“I do not intervene, I am merely a politician.”

Northern Ireland Health Minister Michael McGimpsey is resisting media and political pressure on him to interfere with a clinical decision made in line with existing NHS guidelines. Needless to say, the self-styled “biggest show in the country” was involved again. I didn’t hear the whole discussion this morning [mp3 file], but I thought I’d remind the presenter concerned of his comments after a previous attempt to interfere with a clinical decision, in 2006, as transcribed at the time

“Decisions are made by doctors every day of every week. Within that decision making has to be the consideration of the probability of success. Ethical decisions have to made in medicine. We cannot have hosptials and doctors being bullied. Bullied by the media. Bullied by programmes like this when they do not think (the patient) has a good chance of life”

In this case, the restricted resources are not merely monetary. Adds From the Irish Times report

Gareth’s doctor Tony Tham said the Ulster Hospital again contacted King’s College Hospital yesterday but was told there could be no exceptions and its protocol could not be changed. “There are many patients of all ages waiting for liver transplants. Livers are a scarce resource and demand exceeds supply. Liver transplants in certain settings associated with alcohol are risky and have a poor outcome,” he said in a statement yesterday.

Update BBC report.

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  • Clown

    Pete, you do realise that McGimpsey isn’t in Sinn Fein, right?

  • abu nicola

    Proper call by the Minister. Compare this thread with the one “He also called a local solicitor…”
    Which Minister acted more correctly?

  • willis

    It might be worth seeing where that previous intervention ended.

    http://www.bebo.com/Profile.jsp?MemberId=4524649874

    The sad death of this toddler does not seem to have been reported on the BBC news website.

  • Pete Baker

    abu nicola

    Indeed.

    willis

    The decisions that have to be made are always difficult.

    That’s why there are ethical guidelines which need to followed.

    And why attempted populist campaigns by media figures are, usually, unwise.

  • willis

    Pete

    I couldn’t agree more. Doctors and legislators have to live with the consequences of their decisions. It would appear that media populists do not.

  • willis

    Pete

    However since this is the “biggest blog in the country” maybe we can expect a visit.

  • miss ftz

    To be absolutely fair to Stephen Nolan, it seemed to me that on this occasion he ws giving air time to a very distresse father. When he opened the show, he did say that he was not looking to score points or ‘go after’ the Health Service, rather he was looking for information on the clinical guidelines that would prevail in a case such as this.

    The father of the young fellow was very clear that he had gone out on a binge drinking session but that his liver was not able for it and he said on the sow today that his son hs 3 weeks to live. The dilemma in this case is that to qualify for a liver he has to be alcohol-free for 6 months, but he doesnt have long enough to live to prove he can go without alcohol.

    It’s not a clear cut case by any means, and I’d love to know who among us didnt go on a binge at that age? In this case, it’s a very high price to pay.

    I think its fair dues to the Nolan Show on this occasion for highlighting this particular case and indeed the broader issue of organ donation. We have a poor track record here of signing up for donation and if this highlights the need for increased awareness, so be it.

  • exile

    [i]I’d love to know who among us didnt go on a binge at that age?[/i]

    If one binge session was able to cause this much damage to the young man, to the extent that he has three weeks to live, then surely he must have some sort of underlying liver condition that would put him much higher on the priority list?

  • Pete Baker

    miss fitz

    That’s fair enough as far as it goes.

    But it would not be beyond reasonable to expect Nolan to have found out, or had his researchers find out for him, that specific information on the guidelines before broadcast.

  • willis

    Miss Fitz

    If it is the broader issue of Organ donation and indeed the reckless approach we currently have to binge drinking that are being addressed then all well and good.

    Maybe we have to give kids some “safe binge-drinking” guidelines.

    However I am not at all sure that the intention at the start of the show continued through to the end.

    Just a question

    Did Stephen lay into the Drinks industry?

  • Pete Baker

    exile

    From the BBC report

    Mr Anderson said that his son had a few “heavy weekends” but said that he did not seem to be partying any harder than other teenagers.

    But it’s irrelevant. The clinical decision is made by the medical staff based on all available information.

    It’s not an easy decision and it shouldn’t be so readily second-guessed by BBC presenters.

  • miss fitz

    Pete, I don’t know how much you listen to Nolan or understand the format. This appeared to be a case of a man who was desperate to do anything to savethe life of his son. He explained how he had gotten in touch with Peter Robinson’s son and asked him to contact the FM in America to explain the situation. He came across as a very genuine man who would do anything for his son.

    I see no fault in the Nolan show for running with the story and there was no suggestion from Stephen Nolan that there was fault lying with the authorities for the situation. I think it is a valid case to come to public attention, although it is unlikely that any changes will be countenanced.

