Friday, 4 June 2010

NHS cuts

Cross posted from My Blog
"They're starting to get results, [health] Minister!"
"Time to restructure!"


The photo above is from a mug of tea I was drinking at work today. It made me laugh, but also got me thinking about the worrying prospect of NHS cuts in light of the public deficit following the global recession. Quite how our new coalition goverment will handle this I don't know, but my worry is it will impact adversely on Mental Health Services.

Why? Because in this day of public pressure groups and political maneuverings, it is the group of patients with mental health problems who lack a strong and unified voice. It probably stems from stigma, a case which is made worse by the aggressive shift towards community care during '80s conservative days, meaning society has been suddenly and unpreparedly exposed to a fear which they have no idea how to handle or integrate into society. It is a prime target for cuts.

There are very few advocates, people fighting for this vulnerable sector. But politically and socially, think of the huge burden of psychiatric illness: which 1 in 4 people will suffer from sometime in their life. Loss in earnings and taxes. Loss in confidence and stable homes. Worse and untreated physical health. Reduced life expectancy and huge socioeconomic inequalities widening. To not make this a priority, both within specialist services and in primary care when the bulk of illness is treated, would therefore be a huge mistake!

I pray the new goverment can make the correct decisions to cut excess and waste, and prune the health service to make it more efficient, effective, satisfying and above all accessible.

Saturday, 3 April 2010

"For El-ahrairah to Cry"

I wrote a note on my personal blog remembering the death of my son Theodore two years ago. In it I relate how this has affected my work as a physician. It can be found HERE.

Tuesday, 23 March 2010

For those interested, Franciscan University in Steubenville, Ohio has a number of bioethics courses available periodically. You can find the link here.

The next scheduled event is:

Ethical Issues in Suffering and DeathMarch 26-28, 2010



They also have available majors and programs available.

Wednesday, 27 January 2010

New Member

Welcome to Michael DePietro, MD to the Catholic Physicians' Blog. Mike, perhaps you can kick start this thing for us. Posting have been slow recently.

Sunday, 27 September 2009

Emergent Infant Baptism


I recently baptized an infant before he died, and the experience made me pull up some of the teachings of the Catholic Church on infant baptism to review in the event anyone questioned me on this incident.

First of all, I asked for the permission of the infant's father beforehand. I was blessed with the opportunity to speak with him shortly before it was obvious that the child would not survive.

The Catechism of the Catholic Church can be accessed online at this website. It has a search engine attached to it, so one can browse the whole document and dive into the text at will.

The Catechism of the Catholic Church(from here on referred to as CCC) discusses baptism in paragraphs 1213 to 1284. The word baptize comes from the Greek word baptizein, which means to "plunge" or "immerse"; the "plunge" into the water symbolizes the catechumen's burial into Christ's death, from which he rises up by resurrection with him, as "a new creature." (CCC 1214)

The CCC gives several examples of the prefigurement of the sacrament of Baptism found in the Old Testament. Noah and the Ark show life starting over after washing away sin, and the Israelites crossing the Red Sea prefigure the liberation from the slavery of sin through baptism. Later, the baptism is prefigured when the Israelites cross over the Jordan to enter the promised land; entering the promised land is symbolic of entry into Heaven. (CCC 1217-1222; they write it far better than I do)

I recall reading somewhere that St. John the Baptist, when he was baptizing in the River Jordan, was baptizing on the 'far' side of the river, so that those who were baptized had to cross back over the Jordan, just as the Israelites did in the Old Testament. This brings up the most important reason for baptism: Jesus Himself insisted on it before starting his ministry.

Baptism of infants is brought up in paragraphs 1250 to 1252, and the main sentences which motivated me are highlighted below. I saw a chance to bring this infant to become a child of God, and I did not think anyone would be able to get to the child before he died.

