Dr Charles B Shepherd,
Hon Medical Adviser
The ME Association
Severely affected - severely neglected:
Santhouse et al (1) are correct to say that therapeutic defeatism is not the answer to ME/CFS and that suicidal intentions must always be taken seriously. However, they make a number of conclusions and observations that are over-simplistic, premature or inaccurate.
First, the media have, quite rightly, used the tragic case of Lynn Gilderdale to highlight the fact that severe ME/CFS exists and that there is a desperate need for biomedical research into the underlying cause. But the media coverage did not imply that ME/CFS is a 'commonly fatal' condition, and it was premature of the authors to then go on and conclude - without the benefit of robust epidemiological data - that mortality is not increased.
Second, a considerable amount of accumuating patient evidence (2) indicates that a significant proportion of people with ME/CFS find that the two behavioural treatments being recommended - cognitive behaviour therapy (CBT) and graded exercise therapy (GET) - are either ineffective (ie CBT) or harmful (ie GET). And the only research so far to investigate potential risk factors which are involved in the development of severe ME/CFS (3) has concluded that there is no evidence to implicate personality or neurotic traits. It is therefore disingenuous to claim that the use of these two behaviour-based therapies, in a group of patients who cannot normally travel to hospital to access them, is going to produce a 'dramatic recovery'.
Third, having dealt with the families of a number of people with ME/CFS who have committed suicide in recent years, the reasons for doing so are often related to a combination of factors which predominently involve lack of medical care and social support, failure to control key symptoms, and inadequate financial help.. While depression may be a factor in some cases it is not always present.
People with severe ME/CFS require multidisciplinary services in both a domiciliary and accesible hospital based setting that matches their complex individual needs. Having strongly criticised the current lack of care that is available, we question whether the NHS trusts the authors work for are in fact putting words into action and supplying domiciliary and in patient facilities for their severely affected ME/CFS patients.
References
1 Santhouse AM, Hotopf M, David AJ. Chronic fatigue syndrome. BMJ 2010; 340: 738 (13 February)
2 Report of the CFS/ME Working Group. Department of Health; January 2002. http://www.dh.gov.uk/dr_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4059506.pdf
3 Pheby D and Saffron L. Risk factors for severe ME/CFS. Biology and Medicine 2009; 1: 50 -74.http://biolmedonline.com/Articles/vol1_4_50- 74.pdf
Competing interests: Medical Adviser to an ME/CFS patient support and research funding charity. Member of MRC Expert Group on ME/CFS research.
Doctor Speedy and ME in search of medical honesty
Saturday, February 13, 2010
Friday, February 12, 2010
Why do doctors refuse to believe patients?
Ellen Goudsmit, psychologist:
As a patient with a progressive form of myalgic encephalomyelitis (ME), a psychologist who trained in Clinical as well as Health Psychology and a specialist in ME and chronic fatigue syndrome (CFS), I consider that I may have a useful contribution to make in the debate about the needs of people with fatigue syndromes and the treatments mentioned by Santhouse et al. I am in the unhappy position of being familiar with both sides of the couch, as it were. For the record, I differentiate between ME and CFS because the assumption of equivalence has not been tested and I don't recognise myself in many descriptions of CFS.
As Sandhouse et al suggested, people with ME and CFS need better access to specialist clinics. As things stand, too many patients are left to cope on their own and even the most sympathetic GP is limited in what he or she can offer, courtesy of NICE.
What patients, groups and professionals like myself have been arguing for years is that CBT and the other approaches noted by Sandhouse et al are neither appropriate nor particularly helpful for everyone with fatigue syndromes. However, the article illustrates that we're simply not believed.
As a psychologist, I recognise that CBT and GET can alleviate fatigue and that many patients feel better, if only for a few months. However, I submit that too many commentators have overlooked the methodological flaws in the various trials and that they have overstated the results. For example, a recent review supports an earlier meta-analysis that effect sizes tend to be modest (1). Moreover, there are doubts about the value of the different elements within the interventions, e.g. CBT may help simply because it provides support and an opportunity to vent our frustration (2). Similarly, research using objective measures have shown that improvements following CBT can not be attributed to increases in activity (3). So why continue to include it and risk a relapse?
There are also other arguments that we need more flexible and individualized programmes. For instance, there is no evidence as yet that CBT and/or GET help those of us with neurological symptoms like muscle weakness, vertigo and visual disturbances. As for the tendency for some of us to develop multiple sensitivities to chemicals and foods, it's disabling and extremely depressing but often psychologised, trivialised and ignored.
There is now enough evidence for therapeutic options which are as effective as CBT and GET, but more acceptable (4,5). However, NICE misclassified them under the wrong headings so didn't realise that there were alternatives and those of us who alerted them to the problem were dismissed.
In terms of my own experience, I know that things can get worse. Some of my friends are more disabled than me; they too have tried all the therapies offered by their consultants, but these have not halted the progession of their disease and some are now barely able to eat a normal diet. We're all living on hope and it's hard.
Articles like those by Sandhouse et al reinforce the impression that editors and researchers are keen to lump everyone with fatigue together because it's neat and tidy. We're human, we dislike complexity and we prefer simple solutions. CBT and GET seem to solve a lot of problems but they rely on the asssumption that any differences within the CFS population are of no clinical significance. They depend on the concept of CFS as an entity with no ongoing pathology such as infection.
