livor mortis, 253
London Hospital, 239
love, 106—10, 125
lumbar punctures, 171, 182
lungs, 217, 236
embolism, 290—1, 302, 306
terminal failure, 3 46
Macmillan Nurses, 66, 162, 279, 284
Majdanek death camp, 53
Manhattan State Hospital, 54
manual cardiac defibrillation, 357
Marie Curie Hospital, 81—144
Massen, Louise, 254—7, 357—67
mastectomy, 82, 318
matrons, 24, 203
medical students, 54
memory loss, 287
Mental Capacity Act, 243, 354, 372
mersaryl, 217
Merton, Mrs, 102—5, 107—10
Methodist Homes for the Aged, 197—8
Mohammed, Prophet, 326
monastic offices, 163
morticians, 156, 160
Moslems, 112—14, 332
motor neurone disease, 278
Mount St Helens, 260—9
mouth care, 99, 382
Mozart, Wolfgang Amadeus, 277
MRSA, 291, 307—8
multiple sclerosis, 278
music therapy, 258
myocardial infarction, 272, 358
naso-gastric tubes, 199—200, 281—2, 381
naso-jejunostomy, 381
National Council for Palliative
Care (NCPC), 254, 365, 374
National End of Life Care
Programme, 161
National Health Service, 30—31, 75, 293, 301
Gold Standard Framework, 161, 342, 371—3, 376
and hospice movement, 65—6
National Health Service
Training Directorate
(NHSTD), 357
National Service Framework for Older People, 258
National Vocational
Qualifications (NVQs), 207—8, 210,212—13
near-death experiences, 106—7, 270
neuro-muscular disease, 258, 278
New York Times, 166
Nightingale, Florence, 203
Nuland, SherwinB, 196—7, 235, 241
nuns, 243—4, 308, 324
nurses
agency, 293
and hierarchy, 23—4
and incurable conditions, 136—7
and laying-out, 160
presence at death, 83—4
training reforms, 203—5, 211
nurses homes, 30
nursing auxiliaries, 137, 205—6
Nursing Times, 66, 238, 257
oedema, 230—1, 235, 382
oestrogen, 90
old age, 45—9, 329
as cause of death, 5, 7, 45
and resuscitation, 252, 258, 352—3
old man’s friend, 196, 308
On Death and Dying, 51, 59—60, 67
oncotic pressure, 382
Ontario, 343
opoid metabolites, 383
Oral Feeding Difficulties and Dilemmas, 199—200
oro-pharyngeal airway, 339
Orthodox Church, 97, 157
osteoporosis, 320
oxygen, 217
palliative care (specialism), 66, 368—395
pancreas, 217, 229
paraldehyde, 23—4, 28
paralysis, 195
creeping, 200—1, 279
psychosomatic, 54
paramedics, 246, 248—9, 252, 256, 357—67, 370
training and education, 357—9
Parkinson’s disease, 278, 366
pelvic fractures, 41—2, 104—5, 307
phlebitis, 151
physiotherapy, 178, 188, 190, 231, 293
pneumonia, 196, 229, 308, 353
poisoning, 338, 354
Poland, 51—3
police, 249
population, ageing, 194
post-cardiac arrest syndrome, 344
post-mortems, 249
post-resuscitation disease, 369
potassium citrate, 90, 94
powers of attorney, 352, 354
primary progressive aphasia, 278
private hospitals and clinics, 206, 208, 210, 212
progesterone, 90
Project 2000, 204—5
prostatectomy, 90—1
public access defibrillation, 338
public expectations, 242, 371
pulmonary oedema, 382
pupillary light response, 345
Queen Alexandra Royal Army
Nursing Corps, 239
Quinlan, Karen Ann, 345—6
radiotherapy, 81—2, 84, 90—1, in, 120, 143—4
as evidence of cancer, 130—1, 133—5, 139—41
as placebo, 124—5
Ratski, Mrs, 9—42
Reading, 10, 118, 136, 209
Recognition of Life Extinct
(ROLE), 256, 363
refugees, 51—2
resuscitation, 197, 211, 218—19, 222—59, 275—6, 330—1, 337—56
ABC guidelines, 255, 338—9
and advanced directives, 354—6, 365—6
and age discrimination, 252, 258, 353
and Allow a Natural Death
(AND) procedure, 348—9
and ambulance services, 253—7, 359—61, 365—7
cessation of, 343—4, 353—4
and choice, 368—76
developments in, 237—8, 337—40, 356
and DNAR orders, 242—3, 251, 253—6, 258, 346—8, 356, 360—1, 365—7, 372, 374,376
