The Archie Battersbee case

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It's fine to care but it's not acceptable for the emotional needs of staff to be centered. They should not have a stake in this and I find it ridiculous that their "distress" from doing their job should be given any credence at all. These people see horrific injuries and tremendous pain on a regular basis and we are supposed to believe that caring for Archie - who is universally agreed to not be suffering - is somehow emotionally damaging them, to the point their precious feelings should be considered in court.
Okay well you have misunderstood everything I was trying to say. It’s not that they are saying “oh Nurse Alice is super upset about poor Archie, she can’t sleep or even eat her dinner, we must turn everything off now for her sanity. There’s sad Nurse emotions everywhereeee”. 🤦🏼‍♀️

But I shall take note that you don’t want people caring for you to have any feelings or be too “precious”. Robot, stone hearted, job orientated, non person centred healthcare practitioners from now on.
 
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Me-rail: my dad died needlessly because he had such severe death anxiety, that it made him scared of medical treatment because he was so frightened of hearing something negative. Minor niggles became lethal catastrophes. He did not understand that he was harming and killing himself and couldn't process that he would actually avoid hospitals more effectively, if only he would do the initial treatments/investigations. He would lie to the doctors so they would say what he wanted to hear. He hid his medical papers from us. He would not admit to anyone the extent of his health issues. He chose which medication (very important medications) to have or to not have, and how much. He believed the body had a huge healing capacity with the correct lifestyle and diet. He would not believe or accept that some things are irreversible. Such as his self-inflicted kidney failure and subsequent heart attack. We couldn't talk to him about it because he would become too distressed (that is simplifying it - a lot). We couldn't get doctors or nurses to believe he lacked capacity and truly didn't understand that he was killing himself. We couldn't get social services involved because he would have known exactly what to say to get them off his back (also, he hated them and would have never have forgiven us and it would have been futile anyway).

I have a lot of empathy for Hollie because I have lived experience of dealing with a delusional person. Just like Hollie, my dad wasn't completely delusional, because if he was, he wouldn't have known what information to selectively share or hide, and he wouldn't have known what to say to doctors or doubters. Delusional beliefs are weird because they are genuine and strongly held, yet they are somewhat partial. Also like Hollie, my dad in some ways wasn't too bright, and also didn't have much medical or scientific knowledge. Another similarity was that hearing the right things was of the utmost importance to him. It didn't matter that the doctors telling him he was absolutely fine was based on his lies - the most important thing was that they said it. I see similarities with Hollie in that she is cultivating her followers to say things that are comforting to her, so that at least some of the time, she can retreat into a comforting fantasy that miracles exist and Archie might wake up. Even though they say these things as a result of her manipulation. There is also a similarity in that she is saying what needs to be said in court (and on some level, may logically accept it) just like my dad would say what was necessary to doctors, yet as soon as she is away she says what she really feels.

My dad had severe mental health problems, and I suspect Hollie does too. People would rally round my dad because his distress was just so extreme that you would rather prop him up emotionally with whatever he needed than let him face his genuine turmoil. He was not capable of learning or changing so there was no point in denying him. I get the sense that Archie's other family members are rallying like this for Hollie's sake. Even if they personally would rather let him go, Hollie being in Fight Mode is what is sustaining her right now, along with clinging to Archies warm body. So they are joining her because that's what she needs emotionally. Now Archie is essentially gone, their main focus is on protecting Hollie. I also suspect that her family have long since accepted that Hollie is not capable of changing or learning.
Honestly, I was about to text my sister and ask her if she was on tattle, because this sounded exactly like my dad. He really struggled with the concept of being seriously sick.
 
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Okay well you have misunderstood everything I was trying to say. It’s not that they are saying “oh Nurse Alice is super upset about poor Archie, she can’t sleep or even eat her dinner, we must turn everything off now for her sanity. There’s sad Nurse emotions everywhereeee”. 🤦🏼‍♀️

But I shall take note that you don’t want people caring for you to have any feelings or be too “precious”. Robot, stone hearted, job orientated, non person centred healthcare practitioners from now on.
I haven't misunderstood a thing, however you are now deliberately misrepresenting what I am saying.

When exactly did I say anything like what is in your last paragraph?

And you do realise that Barts Health NHS Trust's stated in court that their staff are distressed at having to provide care for Archie, as part of their reasons for taking the family to court?
 
