I had to look it up: candor (or ‘candour’). Having lived and worked in Ireland for more than 27 years, I don’t recall to have come across this word ever before. I might just not remember it. It’s also late and it has been a very long day… For those of you who, like myself, cannott remember to have come across the word before – it means openness, honesty, sincerity. Duty of Candor, at least in the U.K., has come to describe the concept that a public authority should not seek to win the litigation at all costs but to assist the court in reaching the correct result and thereby to improve standards in public administration. A solicitor’s firm describes the concept on their webpage as follows: the contractual duty of candor in Healthcare will be an enforceable duty on providers to be open and honest with patients or their families when things go wrong ensuring they receive prompt information about their medical problems.”

Ms Justice Mary Irvine was quoted by The Irish Times on 29 November as saying that “she rarely made remarks about the conduct of a defendant in defending a case but this was the second case before her this week where the HSE had delayed in admitting liability, causing additional stress and fear for the children and families involved”. The ‘delay’ she was referring to lasted 5 years!

According to the Irish Medical Organisation (IMO), “Doctors have a duty of advocacy as laid out in the Medical Council Guide to Professional Conduct and Ethics for Registered Medical Practitioners.  (…) Advocacy is “to promote the patient’s best interests within a disjointed system of which sections often have competing priorities”. (…) Advocacy is about navigating patients through the health system or representing patients, particularly vulnerable patients and speaking out on their behalf. (…) It’s about “assisting patients in their contacts with the HSE and other health professionals” and acting as “mediator, supporter”. ”

Now, there are significant delays in getting early intensive rehab for patients with brain injuries in Ireland. Waiting times for a 3-months stay in the one and only National Rehabilitation Hospital (NRH) are about a year. This is intolerable and the consequences for patients are dire. Where are the health professionals speaking out against this situation? Where is the Advocacy doctors and consultants have a duty to exercise on behalf of their patients? How can injuries and damage to patients be tolerated because of lack of appropriate care? Where is the duty of candor doctors and consultants should exercise when working with patients? In my experience, doctors often close ranks and, instead of being the patients’ advocate, accept the prevalent lack of resources and treatment facilities, instead of campaigning for change.

When this practice comes out in the open, people are shocked and judges quite frank, like Ms Justice Mary Irvine was in late November.

Pádraig’s condition has not changed that much over the past days. However, he is definitely more aware and awake these days. I reacts to people arriving at his bedside and talking to him by squeezing their hand and opening his eyes. He is still in a coma, but showing very definite signs of regaining a small bit of his consciousness. Today, the nurses had moved up the back end of his bed, so that he was almost in a sitting position – great stuff for his circulation and lungs. Talking about his lungs: we were told that they will start trying to reduce the artificial vacuum on his left lung most likely on Monday, and then try to wean him off this tube, hoping that his lung will stay inflated.

Monday will also be the day we will receive the keys to our new ‘home’ in Hamburg. The place will be empty – but freshly renovated. We started to think about where we’ll get lamps, curtains, beds, … As much as I like our little Ferrari-red KIA, the thought of not having to get into this thoroughbred-like racing machine, for one or even a few days, is extremely attractive. Can’t wait, to be honest.

Today’s German Music Tip
Udo Lindenberg, König von Scheißegalen (2013). This is one of my all-time favorites, you might want to follow the lyrics to appreciate it. Udo lives in the Hotel Atlantic in Hamburg which we pass every day on the way to the Schön-Klinik.
What’s hot
Duty of Candour and Advocay.
What’s cold
Compliance with the status quo.
The German word/phrase/verse of the day
König von Scheißegalen

Twitter: @forPadraig
#caringforPadraig
web: http://www.caringforPadraig.org