Mike's Cheeky Blog: Universal Conflation Theory
Sharon Coley pointed me at a webpage during a Dignity in Action Facebook discussion recently:
It should take you to West Suffolk's 'Yellow Folders - My Care Wishes' webpage, from where various PDFs can be downloaded related to end-of-life planning. I've glanced over them, and sent a few comments to West Suffolk.
The stuff you can download from the website, is definitely better than how things typically were a few years ago, and it is pretty-much in line with a lot of contemporary material around ACP and DNACPR.
But it still conflates different conceptual issues - I wish that people would 'get those [quite basic and clear] things right'. This seems to me, when I read what clinical authors write, to be a situation of 'universally present conflation'.
For example, the MCA clearly separates between the situations of a patient being mentally capable [for a given decision at a particular time] or mentally-incapable: much clinical writing, seems to analyse a sort of 'partial mental capacity' which is the very thing the MCA says CANNOT exist.
This Yellow Folders material, does understand the difference between legally-binding Advance Decisions to refuse treatment, and the patient's views about the future treatments he/she might want to receive. But it then goes on to conflate these two very different legal situations, within single documents (something I dislike a great deal). It isn't difficult to get the description of this right - but that correct description, still doesn't seem to be what I find within clinically-authored end-of-life guidance.
There is also rampant conflation between DNACPR decision-making and post-mortem certification of death - not really a feature of the Yellow Folders material which stops at the death, but very unsatisfactory.
The troubling deeper question, is are clinicians conflating these things, because they don't properly understand them [which would be quite a bad situation], or is it because they are resistant to stating things legally correctly [which is even worse if true].