They are perpetuated by discussions which dismiss evidence to the contrary.
And above all, they need decision makers to question the knowledge and credibility of the patient. Even those who are Fellows of the BPS (British Psychological Society).
What I don't see is an impartial, evidence-based approach. I see a textbook example of group-think, where dissident voices are unwelcome and relegated to the letters page. I see an 'obsession' with CBT and GET. I understand it, but the scientific process requires more objectivity and we will all be better off if we accept that there's more to CFS than fatigue.
As a patient with a progressive form of myalgic encephalomyelitis (ME), a psychologist who trained in Clinical as well as Health Psychology and a specialist in ME and chronic fatigue syndrome (CFS), I consider that I may have a useful contribution to make in the debate about the needs of people with fatigue syndromes and the treatments mentioned by Santhouse et al. I am in the unhappy position of being familiar with both sides of the couch, as it were. For the record, I differentiate between ME and CFS because the assumption of equivalence has not been tested and I don't recognise myself in many descriptions of CFS.
As Sandhouse et al suggested, people with ME and CFS need better access to specialist clinics. As things stand, too many patients are left to cope on their own and even the most sympathetic GP is limited in what he or she can offer, courtesy of NICE.
What patients, groups and professionals like myself have been arguing for years is that CBT and the other approaches noted by Sandhouse et al are neither appropriate nor particularly helpful for everyone with fatigue syndromes. However, the article illustrates that we're simply not believed.
As a psychologist, I recognise that CBT and GET can alleviate fatigue and that many patients feel better, if only for a few months. However, I submit that too many commentators have overlooked the methodological flaws in the various trials and that they have overstated the results. For example, a recent review supports an earlier meta-analysis that effect sizes tend to be modest (1). Moreover, there are doubts about the value of the different elements within the interventions, e.g. CBT may help simply because it provides support and an opportunity to vent our frustration (2). Similarly, research using objective measures have shown that improvements following CBT can not be attributed to increases in activity (3). So why continue to include it and risk a relapse?
There are also other arguments that we need more flexible and individualized programmes. For instance, there is no evidence as yet that CBT and/or GET help those of us with neurological symptoms like muscle weakness, vertigo and visual disturbances. As for the tendency for some of us to develop multiple sensitivities to chemicals and foods, it's disabling and extremely depressing but often psychologised, trivialised and ignored.
There is now enough evidence for therapeutic options which are as effective as CBT and GET, but more acceptable (4,5). However, NICE misclassified them under the wrong headings so didn't realise that there were alternatives and those of us who alerted them to the problem were dismissed.
In terms of my own experience, I know that things can get worse. Some of my friends are more disabled than me; they too have tried all the therapies offered by their consultants, but these have not halted the progession of their disease and some are now barely able to eat a normal diet. We're all living on hope and it's hard.
Articles like those by Sandhouse et al reinforce the impression that editors and researchers are keen to lump everyone with fatigue together because it's neat and tidy. We're human, we dislike complexity and we prefer simple solutions. CBT and GET seem to solve a lot of problems but they rely on the asssumption that any differences within the CFS population are of no clinical significance. They depend on the concept of CFS as an entity with no ongoing pathology such as infection.
They are perpetuated by discussions which dismiss evidence to the contrary.
And above all, they need decision makers to question the knowledge and credibility of the patient. Even those who are Fellows of the BPS (British Psychological Society).
What I don't see is an impartial, evidence-based approach. I see a textbook example of group-think, where dissident voices are unwelcome and relegated to the letters page. I see an 'obsession' with CBT and GET. I understand it, but the scientific process requires more objectivity and we will all be better off if we accept that there's more to CFS than fatigue.
Wednesday, February 10, 2010
Tuesday, February 9, 2010
Modern medicine is not scientific
Abram Hoffer MD:
"Modern medicine is not scientific, it is full of prejudice, illogic and susceptible to advertising. Doctors are not taught to reason, they are programmed to believe in whatever their medical schools teach them and the leading doctors tell them. Over the past 20 years the drug companies, with their enormous wealth, have taken medicine over and now control its
research, what is taught and the information released to the public."
"Modern medicine is not scientific, it is full of prejudice, illogic and susceptible to advertising. Doctors are not taught to reason, they are programmed to believe in whatever their medical schools teach them and the leading doctors tell them. Over the past 20 years the drug companies, with their enormous wealth, have taken medicine over and now control its
research, what is taught and the information released to the public."
Saturday, February 6, 2010
Breaking the ME enigma
A joint letter appealing to the nation to start taking ME seriously appears in The Daily Telegraph today.
It is signed by 20 leading figures in the ME debate – including parliamentarians, clinicians, researchers and figures from the ME national organisations and patient support groups.
Breaking the ME enigma
SIR – The death of Lynn Gilderdale and the humane verdict in the trial of her mother brought home to many people for the first time what a devastating illness myalgic encephalomyelitis (ME) can be.
Many of the estimated quarter of a million people with ME in Britain experience not only extreme pain and disability, but also incomprehension, ignorance, lack of sympathy and at times outright hostility, not only from the public but also from professionals responsible for their care.
Such lack of understanding even extends to blaming parents for the severity of their child’s illness.
