residents were not given the end of life care that they would normally have received and in some cases that appear to be the focus on providing end of life medication to Residents in respect impact it's submitted that the evidence has demonstrated a clear overarching impact on those residents and Care Homes the restrictions imposed on them during the covid-19 pandemic reduced their quality of life and their Dignity of Life the restrictions affected them in many different ways and to different extents but overall it's clear that care home residents are one of the groups of society that were disproportionately impacted by the restriction the right to contact and socialization with loved ones and to engage in wider Society is one of the most fundamental human needs its denial and isolation is a most extreme form of punishment all car home residents young and old have a right to have these rights respected however there were excessive and prolonged periods where significant restrictions were placed on visits and their ability to socialize out with their their homes which impacted on their health and well-being as well as infringing their human rights there was little apparent balancing of risk that the impact of such severe restrictions and isolation could have on people particularly those with conditions such as Dementia in this respect it's vital to remember the impact of the many who died not of Co but alone and craving cont contct from the loved ones the denial of contact had a devastating effect the inquiries heard many harrowing tales of the ways in which basic and essential contact with loved ones was denied and the impact this had on residents and their families in many instances residents quite simply did not understand what was happening to them Kathy Russell's mother and Jullian Duncan's father both asked whether they were in prison veruna Gibson's daughter said she felt like a prisoner the mortality rate from covid infection is very age dependent and higher if the person is frailer and has complex comorbidities people aged over 65 made up 87.9% of total deaths from from covid-19 during that period and tragically almost 100% of deaths in Care Homes a number of witnesses spoke of the adverse fact that the period of complete isolation had on the resident in terms of both of their physical and mental well-being lockdown affected many older people's ability to undertake activities such as regular exercise social interaction and a sense of purpose and the longer term impact is likely to be negative for their physical and mental health restrictions eased in many settings but were slower to relax for those living in Care Homes social isolation is harmful to care home residents and can result in low mood or cognitive functional decline we were restrictive for a lot of the pandemic for reasons that at the time I that being Dr Burns supported but on reflection and feedback from Members I consider that these restrictions were too prolonged a specific issue that emerg in the evidence was the prevalence of DNA CPR notices we will look in more detail at this given that it is specifically referred to in our terms of reference to I however a number of witnesses complained that DNA CPR notices were placed on their relatives notes without an appropriate level of consultation and as I said many uh more hours of material there it's all on the on the website in the public domain so thanks today for putting that clip together it does summarize some of the some of the key points of course there are there are many um good to see that some further investigation does seem to be going on into the do not resuscitate attempt resuscitation orders let's hope there's equal investigations into the use uh overuse abuse whatever of maalam and morphine as end of life medications in my experience old people are are exquisitly sensitive to these drugs or vulnerable people or people that are already ill um a dose of morphine that might be fine for a younger fit person can be um uh life ending in in an order more vulnerable metabolically less active person was this always taken into account lessons to learn for All healthc Care Providers nurses doctors pharmacists everyone um lessons to be learned for society as a whole and let's move on to protecting the vulnerable the people that we've lost have lost but we can learn lessons for the future and relatives need uh transparency let me know what you think but for now as always thank you for watching

Channel: Dr. John Campbell

Views: 178,678

Keywords: physiology, nursing, NCLEX, health, disease, biology, medicine, nurse education, medical education, pathophysiology, campbell, human biology, human body

Id: NCteHX7jxyg

Length: 18min 26sec (1106 seconds)

Published: Mon Jul 08 2024