1250 Born with a fallen human nature and tainted by original sin, children also have need of the new birth in Baptism to be freed from the power of darkness and brought into the realm of the freedom of the children of God, to which all men are called. The sheer gratuitousness of the grace of salvation is particularly manifest in infant Baptism. The Church and the parents would deny a child the priceless grace of becoming a child of God were they not to confer Baptism shortly after birth.

1251 Christian parents will recognize that this practice also accords with their role as nurturers of the life that God has entrusted to them.

1252 The practice of infant Baptism is an immemorial tradition of the Church. There is explicit testimony to this practice from the second century on, and it is quite possible that, from the beginning of the apostolic preaching, when whole "households" received baptism, infants may also have been baptized.

How to Baptize:

There are two things needed for the sacrament: one is water to pour over the head(preferably) of the patient; the other is to say the words of baptism while pouring the water three times over the head of the patient. The words of baptism are:
"N., I baptize you in the name of the Father, and of the Son, and of the Holy Spirit."

When I realized that things were going downhill fast, I turned to one of the nurse anesthetists (CRNA) who was working with me, and asked her to get me some water from the scrub sink. She pointed to a small bowl of water on top of the anesthesia cart. "I got you covered, Doc," she said.

As a footnote, by some miracle, we were able to get this child back to his mother and father, and they were able to hold their son as he died. It was heartwrenching and difficult to talk to the young couple, but I did manage to tell them that their son had been baptized. The experience brought back a flood of memories of losing Theodore, and the desolation which accompanied that loss. The pained expression I saw on the face of this young couple reminded me of the way Carolyn looked after Theodore died.

Friday, 10 July 2009

"No Kill" Nursing Homes

I just discovered that the senator for our region of Pennsylvania, Lisa Boscola, co-sponsored a senate bill 404 that will legalize physician assisted suicide if it is eventually passed. What this will mean is that if grandma is diagnosed with "terminal cancer" and wishes to end her life, she can ask the kind family doctor for a prescription cocktail that will end her life.The Hippocratic Oath which I took in 1985 makes me promise to not give anyone something that would end their life, nor counsel them on how to do it. Most western cultures have prohibited suicide and have laws against it. Both Christian and Jewish theologians have understood suicide to be a grave moral evil. Now in our enlightened age, we are going to change the rules and say it's ok to kill grandma or grandpa. Giving a patient a prescription to end their life is no different than me (a physician) going to K Mart and buying a shotgun and shells, sawing off the barrel for convenience and leaving it at the doorstep of my suffering patient so they can end their life.Does anybody have a problem with this?I am the medical director of two nursing homes and oversee the care of over 200 frail elderly patients. I spend my day attempting to alleviate the pain and suffering that is often experienced in the end stages of life. It is not usually easy, but often labor intensive and emotionally draining at times. However, I view it as my privilege to be entrusted to care for the most vulnerable of our society and would want no other job. But is if this bill becomes law, some will view it as cheaper and more convenient to encourage patients to end their life. The value of a older suffering person's life will drop faster than the stock market as it has in the European countries that have embraced PAS and EuthanasiaI am thinking of asking the administrators of my nursing homes to designate them as "No Kill Nursing Homes" just as they do with dog shelters, so the patients can be assured that they will be cared for and not put out of their misery. How can the hand that heals also be the hand that kills? How will patients trust me?The fact that most people I have spoken to in the medical profession have no idea that this bill was proposed back in March is frightening. This is not unintentional. Will we be the next Oregon or Washington state?In the next several months I am hoping to organize some effort to educate those around us to Physician Assisted Suicide and hopefully, by the time the bill is put up for a vote, or a public referendum, the public should be well-informed of this evil. The trick is to get to the public before the well-oiled and funded euthanasia lobbying machine gets to our legislators. Let your senators and representatives know how you feel about this.If you wish to let SenatorLisa Boscola (Lehigh Valley Region) know about your feelings towards this bill and her co-sponsorship of it, email her at:boscola@pasenate.com