It is time the nation began to take ME seriously. Provision of adequate clinical and other services by properly informed and sympathetic professionals is currently subject to a postcode lottery. Such provision should avoid inappropriate treatments, and range from support for home tuition for school-age children to respite care for the severely affected.
Above all, we should fund biomedical research to resolve the enigma of the underlying pathology of this illness. We should build on recent scientific advances to develop effective treatments, so that no one in future need experience the pain, isolation and despair that were Lynn Gilderdale’s fate.
Countess of Mar
Secretary, All Party Parliamentary Group on ME
Dr Neil Abbot
Operations Director, ME Research UK
Jane Colby
Executive Director, The Young ME Sufferers Trust
Anne Faulkner
Hon Director, CFS Research Foundation
Tanya Harrison
Chairman, BRAME
Malcolm Hooper
Emeritus Professor of Medicinal Chemistry, University of Sunderland
Andy Kerr MSP
Dr Jonathan Kerr
Consultant Senior Lecturer, St George’s, University of London
Simon Lawrence
Chairman, 25 per cent ME Group
Kathleen McCall
Chairman, Invest in ME
Dr Luis Nacul
Consultant in Public Health, London School of Hygiene and Tropical Medicine
Professor Derek Pheby
National ME/CFS Observatory
Neil Riley
Chairman, ME Association
Dr Charles Shepherd
Dr Nigel Speight
Sir Peter Spencer
Chief Executive Officer, Action for ME
Des Turner MP
Chairman, All Party Parliamentary Group on ME
Dr William Weir
Mary-Jane Willows
Chief Executive Officer, Association of Young People with ME
Andrew Stunell MP
Vice Chairman, All Party Parliamentary Group for ME/CFS
It is signed by 20 leading figures in the ME debate – including parliamentarians, clinicians, researchers and figures from the ME national organisations and patient support groups.
Breaking the ME enigma
SIR – The death of Lynn Gilderdale and the humane verdict in the trial of her mother brought home to many people for the first time what a devastating illness myalgic encephalomyelitis (ME) can be.
Many of the estimated quarter of a million people with ME in Britain experience not only extreme pain and disability, but also incomprehension, ignorance, lack of sympathy and at times outright hostility, not only from the public but also from professionals responsible for their care.
Such lack of understanding even extends to blaming parents for the severity of their child’s illness.
It is time the nation began to take ME seriously. Provision of adequate clinical and other services by properly informed and sympathetic professionals is currently subject to a postcode lottery. Such provision should avoid inappropriate treatments, and range from support for home tuition for school-age children to respite care for the severely affected.
Above all, we should fund biomedical research to resolve the enigma of the underlying pathology of this illness. We should build on recent scientific advances to develop effective treatments, so that no one in future need experience the pain, isolation and despair that were Lynn Gilderdale’s fate.
Countess of Mar
Secretary, All Party Parliamentary Group on ME
Dr Neil Abbot
Operations Director, ME Research UK
Jane Colby
Executive Director, The Young ME Sufferers Trust
Anne Faulkner
Hon Director, CFS Research Foundation
Tanya Harrison
Chairman, BRAME
Malcolm Hooper
Emeritus Professor of Medicinal Chemistry, University of Sunderland
Andy Kerr MSP
Dr Jonathan Kerr
Consultant Senior Lecturer, St George’s, University of London
Simon Lawrence
Chairman, 25 per cent ME Group
Kathleen McCall
Chairman, Invest in ME
Dr Luis Nacul
Consultant in Public Health, London School of Hygiene and Tropical Medicine
Professor Derek Pheby
National ME/CFS Observatory
Neil Riley
Chairman, ME Association
Dr Charles Shepherd
Dr Nigel Speight
Sir Peter Spencer
Chief Executive Officer, Action for ME
Des Turner MP
Chairman, All Party Parliamentary Group on ME
Dr William Weir
Mary-Jane Willows
Chief Executive Officer, Association of Young People with ME
Andrew Stunell MP
Vice Chairman, All Party Parliamentary Group for ME/CFS
Friday, February 5, 2010
Oddball styling ...
Jason Dawe The Sunday Times
If you fancy standing out from the crowd, then a used Tribeca may fit the bill. If you can live with oddball styling.
The Subaru B9 Tribeca is far from being a pretty car, and its name — that of a ritzy neighbourhood in Manhattan — doesn’t suit it at all. Thanks to the ravages of depreciation, though, it is now beginning to look like a good go-anywhere, carry-anything family holdall.
Launched in the UK in November 2006, the Tribeca had already proven to be something of a hit in North America, where its combination of practicality (it can be bought with seven seats) and pricing made it an attractive alternative to top-notch European 4x4s such as the BMW X5 and Volvo XC90. UK consumers proved a tougher crowd to win over, though. Unlike the gas-guzzling US market, the British one demands diesel SUVs, and without a diesel-powered engine in the range, the Tribeca didn’t stand much of a chance against cheaper alternatives from Citroën, Ford, Peugeot, Renault and Vauxhall.
As quietly as the Tribeca appeared in UK showrooms, so too it vanished in mid-2009 with barely a murmur. After three years of faltering sales, the company’s flagship model was consigned to the UK car market’s history books. Clearly, that was far from great news for the few who bought a new Tribeca, but today those shopping for a well-built, distinctive SUV at sensible money — from £12,000 — may find it holds more appeal.