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Just putting this here … for anyone who believes medical staff are not distressed by caring for brain dead patients …

The susceptibility of patients in the ICU, exposure to critical situations, and the high anxiety of relatives of patients while seeing their vulnerable loved ones, have made nursing to be considered as a complex care and the heaviest of duties for nurses in the ICU. This challenge affects nurses’ performance in caring for patients in the whole process due to the increased workload, priority and sensitivity of caring in the ICU (20). Therefore, considering the stressful factors of caring for brain-dead patients is important for nurses (1), since accurate and comprehensive recognition of challenges of caring for brain dead patients from the nurses’ point of view, will be of great importance in providing holistic and quality care (21, 22).

Researchers have found that considering nurses’ experiences and employing them will provide more knowledge to facilitate the caring for these patients (23). However, with regard to the sensitivity of the ICU and the need for total care for brain-dead patients that includes both caring for patient and interaction with other members of the medical team (the physician and donation team) and even the patient’s family, nurses’ experiences of caring for brain-dead patients are less considered. Considering these stressful conditions in the process of caring for the brain dead, nurses are asked to intervene correctly, to be in contact with patients’ families and support them. Therefore, expecting the correct intervention of nurses in this challenging issue will not certainly be successful. In order to achieve such a goal, nurses’ real experiences in this difficult situation should be taken into account.


Or this, in which they note that caring for brain dead patients is one of the hardest tasks for ICU nurses…

 
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I feel like you have to be some sort of sociopath not to be affected by nursing a brain dead patient. I really struggled with it ethically. It felt wrong and it felt like a violation. I struggled to deal with it. Sorry if that doesn't meet some people's expectations of nurses. Obviously I packed that away on shift and I did professionally raise it for at least one patient. I wouldn't have nursed to the standard I did without having compassion. They're human, I hope they have the support they need.
 
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I feel like you have to be some sort of sociopath not to be affected by nursing a brain dead patient. I really struggled with it ethically. It felt wrong and it felt like a violation. I struggled to deal with it. Sorry if that doesn't meet some people's expectations of nurses. Obviously I packed that away on shift and I did professionally raise it for at least one patient. I wouldn't have nursed to the standard I did without having compassion. They're human, I hope they have the support they need.
Having to do CPR on dead patients is a really damaging experience. You know they are dead and the actions you take cause physical harm to their bodies. It's something that can happen if there is no DNR in place.
 
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Having to do CPR on dead patients is a really damaging experience. You know they are dead and the actions you take cause physical harm to their bodies. It's something that can happen if there is no DNR in place.
I'm honestly so cross with Hollie. Not because of what she's putting the healthcare staff through, that's an aside, but what she's putting that child's body through.
 
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I'm honestly so cross with Hollie. Not because of what she's putting the healthcare staff through, that's an aside, but what she's putting that child's body through.
Caring for the dead is a privilege and responsibility that is baked into you as a nurse. Having to desecrate a body is awful- and what is happening to Archie is desecration.
 
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Caring for the dead is a privilege and responsibility that is baked into you as a nurse. Having to desecrate a body is awful- and what is happening to Archie is desecration.
Exactly this. Caring for the dying and the dead is a huge privilege. I do feel like this is desecration.
 
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I personally believe that keeping anyone going who has no quality of life is barbaric and inhumane. I include those who are in the end stages of MS and MND etc. Doing those things really damaged me and went against my moral and philosophical beliefs. I have an Advance Directive set up - I wouldn't want to end up on the receiving end of it. I left nursing after I'd been expected to participate in starving someone to death because they couldn't tolerate their PEG feeds anymore, but the GPs refused to stop prescribing antibiotics for reoccurring chest infections. It took six weeks for them to die. Never again. Medicine has lost its moral compass when it sanctions treatment of the dying in this way.

I can't imagine how ITU staff feel being forced to keep a brain dead person going. It's Sci Fi levels of sick. I would imagine that some relatives lack the intellect to even have a moral compass and won't see that what they're demanding is wrong. This is why the courts should protect the individual.
 
