Those who read this blog with any regularity will know by now that the regional government of the Comunidad de Madrid does not count with my approval. Perhaps some of you think that I am too hard on them, with my constant cheap jibes at the pauper president Esperanza Aguirre. Maybe so, but I have my reasons, and at least some of these reasons go beyond what might be considered as routine political bias; although that undoubtedly plays its part. Sometimes those in power do things which demand a strong response, because of the degree of venality that their actions or words reveal. In the case of Espe’s administration one of those issues has already been written about extensively by me, their attempts to promote the conspiracy theories surrounding the Madrid bombings. That those who govern the region where that atrocity took place should join a campaign to spread poisonous lies about it sticks in my throat. However, there is another issue which has not attracted so much attention, but which is equally revealing on the way in which these people go about their business.
The story concerns a hospital called Severo Ochoa in the town of Leganés, not far from Madrid. Until the year 2005 this hospital was probably unknown much outside of the area which it serves. In March that year an anonymous accusation was made that 15 doctors in the hospital had “killed” 400 patients as a result of their policy of sedation of terminally ill patients. A serious accusation, effectively claiming that doctors in the hospital were practising euthanasia on those who were admitted into their care. The case was referred by the health department of the Comunidad to the prosecution service of Madrid. So far it seems entirely proper that they should act in this way, a serious allegation is made and it gets investigated by the appropriate judicial authorities. One of the senior doctors involved, Luis Montes, was temporarily suspended from his position. Others were later removed from their positions.
After this things start to go badly wrong, the prosecution service found no case to present against the doctors involved. However, the villain of our piece and the politician in charge of the Madrid health service, Manuel Lamela, had already gone public claiming that 25 people had died in the hospital as a result of receiving “irregular sedation”. Faced with the prospect that the accusation was going to be shelved, Lamela set up a handpicked medical commission which then found no fewer than 73 alleged cases of medical malpractice in the hospital. Once again the prosecutors looked at the evidence and rejected any possibility of an offence being committed in 57 cases; the other 16 were open to doubt and the case was opened for judicial investigation. In the meantime most of the doctors in charge of the departments involved at Severo Ochoa had been removed from their posts. Finally, last week, the investigating magistrate lifted the cloud of suspicion hanging over Severo Ochoa. He found no evidence that the sedation applied by these doctors had been the cause of death of the patients, who were all very seriously ill and close to death.
It’s a difficult, and emotional, issue. If someone is admitted to hospital in tremendous pain and on the verge of death, the doctors have to make a judgement on the treatment to apply. The doctors in Leganés (and almost certainly in most other hospitals) were applying a policy of humane, palliative, sedation that has no sinister overtones. They were simply acting to reduce the agony of the last hours of patients who had reached the end of the road in that no other treatment options were available for them. Whilst it is possible that the application of such sedation can speed up the death of the patient, it also possible that it can delay it; the circumstances of each case are different.
Unfortunately, those who raced to condemn the doctors of Severo Ochoa were not interested in distinguishing between involuntary euthanasia and humane treatment for the dying; the whole case took on the aspect of a witch hunt led by Lamela who tried to drive through the result that he wanted to see. He was supported, perhaps not surprisingly, by those who have so enthusiastically done their best to turn the Madrid train bombings trial into a farce based around politically interested conspiracy theories. When you become a target of Federico Jimenez Losantos and friends, then you can be sure that you are almost certainly doing the right thing. The doctors in this case were called murderers by Losantos and company. Chief witch finder Lamela has not done badly out of the whole affair, following the recent elections he has been put in charge of transport for the region.
Those who are not doing so well are the doctors involved, who await reinstatement to their positions. It is worse than that, those who are now admitted to hospital in a condition that might previously have been considered worthy of palliative sedation are now much less likely to receive that treatment. Lamela and his band of supporters have succeeding in creating a climate of fear which means that doctors across the region are now unwilling to propose such treatment in case they get accused of being “murderers”. The morality those responsible employ reminds me of that used by the Catholic Church in the case of HIV sufferers; it doesn’t matter how many people die provided that the church’s teaching on contraception is upheld. They feel equally satisfied with the terminally ill dying in agony.
