{"id":3059,"date":"2016-08-09T09:50:00","date_gmt":"2016-08-09T08:50:00","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-ethics\/?p=3059"},"modified":"2016-10-13T18:47:40","modified_gmt":"2016-10-13T17:47:40","slug":"an-accidental-expert","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-ethics\/2016\/08\/09\/an-accidental-expert\/","title":{"rendered":"An Accidental Expert"},"content":{"rendered":"

Guest Post by Derick Wade<\/em><\/strong><\/p>\n

Re:\u00a0Back to the Beside: Making\u00a0Clinical Decisions in Patients with Prolongued Unconsciousness<\/a><\/strong><\/p>\n

In 1994, not long after the Bland judgement, I was telephoned one day by the office of the Official Solicitor. \u201cWas I familiar with the vegetative state, and if so would I be prepared to see two people for them<\/em>?\u201d\u00a0 I could reasonably honestly answer that I was familiar<\/strong> with it \u2013 one sees people left unconscious long after brain injury in my line of work.\u00a0 I did not claim expertise, and nor was I asked.\u00a0 I said \u201cyes, to both questions<\/em>.\u201d and was sent relevant guidelines, and instructions.\u00a0 With practice I improved, and I wrote my first article on the matter with one of the Official Solicitors, published in the BMJ.\u00a0 I also saw one case who was definitely not<\/strong> vegetative (and two very well know experts had said that she was); the case has been written up with a ten year follow-up (not by me).<\/p>\n

In about 2000, having seen about fifteen or more cases for the Official Solicitor and various NHS hospitals, the next chance event occurred.\u00a0 Talking one evening with my family about my work, my elder daughter asked me what I thought about the ethics of withdrawing food and fluid.\u00a0 I replied something like \u201cWell, I have never really thought about it<\/em>.\u201d which horrified her, and surprised me (though research suggests that actually I am quite normal in that regard, as doctors usually consider matters clinically, not ethically).\u00a0 Anyway, I decided to research the issue and wrote another article, which was also published in the BMJ.\u00a0 Interestingly despite making several provocative statements, I only received one letter about it.<\/p>\n

<\/p>\n

I continued to see cases, both for legal proceedings, and also clinically to give an expert opinion and advice. This culminated in being one of three leaders developing the National Clinical Guideline on the management of people with a prolonged disorder of consciousness.<\/p>\n

Then about four years ago I came into contact with Polly Kitzinger and her sisters, especially Professors Jenny and Celia Kitzinger.\u00a0 Our first contact was not perfect, primarily because (as I learned from them) my clinical practice was not proper and I did not follow proper processes.\u00a0 Once the acute issue was settled, I met with three sisters to discuss events and what I could learn, and over two hours or so I learned much, and I hope that I have improved my practice since.<\/p>\n

More importantly we have developed a very good friendship and professional relationship and I have helped a little with work such as recruiting patients for their research, and helping with the absolutely excellent and award-winning healthtalkonline.org<\/a> website about prolonged disorders of consciousness. I now get to see many patients and families who are suffering delays and other problems.<\/p>\n

These experiences, and others have driven me to consider, research and write about the problems with the current clinical and legal processes and how they can be improved.\u00a0 This paper<\/a> arose from one particular case; a second paper I am writing also arose from this one case and the collaboration with Celia and Jenny Kitzinger.<\/p>\n","protected":false},"excerpt":{"rendered":"

Guest Post by Derick Wade Re:\u00a0Back to the Beside: Making\u00a0Clinical Decisions in Patients with Prolongued Unconsciousness In 1994, not long after the Bland judgement, I was telephoned one day by the office of the Official Solicitor. \u201cWas I familiar with the vegetative state, and if so would I be prepared to see two people for […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[968,2153,443],"tags":[],"class_list":["post-3059","post","type-post","status-publish","format-standard","hentry","category-clinical-ethics","category-guest-post","category-jme"],"yoast_head":"\nAn Accidental Expert - Journal of Medical Ethics blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2016\/08\/09\/an-accidental-expert\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"An Accidental Expert - Journal of Medical Ethics blog\" \/>\n<meta property=\"og:description\" content=\"Guest Post by Derick Wade Re:\u00a0Back to the Beside: Making\u00a0Clinical Decisions in Patients with Prolongued Unconsciousness In 1994, not long after the Bland judgement, I was telephoned one day by the office of the Official Solicitor. \u201cWas I familiar with the vegetative state, and if so would I be prepared to see two people for [...]Read More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/medical-ethics\/2016\/08\/09\/an-accidental-expert\/\" \/>\n<meta property=\"og:site_name\" content=\"Journal of Medical Ethics blog\" \/>\n<meta property=\"article:published_time\" content=\"2016-08-09T08:50:00+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2016-10-13T17:47:40+00:00\" \/>\n<meta name=\"author\" content=\"BMJ\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"BMJ\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"3 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2016\\\/08\\\/09\\\/an-accidental-expert\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2016\\\/08\\\/09\\\/an-accidental-expert\\\/\"},\"author\":{\"name\":\"BMJ\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#\\\/schema\\\/person\\\/ba3da426ed20e8f1d933ca367d8216fe\"},\"headline\":\"An Accidental Expert\",\"datePublished\":\"2016-08-09T08:50:00+00:00\",\"dateModified\":\"2016-10-13T17:47:40+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2016\\\/08\\\/09\\\/an-accidental-expert\\\/\"},\"wordCount\":524,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#organization\"},\"articleSection\":[\"clinical ethics\",\"Guest Post\",\"JME\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2016\\\/08\\\/09\\\/an-accidental-expert\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2016\\\/08\\\/09\\\/an-accidental-expert\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2016\\\/08\\\/09\\\/an-accidental-expert\\\/\",\"name\":\"An Accidental Expert - 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