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I would imagine that some relatives lack the intellect to even have a moral compass and won't see that what they're demanding is wrong. This is why the courts should protect the individual. THIS
 
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Caring for the dead is a privilege and responsibility that is baked into you as a nurse. Having to desecrate a body is awful- and what is happening to Archie is desecration.
Exactly. There is a massive difference in continuing intensive care for a short time to allow family to gather and say their goodbyes versus being forced to medically intervene indefinitely on a body that is doing its best to shut down. Anyone with an ounce of compassion can understand that.
 
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It's fine to care but it's not acceptable for the emotional needs of staff to be centered. They should not have a stake in this and I find it ridiculous that their "distress" from doing their job should be given any credence at all. These people see horrific injuries and tremendous pain on a regular basis and we are supposed to believe that caring for Archie - who is universally agreed to not be suffering - is somehow emotionally damaging them, to the point their precious feelings should be considered in court.
Yeah I mean, duck those guys having to care for a dead body day in day out whilst being told they are tit at their job and having feelings. 🙃
 
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I find the attitude that the people looking after Archie should not have their potential distress taken into account quite extraordinarily unfeeling. There is such a taboo throughout human history around the desecration of a corpse that it would be strange for them not to have at least some deeply held negative feelings. There is a reason that we still have a law in most of the UK about preventing the lawful and decent burial of a body. It's rarely used at all, granted but the maximum punishment is still life imprisonment and/or an unlimited fine. A recentish well known conviction for it was that of Hans Kristian Rausing after the death of his wife.
I am not, of course suggesting that this be applied to Ms. Dance and family but it is a measure of how deeply engrained these taboos still are.
 
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Exactly. There is a massive difference in continuing intensive care for a short time to allow family to gather and say their goodbyes versus being forced to medically intervene indefinitely on a body that is doing its best to shut down. Anyone with an ounce of compassion can understand that.
Exactly this. We often try to explain it to family like “we are giving him every medical intervention possible yet he is still ‘declaring himself’ (when trying to cardiac arrest multiple times etc), he has clearly finished with his time here on this unit and is ready to go, let’s give him a peaceful send off now everyone he loves is gathered around” etc etc and normally that gets through to people. But it seems there are exceptions…
 
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I think the longer this goes on, it is almost dehumanising the child at the centre of it.

I cannot begin to imagine what it is like to lose a child, in any circumstances. But I cannot comprehend Archie's mother's behaviour. I hate to say it but the longer this gets dragged out, the more attention (and money presumably) she will receive.
The 'armies' in these cases move on then to the next cause they can find. Dreadful.
 
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I think the longer this goes on, it is almost dehumanising the child at the centre of it.

I cannot begin to imagine what it is like to lose a child, in any circumstances. But I cannot comprehend Archie's mother's behaviour. I hate to say it but the longer this gets dragged out, the more attention (and money presumably) she will receive.
The 'armies' in these cases move on then to the next cause they can find. Dreadful.
Agreed, and sadly these armies are usually made up from the same sort of Facebook experts who are all quick to become doctors/scientists or politicians to fit whichever agenda they are following at the time.

"If Sheila from round the corner posted it to Facebook it must be true" type people.
 
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Agreed, and sadly these armies are usually made up from the same sort of Facebook experts who are all quick to become doctors/scientists or politicians to fit whichever agenda they are following at the time.

"If Sheila from round the corner posted it to Facebook it must be true" type people.
or even when it’s ’someone Who Sheila from round the corner knows’ and the urban myth is off and running.
 
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Maybe some one with a medical background can explain this to me.
In my mind it's only a matter of time before Archie gets sepesis due to the necrosis of the brain tissue.. Would that be the case?
 
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Maybe some one with a medical background can explain this to me.
In my mind it's only a matter of time before Archie gets sepesis due to the necrosis of the brain tissue.. Would that be the case?
This is very difficult. Yes and no. Within the first 1-3 days after brain stem death occurring then I’d say yes, and it would be treated ASAP as often people are kept artificially alive due to becoming organ donors and needing to keep the organs in as great condition as possible for the recipient. But this far down the line, the body won’t be generating new cells/working as it should etc etc and even with antibiotics it won’t fight off an infection as you and I would, or even host an infection as you and I would, so it’s a really tricky one without a black and white answer. Not much research has been done as people aren’t generally kept in this condition for this long as it’s not ethical. Any sign of infection now, I imagine they wouldn’t treat him as it wouldn’t be of benefit. X
 
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