and electric shocks, 238—9, 241
and mental capacity, 243, 351—2, 354, 360, 360, 357
mouth-to-mouth resuscitation, 237, 240, 330,338
open heart resuscitation, 222—5, 230, 238, 338
and palliative care, 255, 257, 361
and Recognition of Life Extinct (ROLE), 256, 363
and relatives, 354—5, 370
and ‘right to die’ case, 345—6
success rates, 341—5, 356, 369—70
Resuscitation Council (UK), 257, 338—9, 341, 344, 355
rheumatoid arthritis, 309
Right to Die, The, 117
Right to Die case, 345—6
rigor mortis, 255
Roberts, Elias, 90—100
Rosen, Shirley, 269
Royal Berkshire Hospital, 11, 64, 240
Royal College of Nursing
(RCN), 204—6, 210, 238, 243, 257
Royal College of Physicians, 199—200
Royal Free Hospital, 81, 90, III, 129
St Christopher’s Hospice, 65—7
St John’s Ambulance, 251
St Joseph’s Hospice, 62—3
St Nicholas Hospice, 257
St Paul, 106
St Thomas’s Hospital, 62—3
Salmon Report, 203
Saunders, Dame Cicely, 62—7,
Second World War, 22, 51—2, 228, 280, 316,337
self-preservation, 286
septicaemia, 42, 196
Shipman, Dr Harold, 310
shock, 20
anaphylactic, 344, 354
surgical, 91
shoulders, broken, 319
Silvester, Dr, 237
Socrates, 326
speech, and human communication, 279
speech therapy, 189
starvation, 196, 281
stroke, 46, 48, 170—1, 189, 359, 366
and rehabilitation, 180, 188—9
stroke patients, 165—91
suffering, 308—9
suicide, 140—1, 313—15, 327
Switzerland, 51—5, 319, 323—5
syphilis, 52
syringe driver, 383
television, 146—8, 251, 342, 369
Termination of Resuscitation Study, 343
Thames, river, 30, 69, 168
Theobald, Sue, 258
Third Spacing, 382
Thomas, Dylan, 313
throat ulcer
ation, 19, 21
thrombolytic therapy, 358—9
thrombosis, 170
thrush, 385
total parenteral nutrition, 381
tracheotomy, 15
transient ischaemic attacks (TIA), 170
trephining, 171, 188
Truman, Harry Randolph, 260—9
UK Central Council for Nurses (UKCC), 204—5
ultrasound, 188
unconsciousness, 220
undertakers, 249
University of Colorado Hospital, 55, 58
University of Washington, 264
uraemia, 91, 229
urinary infections, 21
uterine prolapse, 82
varicose veins, 111
vegetative states, 196, 338—1
ventricular fibrillation, 197, 223, 235, 237, 252, 337—8, 340—1, 359—60, 370
ventricular tachycardia, 340—1, 370
Voluntary Aid Detachments (VADs), 205
volvulus, 15, 20
Warfarin, 170, 299—300
Waters, Mr, 85—9
Whiting, Philip, 196—7
Whitman, Walt, 233
widows, 159, 161
Wieter, Helga, 316—28
Winterton, Mr, 96—7
Women’s Institute, 167—8
World Health Organization, 45
Worth, Philip, 44
Yale University Hospital, 235
Zürich, 52—3, 70, 75, 324—5
Copyright
A PHOENIX EBOOK
First published in Great Britain in 2010 by Weidenfeld & Nicolson.
First published in ebook in 2010 by Weidenfeld & Nicolson.
This updated ebook published in 2011 by Phoenix.
Copyright © 2010 Jennifer Worth
The right of Jennifer Worth to be identified as the author of this work has been asserted by her in accordance with the Copyright, Designs and Patents Act of 1988.
This is a work of non-fiction, and the events it recounts are true. However, the names and certain identifying characteristics of some of the people who appear in its pages have been changed. The views expressed in this book are the author’s.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means without the prior permission in writing of the publisher, nor be otherwise circulated in any form of binding or cover other than that in which it is published without a similar condition, including this condition, being imposed on the subsequent purchaser.
A CIP catalogue record for this book is available from the British Library.