But before you go thinking that’s a lot of car for not a lot of money, consider the running costs.
Saturday, January 30, 2010
Professor Wessely: She died from “acute renal failure as a result of chronic fatigue syndrome
Steve Bird, The Times
January 30, 2010
As Criona Wilson knelt beside her dying daughter’s bedside, she promised her that her death would not be in vain. Before the frail body of 32-year-old Sophia finally succumbed to the medical complications and ravages of ME, she replied in a whisper: “Then it’s all worth it.”
In the years that followed, Mrs Wilson, 66, a former midwife, dedicated her life to proving that her daughter’s condition was not a figment of imagination, nor one that merited her youngest child’s incarceration in a mental hospital.
Her battle saw her take on the medical profession and accepted thinking about the diagnosis and treatment of ME, also known as chronic fatigue syndrome. Eventually, in 2006, a coroner ruled that Sophia’s death was the result of myalgic encephalomyelitis — the first such ruling at an English inquest.
<...>
Her daughter, Sophia Mirza, was a talented and popular arts graduate living with her mother in Brighton in 1999 when she contracted ME at the age of 25. She became confined to her bedroom and, just as Miss Gilderdale had, needed round-the-clock care.
In 2003 she was visited by a psychiatrist, even though Miss Mirza complained only of physical discomfort. The psychiatrist told her that she was making up her symptoms and if she continued to pretend to be ill he would section her under the Mental Health Act. Mrs Wilson said: “I knew my daughter. There was no way she was mentally ill or pretending.”
When the dread knock on her door finally came in 2003, there was little she could do. A policeman forced the door open and the psychiatrist and a social worker locked themselves into Miss Mirza’s room to prepare her for her trip to a psychiatric ward.
Her condition took a dramatic turn for the worse. After 13 days she was released and taken back to the care of her mother. “That spell in a mental hospital set her back terribly. We lost all faith in medical professionals. We were alone,” said Mrs Wilson.
In 2005 Miss Mirza could barely muster the energy to speak, eat or drink. She and her mother had already agreed that no doctors should be called in case she would be sectioned again. On November 25, 2005, Miss Mirza died in her bed at home.
<...>
At the inquest the next year a neuropathologist told the court that Miss Mirza’s spinal cord was inflamed and three quarters of her sensory cells had abnormalities.
It was, the court heard, a clear physical manifestation of ME.
The coroner ruled that she had died from “acute renal failures as a result of chronic fatigue syndrome”.
Thursday, January 28, 2010
Kay Gilderdale: the beginning of the rest of her life
By Neil Tweedie
The Telegraph
Kay Gilderdale is beginning the rest of her life. For the first time in 18 years she has experienced something like relief, the shadow cast by her daughter’s tormented life, and the traumatic manner of its end, lifted at last.
It could have been so different. Mrs Gilderdale, 55, might have been beginning a sentence for attempted murder on Monday, the latest example of Britain’s confused policy on assisted suicide. Last week, Frances Inglis was jailed for nine years for administering a lethal dose of heroin to her brain-damaged son in a not-wholly-dissimilar example of mercy killing. Yet, a few days later, Mrs Gilderdale walked free from Lewes Crown Court, despite admitting that she had helped her daughter, Lynn, to die.
What saved her was a jury, which accepted that she had acted in what she imagined to be the best interests of her daughter. Acquitted of attempted murder, Mrs Gilderdale was given a conditional discharge for the offence of assisting a suicide. The judge queried the decision of the Crown Prosecution Service to proceed with the more serious charge, and there the issue of assisted suicide rests for the time being, in a haze of doubt and inconsistency.
Lynn Gilderdale was 31 when she tried to kill herself in December 2008. It was her second attempt, her first being in 2007, when she took an overdose of morphine.
For 17 years she had endured a twilight life, confined to bed at home, shielded by curtains from the natural light she was unable to bear. Lynn suffered from chronic fatigue syndrome, better known as ME, a condition greeted with scepticism in some quarters for the absence of a clear physiological cause, but which produced the most disastrous symptoms in her.
Unable to move or speak, fed through a tube inserted into her nose, and sustained by a cocktail of drugs, she eventually decided enough was enough.
The Telegraph
Kay Gilderdale is beginning the rest of her life. For the first time in 18 years she has experienced something like relief, the shadow cast by her daughter’s tormented life, and the traumatic manner of its end, lifted at last.
It could have been so different. Mrs Gilderdale, 55, might have been beginning a sentence for attempted murder on Monday, the latest example of Britain’s confused policy on assisted suicide. Last week, Frances Inglis was jailed for nine years for administering a lethal dose of heroin to her brain-damaged son in a not-wholly-dissimilar example of mercy killing. Yet, a few days later, Mrs Gilderdale walked free from Lewes Crown Court, despite admitting that she had helped her daughter, Lynn, to die.
What saved her was a jury, which accepted that she had acted in what she imagined to be the best interests of her daughter. Acquitted of attempted murder, Mrs Gilderdale was given a conditional discharge for the offence of assisting a suicide. The judge queried the decision of the Crown Prosecution Service to proceed with the more serious charge, and there the issue of assisted suicide rests for the time being, in a haze of doubt and inconsistency.
