Fully informed consent: NHS Scotland

This post is based on the following Scottish Parliamentary debate which took place on the 5th December 2017. In this post I have highlighted cross-party considerations relating to fully informed consent. One of the aims of the original petition, Polypropylene Mesh Medical Devices, PE1517 was to call on the Scottish Parliament to urge the Scottish Government to:

“introduce fully informed consent with uniformity throughout Scotland’s Health Boards”.

Johann Lamont, MSP, stated:

Johann Lamont went on to state:


Jackson Carlaw, MSP made the comparison between this Mesh scandal and that of Thalidomide, a prescribed medication:

Jackson Carlaw, cited Brenda O’Hara, MP who like Johann Lamont expressed determination that this should never be allowed to happen again:

Neil Findlay, MSP, has steadfastly supported the Mesh survivors from the outset. He began by expressing very serious concerns about financial conflicts of interest and the medical profession:Neil Findlay, MSP, continued:Currently there is no regulatory requirement for healthcare workers to declare financial interests. In NHS Scotland there exists Guidance (HDL62) but this guidance is being routinely ignored by NHS Boards. This was why I raised petition PE1493, A Sunshine Act for Scotland.

This was the first point raised by the former Health Secretary, Alex Neil, MSP:

The Scottish Public share this view. This was established almost two years ago through a public consultation undertaken by the Scottish Health Council.

An open-access, central register where all healthcare workers are required to declare financial interests would provide a fuller basis for informed consent.

The Scottish public agree with David Torrance, MSP.  There is longstanding evidence that exposure to industry promotional activity can lead to doctors recommending worse treatments for patients.

Michelle Ballantyne, MSP has come to this conclusion:

The evidence gathered for PE1493  (A Sunshine Act for Scotland) came to the same conclusion.

Anas Sarwar, MSP, gave one of the closing speeches and stated that:


SUMMARY:

The Mesh survivors were deprived of fully informed consent and as a result dreadful harm resulted.

This  parliamentary debate demonstrates that there is full cross-party agreement that, in order to prevent future harm, action has to be taken to ensure that consent is fully informed.

Without transparency of financial conflicts of interests, fully informed consent cannot be ensured. The Scottish public came to this conclusion almost two years ago in a consultation arranged by the Scottish Government.

 

6 Replies to “Fully informed consent: NHS Scotland”

  1. I always feel very emotional when I listen to the women harmed by this particular procedure. In particular their pain and suffering was initially dismissed and even deemed psychological. I hear the same from the teenage girl harmed by the HPV vaccine. This seems to be a common and presumably deliberate strategy on the part of clinicians for it seems to happen too often. I note that “tens of thousands of women around the world are living with chronic physical and mental pain and a lifetime of hopes and dreams lost, and are forced to struggle against the might of the medical establishment … ” Of course those of us whose health has been irreparably damaged by drugs of dependence find that we too are forced to enter the same struggle with Governments, drug companies and the medical establishment, played out in the consulting room with the individual prescribing doctor. We did not have a single procedure so it is slightly different, the damage done to us was played out over many years and even decades. However, some are suffering greatly after only a short time on these drugs. I note that Jackson Carlaw states that “Mesh is the 21st century’s thalidomide”. He seem to have forgotten the benzodiazepine medical disaster also compared to the Thalidomide Disaster. Perhaps if Thalidomide had not happened then the victims of benzodiazepines would not have had any chance of compensation snatched from them by the UK Government. So let us not forgot this scandal also. We do not have visible physical deformities, we are not children of course, we do not have obvious internal physical damage like the Mesh women .. but we certainly have damaged brains, whether it is damage to the nerve receptors or some other reason, it is damage nevertheless. I hope that our suffering is not going to be swept under the proverbial carpet just as the suffering of the benzodiazepine victims was repeatedly swept under the carpet for decades by Westminster. So many promises, never any action. Is it perhaps the case that the political and medical establishments simply have too much to hide. Informed consent to me is is a joke. No attempt was ever made to inform me about the extremely damaging effects of long term consumption of benzodiazepines and antidepressants. Perhaps informed consent does not apply to prescription drugs. Perhaps for drugs of dependence there should be a consent form to make it abundantly clear that patients have been informed of the dangers. I hope that things are going to be different in Scotland in the future. But action is sorely needed.

    1. Dear Fiona,
      Thank you for this heart-rending response. I agree with you that action is sorely needed across the medical, scientific and healthcare sectors. Otherwise more harm will happen: body, brain, mind and world.

      I have long held the view that we need to seek balance in the appreciation of where expertise rests; hence my submission on PE1651, Prescribed drug dependence and withdrawal: https://holeousia.com/2017/06/04/to-seek-balance-in-appreciation-of-where-expertise-rests-my-submission-on-pe01651/

      It would be relatively straightforward, and more cost-effective and efficient, to set up a single Register where all competing financial interests were required to be made in the public domain. The USA have this. When I lodged my petition, PE14903, I was hopeful that Scotland could lead the way in the UK, by introducing a Sunshine Act for Scotland. But more than 4 years have now passed since my petition was lodged: http://www.parliament.scot/GettingInvolved/Petitions/sunshineact

      Early next Spring will mark two years since my petition was closed. It closed on a most positive note: the Scottish Public having been consulted (by the Scottish Government) agreed with the petition’s aims. I reflect back now on a written submission made by the Cabinet Minister for Health (presumably written by her officials) which stated “We can find no record of concerns having been raised with the Scottish Executive or Scottish Government about this issue before contact from Dr Gordon, the petitioner.” http://www.parliament.scot/S4_PublicPetitionsCommittee/General%20Documents/PE1493_W_Scottish_Government_24.01.15.pdf As a result I was portrayed as an isolated campaigner alongside the implication that my concerns were of lesser value. It is no wonder that I was emotional in hearing how the Mesh survivors had been treated by some quarters of the Scottish Government. I have come to the conclusion that there is a lack of accountability here: candour is not required.

      I am still hopeful though Fiona! I am proud to have added my wee voice (which is no more important than any other) to remind the big bad world of corporate business, certainty and “objectivity” that we will always need ethics and philosophy. Any intervention of any sort, has the potential not just for benefits but also for harms. I would suggest that Institutions and societies need to consider this more. Then we can truly get on with caring with all our might.

      aye Peter

  2. mental health patients are forced to take drugs they know cause harm and do not need but public sector workers seem to be above the law and psych wards can be lawless hellholes. No human rights = Stigma. But people with conflict of interest meet campaigners at each turn. Scotland has signed the human rights act yet I have ZERO human rights

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