I have another post waiting to be written on the recent antics of the Spanish church, but for personal reasons I have to be in the UK for the next week and it will have to wait.
The story concerns a hospital called Severo Ochoa in the town of Leganés, not far from Madrid. Until the year 2005 this hospital was probably unknown much outside of the area which it serves. In March that year an anonymous accusation was made that 15 doctors in the hospital had “killed” 400 patients as a result of their policy of sedation of terminally ill patients. A serious accusation, effectively claiming that doctors in the hospital were practising euthanasia on those who were admitted into their care. The case was referred by the health department of the Comunidad to the prosecution service of Madrid. So far it seems entirely proper that they should act in this way, a serious allegation is made and it gets investigated by the appropriate judicial authorities. One of the senior doctors involved, Luis Montes, was temporarily suspended from his position. Others were later removed from their positions.
After this things start to go badly wrong, the prosecution service found no case to present against the doctors involved. However, the villain of our piece and the politician in charge of the Madrid health service, Manuel Lamela, had already gone public claiming that 25 people had died in the hospital as a result of receiving “irregular sedation”. Faced with the prospect that the accusation was going to be shelved, Lamela set up a handpicked medical commission which then found no fewer than 73 alleged cases of medical malpractice in the hospital. Once again the prosecutors looked at the evidence and rejected any possibility of an offence being committed in 57 cases; the other 16 were open to doubt and the case was opened for judicial investigation. In the meantime most of the doctors in charge of the departments involved at Severo Ochoa had been removed from their posts. Finally, last week, the investigating magistrate lifted the cloud of suspicion hanging over Severo Ochoa. He found no evidence that the sedation applied by these doctors had been the cause of death of the patients, who were all very seriously ill and close to death.
It’s a difficult, and emotional, issue. If someone is admitted to hospital in tremendous pain and on the verge of death, the doctors have to make a judgement on the treatment to apply. The doctors in Leganés (and almost certainly in most other hospitals) were applying a policy of humane, palliative, sedation that has no sinister overtones. They were simply acting to reduce the agony of the last hours of patients who had reached the end of the road in that no other treatment options were available for them. Whilst it is possible that the application of such sedation can speed up the death of the patient, it also possible that it can delay it; the circumstances of each case are different.
Unfortunately, those who raced to condemn the doctors of Severo Ochoa were not interested in distinguishing between involuntary euthanasia and humane treatment for the dying; the whole case took on the aspect of a witch hunt led by Lamela who tried to drive through the result that he wanted to see. He was supported, perhaps not surprisingly, by those who have so enthusiastically done their best to turn the Madrid train bombings trial into a farce based around politically interested conspiracy theories. When you become a target of Federico Jimenez Losantos and friends, then you can be sure that you are almost certainly doing the right thing. The doctors in this case were called murderers by Losantos and company. Chief witch finder Lamela has not done badly out of the whole affair, following the recent elections he has been put in charge of transport for the region.
Those who are not doing so well are the doctors involved, who await reinstatement to their positions. It is worse than that, those who are now admitted to hospital in a condition that might previously have been considered worthy of palliative sedation are now much less likely to receive that treatment. Lamela and his band of supporters have succeeding in creating a climate of fear which means that doctors across the region are now unwilling to propose such treatment in case they get accused of being “murderers”. The morality those responsible employ reminds me of that used by the Catholic Church in the case of HIV sufferers; it doesn’t matter how many people die provided that the church’s teaching on contraception is upheld. They feel equally satisfied with the terminally ill dying in agony.
I have another post waiting to be written on the recent antics of the Spanish church, but for personal reasons I have to be in the UK for the next week and it will have to wait.
1 comment:
Another excellent post.
"The doctors ... were applying a policy of humane, palliative, sedation that has no sinister overtones." - sad but true, these politicians care not for the reality of palliative medicine.
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