Lynn Gilderdale was 31 when she tried to kill herself in December 2008. It was her second attempt, her first being in 2007, when she took an overdose of morphine.
For 17 years she had endured a twilight life, confined to bed at home, shielded by curtains from the natural light she was unable to bear. Lynn suffered from chronic fatigue syndrome, better known as ME, a condition greeted with scepticism in some quarters for the absence of a clear physiological cause, but which produced the most disastrous symptoms in her.
Unable to move or speak, fed through a tube inserted into her nose, and sustained by a cocktail of drugs, she eventually decided enough was enough.
Wednesday, January 27, 2010
Tuesday, January 26, 2010
Lynn Gilderdale’s moving account of why she decided to end her life
From The Times
January 26, 2010
OK guys, I have something really important to say. I want to talk about something extremely private and personal to share with you, my closest friends. After many years of serious deliberation, I have pretty much come to a huge decision. I hope you will try to understand my reasons for this decision and even if you don’t personally agree with it I hope you won’t judge me too harshly.
I don’t know how to begin. I am just going to come out with it. Here goes, deep breaths. Basically I think some of you have known for a while I have had enough of this miserable excuse for a life, of merely semi-existing for the last 16½ years. I have had enough and I want to die. This is no whim and certainly not just because of the reactive depression diagnosed a few months ago. I am no longer on antidepressants because they weren’t doing anything for me.
I really, really, really want to die and have had enough of being so sick and in so much pain every second of everyday and, basically, one serious health crisis after another. I am tired, so very, very tired and I just don’t think I can keep hanging on for that elusive illness-free existence.
January 26, 2010
OK guys, I have something really important to say. I want to talk about something extremely private and personal to share with you, my closest friends. After many years of serious deliberation, I have pretty much come to a huge decision. I hope you will try to understand my reasons for this decision and even if you don’t personally agree with it I hope you won’t judge me too harshly.
I don’t know how to begin. I am just going to come out with it. Here goes, deep breaths. Basically I think some of you have known for a while I have had enough of this miserable excuse for a life, of merely semi-existing for the last 16½ years. I have had enough and I want to die. This is no whim and certainly not just because of the reactive depression diagnosed a few months ago. I am no longer on antidepressants because they weren’t doing anything for me.
I really, really, really want to die and have had enough of being so sick and in so much pain every second of everyday and, basically, one serious health crisis after another. I am tired, so very, very tired and I just don’t think I can keep hanging on for that elusive illness-free existence.
Monday, January 25, 2010
Mother Kay Gilderdale cleared of trying to murder bedridden daughter
By Tom Pugh, Press Association
Monday, 25 January 2010
A mother was found not guilty today of attempting to murder her bed-ridden daughter by giving her morphine and a cocktail of drugs
Bridget Kathleen Gilderdale, known as Kay, had already admitted aiding and abetting the suicide of 31-year-old Lynn Gilderdale at the family bungalow.
She was given a 12-month conditional discharge for assisting the suicide.
The jury returned its verdict after deliberating for less than two hours.
Cries were heard from the public gallery as the not guilty verdict was read by the foreman.
Mr Justice Bean said: "I do not normally comment on the verdicts of juries but in this case their decision, if I may say so, shows that common sense, decency and humanity which makes jury trials so important in a case of this kind.
"There is no dispute that you were a caring and loving mother and that you considered that you were acting in the best interests of your daughter."
The judge added that she acted selflessly and with exemplary devotion for 17 years.
Jurors heard she crushed up pills and fed them through her daughter's nasal tube, handed her morphine and injected three syringes of air into her vein after she made a failed suicide bid.
Gilderdale, 55, initially tried to stop her daughter ending her life following a 17-year battle with the chronic fatigue illness ME but backed down after she said: "I want the pain to go."
Lewes Crown Court was told she was a loving and devoted mother to her daughter, who was struck down by ME at the age of 14 and needed round-the-clock care at her home in Stonegate, near Heathfield, East Sussex.
Miss Gilderdale, a once active, sporty and musical girl, led an "unimaginably wretched" life in her later years.
She was paralysed from the waist down, unable to speak, eat or drink and was fed through a tube.
Communication to her parents, who were divorced but remained supportive of her, was through a form of sign language they devised themselves.
She was bed-bound, socially isolated, unable to sit up and developed suicidal thoughts, which she published on an online forum for people suffering from illnesses.
She had attempted suicide in the past, had drafted a "living will", placed a Do Not Resuscitate note on her medical records and considered ending her life at Dignitas, the Swiss-based assisted suicide clinic.
In the early hours of December 3 2008, she took an overdose of morphine by injecting the pain-relieving medicine directly into her vein, according to Gilderdale's own account to the family GP, Dr Jane Woodgate, on the morning of the death.
When she realised that the dosage was not high enough, Miss Gilderdale called out to her mother, who then spent around an hour trying to persuade her not to press ahead with killing herself.
But after telling her mother that she wanted the "pain to go" and that she did not want to go on, she set about, over the course of 30 hours, helping her end her life, the trial heard.
Gilderdale handed her two syringes of morphine, consisting of 210mg each, which her daughter administered herself through her Hickman line directly into her vein.