ISBN: 9780297859598
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* from How We Die, Sherwin B Nuland, Alfred A. Knopf, New York, 1993
* It is very difficult to remove a feed-peg because it is a life-maintaining device. It requires a major medical/legal decision and this is not easy to come by.
** Ahronheim, J C, Morrison, R S, Baskin, S A, Morris, J, Meier, D E. Treatment of the dying in the acute care hospital. Advanced dementia and metastatic cancer. Archives of Internal Medicine, 1996; 156: 2094-100.
* A joule is a unit of heat, energy and force – in this case electricity.
* For an update, see Appendix I, Medical Aspects of Cardio-Pulmonary Resuscitation, by David Hackett, MD, FRCP, FESC.
* From Shirley Rosen,‘ Truman of St Helens’, published by Madrona Publishers, Seattle, Washington State, 1981
* Dylan Thomas, 1951.
* The Resuscitation Council. http://www.resus.org.uk/SiteIndx.htm
* The Resuscitation Council. http://www.resus.org.uk/pages/mediMain.htm
* Gwinnutt C, Columb M, Harris R. Outcome after cardiac arrest in adults in UK hospitals: effect of the 1997 guidelines. Resuscitation 2000; 47: 125-135. http://www.resuscitationjournal.com/article/S0300-9572(00)00212-4/abstract f National Cardiac Arrest Audit (NCAA). https://www.icnarc.org/
* Diem SJ, Lantos JD, TulskyJA. Cardiopulmonary Resuscitation on Television - Miracles and Misinformation. New Engl J Med 1996; 334: 1578-152. http://content.nejm.org/cgi/content/short/334/24/1578
† Stiell IG, Wells GA, Field B et al, for the Ontario Prehospital Advanced Life Support Study Group. Advanced Cardiac Life Support in Out-of-Hospital Cardiac Arrest. New EnglJ Med 2004; 3 51:647-656.http://content.nejm.org/cgi/content/short/351/7/647 £ HerlitzJ, Bang A, GunnarssonJ, EngdahlJ, Karlson BW, LindqvistJ, Waagstein L. Factors associated with survival to hospital discharge among patients hospitalised alive after out-of-hospital cardiac arrest: change in outcome over 20 years in the community of Goteborg, Sweden. Heart 2003; 89: 25-30. http://heart.bmj.com/content/89/1/25.abstract
* Sasson C, Rogers MAM, Dahl J, Kellermann AL. Predictors of Survival From Out-of-Hospital Cardiac Arrest. A Systematic Review and Meta-Analysis. Circulation: Cardiovascular Quality and Outcomes. 2010; 3: 63-81. http://circoutcomes.ahajournals.org/cgi/content/short/3/1/63
† The Public Access Defibrillation Trial Investigators. Public-Access Defibrillation and Survival after Out-of-Hospital Cardiac Arrest. New Engl J Med 2004; 351: 637- 646. http://content.nejm.org/cgi/content/short/351/7/637
* Morrison LJ, Visentin LM, Kiss A, Theriault R, Eby D, Vermeulen M, Sherbino J, Verbeek PR, for the TOR Investigators. Validation of a Rule for Termination of Resuscitation in Out-of-Hospital Cardiac Arrest. New Engl J Med 2006; 355: 478- 487. http://content.nejm.org/cgi/content/short/355/5/478
* Neumar RW, Nolan J P, Adrie C et al. Post-Cardiac Arrest Syndrome. Epidemiology, Pathophysiology, Treatment, and Prognostication. A Consensus Statement From the International Liaison Committee on Resuscitation. Circulation 2008; 118: 2452-2483. http://circ.ahajournals.org/
† Fischer M, Fischera NJ, Schuttlerb J. One-year survival after out-of-hospital cardiac arrest in Bonn city: outcome report according to the ‘Utstein style’. Resuscitation 1997; 33: 233-243. http://www.resuscitationjournal.com/ X http://www.karenannquinlan.org/
* The Resuscitation Council. http://www.resus.org.uk/pages/DNARrstd.htm
† Allowing a Natural Death: http://allowingnaturaldeath.org/
† The NHS National Gold Standards Framework Centre. http://www.goldstandards framework.nhs.uk/
* The NHS Gold Standards Framework. http://www.goldstandardsframework. nhs.uk/
† Avon, Somerset and Wiltshire Cancer Services Allow a Natural Death (do not attempt resuscitation) Order. http://www.aswcs.nhs.uk/