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Friday, 16 December 2016

Government to scrap 'bureaucratic nightmare' of Deprivation of Liberty Safeguard coroner inquests



The Government are to scrap 'bureaucratic nightmare' of Deprivation of Liberty Safeguard coroner inquests it has been announced.

Maybe I’m too close to this topic, and maybe I am wrong in my belief but I find that I am slightly skeptical of a recent decision to scrap Deprivation of Liberty Safeguard coroner inquests.

Coroners will no longer be required to carry out inquests for anyone who dies while under Deprivation of Liberty Safeguards (DoLS), under an amendment to the Policing and Crime Bill.

The Government has ruled that a person who dies while subject to a DoLS order will no longer be considered to have died in ‘state detention’ and, as such, will not be subject to an automatic coroner inquest if they die of natural causes.

Whilst we understand that families might not want to suffer all the heartache of a Coroner's Inquest into a long and extended wait for the cases to be heard and outcomes to be determined, this decision worries me when families do have concerns about the level of care prior to their loved one’s death, and whether justice might no longer to seen to be done. 

Crossbench peer Baroness Finlay of Llandaff, who strongly campaigned for the amendment, said she was “delighted” and that “it will save a great deal of distress to the bereaved. When someone subject to DoLS dies of natural causes and the death was expected, an inquest will no longer be required.”

Professor Martin Green, chief executive of Care England, added: “Care homes need to be a place of safety, but our members have reported uniformed police officers attending care homes under their legal duties to investigate a death of a resident making it a crime scene even when the death was expected.”

But sometimes, Care Homes are not a place of safety, and this could open up to the mistreatment of the amendment.

Sometimes closure of death of a loved one only comes in the knowledge that fears were justified and death was not inevitable had the right care been given at the right time. Despite the time, it takes, (and this is the one of the major concerns with the Coroners' Court and even the Coroner's themselves). It goes a little toward redressing all the unheard concerns expressed during the last days, weeks or months of their loved one’s care.

With current documentation on DNA/CPR forms showing only 33% of people signing, or their legal Guardians' signing, and agreeing they do not wish to be resuscitated, 67% of this decision are taken by health professional without consultation with people that might have MCA or their families, if they might feel otherwise, and legally able to insist they follow the wishes of their loved ones.

With so much lack of understanding to the Mental Capacity Act and DoLS by care staff and Social Care professionals, it worries me whether this decision opens the flood gates for a blanket system of writing off the lives of our frail and vulnerable people, without having to make anyone aware people they have choice. Consent to treatment is all, and that, regardless of a person’s wish to die, there remains a duty of care.

If somebody does not consent, you cannot do things to them. If they withhold consent, and that is informed consent and they have the capacity to make that decision, it must be respected but they must still get all other care.
And it is their choices and their involvement which determine their wishes to live on or not, not assumptions taken by heath professional, that could well lead to an unnecessary and untimely death of loved ones, with no way of comfort or redress?  

Also, making the point that many of our older population already fear going into hospital because they feel they may not come out, and families of people in care homes fear their concerns about staff care is being suppressed, does it mean if admitted or suffering from only a chest infection in the care home, there might be an element of care can ignore treatment?

It would be cruel to simply write off people's lives if someone perceived them as worthless and the documentation on the form says reason for DNA/CPR Dementia Frail and Vulnerable; since now we don't need to justify decisions with a Coroners' Inquest after their deaths, particularly in care homes?

I believe that further information is need to make sure that where families are not happy when their loved ones pass unexpectedly away, there is still a good opportunity to request a full Coroner's Inquest into their deaths.

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