Hours later, at about 6am, Gilderdale felt that the morphine had not achieved her daughter's aim of killing herself and searched the house for tablets, fearing that she would be brain-damaged.
These pills were crushed using a pestle and mortar and then inserted into her daughter's nasogastric tube.
Evidence from Sussex Police found that during the period until her death, Gilderdale trawled the internet for details on drug overdoses and euthanasia.
Following "two or three" more doses of morphine, three syringes of air were pumped into her Hickman line with the intention of causing air embolisms, it was alleged.
Miss Gilderdale died at 7.10am on December 4, with only her mother present. A post-mortem examination at the Conquest Hospital in Hastings found the cause of death was morphine toxicity.
Gilderdale's ex-husband, Richard Gilderdale, told the court he discovered his daughter had died after he received a text message from his former wife, saying: "Please can you come now. Be careful. Don't rush."
When he received the message, he knew what had happened, he told the court.
He said he could never imagine his ex-wife trying to kill their daughter, saying she gave up work without regret and rarely took a holiday.
Describing Gilderdale's reaction to the death, he said: "Her world had come to an end, she was crestfallen, heartbroken - everything you could describe about somebody who had been to hell and back."
Miss Gilderdale had attempted to kill herself before in mid-2007 with a morphine overdose, but her father walked into her bedroom to find her sleepy.
Retired Sussex Police officer Mr Gilderdale said Gilderdale, whom he divorced in around 2001, remained positive that she would get better, although he privately thought otherwise.
Despite their marriage split, they remained actively supportive of their daughter.
Throughout the trial, Gilderdale was supported by a large number of family and friends, including her son Steve and her former husband.
She declined to give evidence. Jurors were told that she could not be tried for murder as it was uncertain whether her daughter died from the overdose she gave herself or from that given by her mother.
Standing on the steps of the court, Gilderdale's son, Steve, read a statement praising the verdict.
Flanked by his mother and father, he said: "We believe this not guilty verdict properly reflects the selfless actions my mother took on finding that Lynn had decided to take her own life, to make her daughter's final moments as peaceful and painless as possible.
"These actions exhibit the same qualities of dedication, love and care that mum demonstrated throughout the 17 years of Lynn's illness.
"I'm very proud of her and I hope she will be afforded the peace that she deserves to rebuild her life and finally grieve for the death of her daughter."
The case has drawn parallels with that of Frances Inglis, the mother jailed at the Old Bailey last week for injecting her brain-damaged son with a lethal dose of heroin, and reignited the debate about assisted suicide.
Mr Justice Bean asked prosecutor Sally Howes QC to explain "why it was considered to be in the public interest" to pursue Gilderdale on the attempted murder charge when she had already admitted aiding and abetting her daughter's suicide.
Ms Howes said the prosecution decided at "the highest level" to press on with a jury trial after Gilderdale had told her GP and the police that she had administered an air embolism with the intent to end her daughter's life.
"There was no submission of no case to answer and the matter went to the jury," Ms Howes said.
Defence counsel John Price QC asked the judge to consider an absolute discharge based on interim guidelines by the Director of Public Prosecutions, Keir Starmer QC, who last year outlined 16 "public interest factors" in favour of a prosecution and 13 factors against taking legal action to bring clarity to existing assisted suicide legislation.
The move came after law lords backed multiple sclerosis sufferer Debbie Purdy's call for a policy statement on whether people who help someone commit suicide should be prosecuted.
Mr Price said that if the DPP was handling the case today, in light of the verdict, it would not be considered in the public interest to prosecute.
Monday, 25 January 2010
A mother was found not guilty today of attempting to murder her bed-ridden daughter by giving her morphine and a cocktail of drugs
Bridget Kathleen Gilderdale, known as Kay, had already admitted aiding and abetting the suicide of 31-year-old Lynn Gilderdale at the family bungalow.
She was given a 12-month conditional discharge for assisting the suicide.
The jury returned its verdict after deliberating for less than two hours.
Cries were heard from the public gallery as the not guilty verdict was read by the foreman.
Mr Justice Bean said: "I do not normally comment on the verdicts of juries but in this case their decision, if I may say so, shows that common sense, decency and humanity which makes jury trials so important in a case of this kind.
"There is no dispute that you were a caring and loving mother and that you considered that you were acting in the best interests of your daughter."
The judge added that she acted selflessly and with exemplary devotion for 17 years.
Jurors heard she crushed up pills and fed them through her daughter's nasal tube, handed her morphine and injected three syringes of air into her vein after she made a failed suicide bid.
Gilderdale, 55, initially tried to stop her daughter ending her life following a 17-year battle with the chronic fatigue illness ME but backed down after she said: "I want the pain to go."
Lewes Crown Court was told she was a loving and devoted mother to her daughter, who was struck down by ME at the age of 14 and needed round-the-clock care at her home in Stonegate, near Heathfield, East Sussex.
Miss Gilderdale, a once active, sporty and musical girl, led an "unimaginably wretched" life in her later years.
She was paralysed from the waist down, unable to speak, eat or drink and was fed through a tube.
Communication to her parents, who were divorced but remained supportive of her, was through a form of sign language they devised themselves.
She was bed-bound, socially isolated, unable to sit up and developed suicidal thoughts, which she published on an online forum for people suffering from illnesses.
