Vincent Van Gogh. Self Portrait with Bandaged Ear, 1889. London, Courtauld Institute Gallery.

http://www.nationalgallery.org.uk/cgi-bin/WebObjects.dll/CollectionPublisher.woa/wa/artistBiography?artistID=301

This month the Mental Health Act (MHA) 2007 came into force in England and Wales. This Act, which amends the MHA 1983, is just the latest in a series of Acts of Parliament that form part of an on-going search for the fine balance between personal liberty and public safety.

http://www.dh.gov.uk/en/Healthcare/NationalServiceFrameworks/Mentalhealth/DH_078743

The language used in these various Acts, both in their naming and in the way in which the illnesses and disorders suffered by those falling within their remit are described and defined, is interesting. The Lunacy Act 1890 talks of “lunatics, idiots and persons of unsound mind”. The Mental Deficiency Act 1913 introduced safeguards to monitor what went on in what were then termed asylums. In 1959, with the introduction of the  first incarnation of the Mental Health Act, we see perhaps the first, modest, attempt to move away from the use of language that appears to blame and diminish those affected by the Act. more…

http://www.munch.museum.no/content.aspx?id=15

This week a leading national paper in the UK broke news  of what has been rightly called a medical scandal. They revealed the existence of a report into the systemic inadequacies of management systems at Birmingham Children’s Hospital. The impact of these failings on the standard of care provided by the hospital are now the subject of a further report, deemed necessary once the contents of the first report were made public.

http://www.guardian.co.uk/society/2008/nov/09/royal-college-surgeons-birmingham-childrens-hospital-scandal-report

The report was commissioned by the local Primary Care Trust (PCT) for whose patients the hospital provides care. Rather than being commissioned because  of identified negative impacts in terms of increased patient morbidity and mortality, the report is, instead, the result of the PCT’s response to a collective and anguished cry for help from the world class doctors at Birmingham Children’s Hospital and other local hospitals. No longer able or willing to stand by whilst their reasoned arguments about patient safety, duty of care, and the ethical imperatives inherent in their role as both care givers and patient advocates fell on deaf and ignorant ears, they looked elsewhere in the hope that reason and integrity would prevail.  more…

In a letter published today in The Times Newspaper a group of Medical Law and Ethics academics call for the UK’s Abortion Act to be modernised. Whilst I welcome this contribution to the on-going debate about the provision of abortion services in the UK, I am concerned by the focus on the suggested paternalistic role of doctors in restricting a woman’s access to abortion. 

more…

This week there was good news for patients in England with an age-related eye condition that leads to blindness. This week, long after a new and effective drug treatment for a relatively common condition called wet macular degeneration became commercially available, the National Institute for Health and Clinical Excellence (NICE) ruled that it should be made available to NHS patients in England.

It’s easy to have the impression that most recent rulings from NICE have been negative, in the sense of declaring a new treatment insufficiently cost-effective to merit provision by the tax-funded National Health Service. So this positive ruling- allowing access to effective drugs- is to be welcomed. Nevertheless I found something rather disturbing in the tone of the media coverage of this news story and therein lies a medical humanities perspective. more…