    Exile, there had been no pre-existing conditions, from whatI gathered from the show. Given his extreme young age to develop end-stage liver disease, you wonder if it wouldn’t be worth saving his life. But the same kind of guidelines are in existence in most transplant regimes, so this is not an NHS story, per se. Organs are precious, rare commodoties, so there is sense is saying they should only go to those who can prove they can take good care of their bodies.
    On the other hand, my heart goes out to the family of thisvery young man who is paying a very high price for a weekend of heavy drinking.,

  • Peter Brown

    I listened to part of the show this morning and quite frankly I was incensed

    Nolan was his usual self – a father and other family members of a binge drinker were allowed airtime to try to steal a liver from a more deserving recipient with no questions asked about the consequences for the person to be deprived of the donor liver and their family. They presumably didn’t poison themselves and then try to deceive the public that it was a one off and a misguided accident.

    Nolan asked none of these necessary difficult questions as to why this individual warranted jumping the queue in front of the 20 other people in the same age group and 300+ other critically ill people awaiting a liver many of them not to blame for their own condition. The interview of the consultant at the Ulster made me cringe as he was emotionally blackmailed in an attempt to undermine principles for donor entitlement he clearly still supported…

    On my way to an appointment with a consultant’s appointment for one of my own children I take my hat off to the family for trying every possible means to save their son. Nothing excuses Nolan’s one sided crusade which fails to take into account those who would suffer if his self promoting campaign – people who the medical profession believes (with considerable justification in my opinion) are more deserving of help that the admiitedly unfortunate young man who was the centrepiece of this campaign.

    Most annoying moment – the giving of airtime to the muppet quoting the right to life under the Human Rights Act and claiming this was a death sentence with no reference to the unfortunate person who had waited for years for the organ he wanted to give to someone jumping the 300+ queue from the back to the front!

    Here endeth the rant for today….

  • willis

    “The interview of the consultant at the Ulster made me cringe as he was emotionally blackmailed in an attempt to undermine principles for donor entitlement he clearly still supported…”

    How can this be defended?

  • Pete Baker

    Miss Fitz

    I understand the format perfectly well.

    As I thought our previous experience in debating the Nolan Show’s attempted interference in clinical decisions demonstrated.

    But I cede the floor to Peter Brown’s eloquent ‘rant’.

  • DC

    Peter Brown how does Georgie Best rank in your list of others more deserving and in relation perhaps to someone like that or similar taking up a liver that could have been used on a younger person?

    Is this not another case of the Belfast Boy?

  • Comrade Stalin

    Agree with Peter Brown. I’m profoundly sorry about the situation this young man is in, but there would be a serious scandal if he got to jump the queue. The scandal would have been equally serious had the minister intervened.

    The real eye opener here is the lack of available donor organs and the fact that this leads to avoidable deaths. I don’t care that much for Nolan but the show this morning has made me think about registering as an organ donor.

    Total liver failure in someone this young surely must be rare. I guess that makes the story more noteworthy than someone with a longer term chronic alcohol problem.

  • boots

    this thread has difficulty posting to?

    Ethical dilema

  • miss fitz

    CS
    I dont think there was ever a suggestion he would jump the queue. The issue for the family appears to be the fact that to even get on the waiting list, he has to have proven he can be without alcohol for 6 months.
    It’s quite a dilemma really, because he was never given the chance to be alcohol-free and if he only has 3 weeks to live, he will never have the chance to demonstrate he can go 6 months without.

    I think a greater concern to me now is the fact that the family have decided to seek full publicity for the story while at the same time taking the decision not to tell the chap how ill he is. I am wild conscious that he is going to pick his story up on the web or in a paper and that would be devastating.
    Major moral mazes here.

  • willis

    Let’s look at another instance where contact with a particular food? can cause death to a small number of individuals. Nut Allergies.

    Many schools have gone out of their way to prevent this happening to their pupils.

    How rare is catastrophic liver failure? Could screening help?

  • Seceder

    Normal senational journalism of the Nolan show.

    I appreciate and understand the father’s position, I have kids and I’d do anything for them – but clinicians and policy makes have to take decisions outside the pressure of emotion and then stick by it.

    No matter how tragic this case is all cases of organ failure leading to death is tragic and no one ase can or should be views in isolation.

    The father has the right to campaign but the clinicians and the politicians have the right and th duty to maintain the set standards and criteria

  • Call me a cynic, but absent direct evidence I have a sense of the Mandy Rice-Davies about claims in respect of the amount consumed.

    Mr Anderson said he did not know how much his son had to drink over that weekend. “I don’t know. I wasn’t there. They had been out from Friday and didn’t come home until Sunday,” he said.

    He said Gareth started drinking at 16 but his alcohol intake was no different than other people his age.

    The amount 16 years and up consume in the UK/NI/Republic being easily demonstrated by CCTV any weekend night. I hope he’s the exception.

    This young fella is paying and will likely pay a mighty high price, more than some would say is right, but there wouldn’t be anything like the sympathy if he’d fallen off a bridge or wrapped a car round a pole. It is that he didn’t die immediately, and now will suffer in the full gaze of the media and the prism that brings to moral judgements and the need to Do Something while those on the waiting list suffer out of the public eye.

    Lucky for McGimpsey he’s not a DUPer – otherwise the chat might be that his straight bat on his duty as a Minister would be portrayed as a puritan streak/God’s Judgement/etc. (and might be correct too)