She had attempted suicide in the past, had drafted a "living will", placed a Do Not Resuscitate note on her medical records and considered ending her life at Dignitas, the Swiss-based assisted suicide clinic.
In the early hours of December 3 2008, she took an overdose of morphine by injecting the pain-relieving medicine directly into her vein, according to Gilderdale's own account to the family GP, Dr Jane Woodgate, on the morning of the death.
When she realised that the dosage was not high enough, Miss Gilderdale called out to her mother, who then spent around an hour trying to persuade her not to press ahead with killing herself.
But after telling her mother that she wanted the "pain to go" and that she did not want to go on, she set about, over the course of 30 hours, helping her end her life, the trial heard.
Gilderdale handed her two syringes of morphine, consisting of 210mg each, which her daughter administered herself through her Hickman line directly into her vein.
Hours later, at about 6am, Gilderdale felt that the morphine had not achieved her daughter's aim of killing herself and searched the house for tablets, fearing that she would be brain-damaged.
These pills were crushed using a pestle and mortar and then inserted into her daughter's nasogastric tube.
Evidence from Sussex Police found that during the period until her death, Gilderdale trawled the internet for details on drug overdoses and euthanasia.
Following "two or three" more doses of morphine, three syringes of air were pumped into her Hickman line with the intention of causing air embolisms, it was alleged.
Miss Gilderdale died at 7.10am on December 4, with only her mother present. A post-mortem examination at the Conquest Hospital in Hastings found the cause of death was morphine toxicity.
Gilderdale's ex-husband, Richard Gilderdale, told the court he discovered his daughter had died after he received a text message from his former wife, saying: "Please can you come now. Be careful. Don't rush."
When he received the message, he knew what had happened, he told the court.
He said he could never imagine his ex-wife trying to kill their daughter, saying she gave up work without regret and rarely took a holiday.
Describing Gilderdale's reaction to the death, he said: "Her world had come to an end, she was crestfallen, heartbroken - everything you could describe about somebody who had been to hell and back."
Miss Gilderdale had attempted to kill herself before in mid-2007 with a morphine overdose, but her father walked into her bedroom to find her sleepy.
Retired Sussex Police officer Mr Gilderdale said Gilderdale, whom he divorced in around 2001, remained positive that she would get better, although he privately thought otherwise.
Despite their marriage split, they remained actively supportive of their daughter.
Throughout the trial, Gilderdale was supported by a large number of family and friends, including her son Steve and her former husband.
She declined to give evidence. Jurors were told that she could not be tried for murder as it was uncertain whether her daughter died from the overdose she gave herself or from that given by her mother.
Standing on the steps of the court, Gilderdale's son, Steve, read a statement praising the verdict.
Flanked by his mother and father, he said: "We believe this not guilty verdict properly reflects the selfless actions my mother took on finding that Lynn had decided to take her own life, to make her daughter's final moments as peaceful and painless as possible.
"These actions exhibit the same qualities of dedication, love and care that mum demonstrated throughout the 17 years of Lynn's illness.
"I'm very proud of her and I hope she will be afforded the peace that she deserves to rebuild her life and finally grieve for the death of her daughter."
The case has drawn parallels with that of Frances Inglis, the mother jailed at the Old Bailey last week for injecting her brain-damaged son with a lethal dose of heroin, and reignited the debate about assisted suicide.
Mr Justice Bean asked prosecutor Sally Howes QC to explain "why it was considered to be in the public interest" to pursue Gilderdale on the attempted murder charge when she had already admitted aiding and abetting her daughter's suicide.
Ms Howes said the prosecution decided at "the highest level" to press on with a jury trial after Gilderdale had told her GP and the police that she had administered an air embolism with the intent to end her daughter's life.
"There was no submission of no case to answer and the matter went to the jury," Ms Howes said.
Defence counsel John Price QC asked the judge to consider an absolute discharge based on interim guidelines by the Director of Public Prosecutions, Keir Starmer QC, who last year outlined 16 "public interest factors" in favour of a prosecution and 13 factors against taking legal action to bring clarity to existing assisted suicide legislation.
The move came after law lords backed multiple sclerosis sufferer Debbie Purdy's call for a policy statement on whether people who help someone commit suicide should be prosecuted.
Mr Price said that if the DPP was handling the case today, in light of the verdict, it would not be considered in the public interest to prosecute.
Sunday, January 24, 2010
Dr. Anne McIntyre Interviews Ean Proctor, the boy Wessely had sectioned
ShowalterdontlikeME:
The events happened 1988. The Channel 4 program was "Frontline" 25 Jul 1993
For details of Wessely's role google "To set the record straight about Ean Proctor from the Isle of Man."
DR. Peter Hudgson was 57 at the time of the film. He died 17 Feb 2005.
The girl near the end of the film holding a hamster is Lynn Gilderdale. She never recovered and sadly died last year (2009). Her mother's nightmare still continues, and has to face a court case this year. I'm sure all send her their best wishes.
The events happened 1988. The Channel 4 program was "Frontline" 25 Jul 1993
For details of Wessely's role google "To set the record straight about Ean Proctor from the Isle of Man."
DR. Peter Hudgson was 57 at the time of the film. He died 17 Feb 2005.
The girl near the end of the film holding a hamster is Lynn Gilderdale. She never recovered and sadly died last year (2009). Her mother's nightmare still continues, and has to face a court case this year. I'm sure all send her their best wishes.
Friday, January 22, 2010
Nursing Times online poll: Is the Daily Mail bad for your health?
Saturday, 16 January 2010 08:25
Following the Daily Mail apology over their online vote about whether ME is a genuine illness, the Nursing Times website has launched its own poll on whether the Daily Mail is bad for people's health.
Their Beyond the Bedpan columnist writes:
If you need health advice, Beyond the Bedpan recommends the Daily Mail. Provided, of course, that you’re not making it up.
The Daily Mail takes pride in its health coverage, and rightly so. Just ask the thousands of children saved from autism when the paper championed an aleged link between the neural disorder and the MMR vaccine.
And I do mean championed. The MMR-autism link went on to be categorically discredited. But The Mail battled on, brushing aside the petty protests of scientific evidence to bring it’s own lucrative version of “truth” to the masses.
Even a claim by the Media Standards Trust - that the anti-MMR claims were increasing the chances of a measles epidemic and putting children's lives at risk - failed to dampen The Mail’s righteous fire.
More recently, the paper questioned the safety of the human papillomavirus virus (HPV) jab when a 14-year-old girl died shortly after being vaccinated. And the paper continued to question it even after public health officials said the girl’s death had been caused by "serious underlying health conditions", and not by the HPV vaccine.
So it should be no surprise to learn that that the Mail’s sympathies extend to people suffering from myalgic encephalopathy (ME). The condition causes chronic fatigue, muscle and joint pain, sleep disorders, gastric disturbances and poor memory. The symptoms are often debilitating enough to prevent sufferers from working, going to school or generally leading normal lives.
And what words of advice would our favourite health correspondents have for people suffering this debilitating symptoms? It was summed up nicely in a reader poll: “Is ME a genuine illness?”
In other words, “not only do we know nothing about your condition, but we think you might have made the whole thing up”.
Shocking stuff. So shocking, that even the immovable Mail saw fit to remove the poll and apologise. An apology that neatly blamed the fiasco on an unnamed “junior” member of staff, and couldn’t resist raising a suggestive eyebrow by reminding offended ME sufferers that “there is still a great deal to learn about what lies behind the condition”. Charming.
Poll
Is the Daily Mail bad for your health?
Yes
No
Don't be silly
I'm vaccinated
It doesn't exist
Following the Daily Mail apology over their online vote about whether ME is a genuine illness, the Nursing Times website has launched its own poll on whether the Daily Mail is bad for people's health.
Their Beyond the Bedpan columnist writes:
If you need health advice, Beyond the Bedpan recommends the Daily Mail. Provided, of course, that you’re not making it up.
The Daily Mail takes pride in its health coverage, and rightly so. Just ask the thousands of children saved from autism when the paper championed an aleged link between the neural disorder and the MMR vaccine.
And I do mean championed. The MMR-autism link went on to be categorically discredited. But The Mail battled on, brushing aside the petty protests of scientific evidence to bring it’s own lucrative version of “truth” to the masses.
Even a claim by the Media Standards Trust - that the anti-MMR claims were increasing the chances of a measles epidemic and putting children's lives at risk - failed to dampen The Mail’s righteous fire.
More recently, the paper questioned the safety of the human papillomavirus virus (HPV) jab when a 14-year-old girl died shortly after being vaccinated. And the paper continued to question it even after public health officials said the girl’s death had been caused by "serious underlying health conditions", and not by the HPV vaccine.
So it should be no surprise to learn that that the Mail’s sympathies extend to people suffering from myalgic encephalopathy (ME). The condition causes chronic fatigue, muscle and joint pain, sleep disorders, gastric disturbances and poor memory. The symptoms are often debilitating enough to prevent sufferers from working, going to school or generally leading normal lives.
And what words of advice would our favourite health correspondents have for people suffering this debilitating symptoms? It was summed up nicely in a reader poll: “Is ME a genuine illness?”
In other words, “not only do we know nothing about your condition, but we think you might have made the whole thing up”.
Shocking stuff. So shocking, that even the immovable Mail saw fit to remove the poll and apologise. An apology that neatly blamed the fiasco on an unnamed “junior” member of staff, and couldn’t resist raising a suggestive eyebrow by reminding offended ME sufferers that “there is still a great deal to learn about what lies behind the condition”. Charming.
Poll
Is the Daily Mail bad for your health?
Yes
No
Don't be silly
I'm vaccinated
It doesn't exist
Wednesday, January 20, 2010
Kay Trial on BBC TV South East, tonight (19 January 2010)
Hope this works for you.
Click here http://www.bbc.co.uk/southeasttoday/
Click on orange text "Latest Programme" to open BBC Media Player
Click Launch this in stand alone player
Starts about counter 12.45
(slide blue bar, bottom left to just before this count to get a good start)
John
drjohngreensmith@mefreeforall.org
Dr John H Greensmith
ME Free For All. org
Click here http://www.bbc.co.uk/southeasttoday/
Click on orange text "Latest Programme" to open BBC Media Player
Click Launch this in stand alone player
Starts about counter 12.45
(slide blue bar, bottom left to just before this count to get a good start)
John
drjohngreensmith@mefreeforall.org
Dr John H Greensmith
ME Free For All. org
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