How do 'consulting' and 'shared decision making' work in my 'Anne, David and Dr Jones' scenario ? (in the PDF) at

@TheSmallPlaces @ProfMarkTaubert @BenTroke Thanks Lucy. I'm currently a bit vexed that I wasn't aware until yesterday that a ruling I'd been following a couple of years ago had been reversed (which screws-up my previous analysis). I do think the law has got some of this wrong, but beyond that I'm still pondering.

@ProfMarkTaubert Interesting letter. As I've commented before 'Ideally an AS/AD law would be accompanied by a law which required adequate funding for and provision of good EoL Care'. And nobody wants a bad AS/AD law - but we don't all agree about what a good law would look like.

The screengrab in the previous tweet was from some written evidence to the MPs re the AD Bill. I'm not certain of exactly what they mean and what their point is - so I've asked a question which I find clearer, and which I think addresses their issue. Answers from anyone welcome.

@RajivShah90 @doctor_oxford 2/2 an unusually high 'degree of capacity' (which I think some people on the anti-AS/AD side will argue): I'll point at when I develop my analysis/argument (if I bother to write it up) @ProfMarkTaubert The MCA doesn't have 'a balance sheet' for BI either!

@ProfMarkTaubert @CMO_England A HoLs report into MCA implementation (ca 2014) mentioned that while there had been a lot of training for social workers, there had been an assumption that clinicians would understand the MCA without the need for training - an assumption which the report concluded was incorrect.

@ProfMarkTaubert 2/2 inadequate funding for EoL: there is currently talk about funding for EoL, but I doubt that will lead to really-good EoL funding.

@ProfMarkTaubert I have briefly pondered this, partly because of what friends have said to me. It seems very tricky when I think about it, because of three words: 'optimism', 'uncertainty' and 'retrospectively' - I would probably think more in terms of those than about 'potential for harm'.

The start of an e-mail from NICE. I got the impression that the RC(UK) implied, to the Covid-19 Public Inquiry, that NICE 'recommends' that the entire UK adopts ReSPECT - I asked, and NICE is NOT recommending the adoption of ReSPECT, as you can read in my screengrab.

@bomb_cancer @ProfMarkTaubert Controversially, I think that CPR should be attempted if a capacitous patient had asked for CPR Most clinicians disagree with my position, but it would at least in part address these 'hidden DNACPRs'.

@bomb_cancer @ProfMarkTaubert 'You' SHOULD see ReSPECT forms when they are created - because either the patient or 'family' should be involved in their creation. And one of the responses, touches on a significant issue (bold text in the text image) @ProfMarkTaubert @drkathrynmannix

@bomb_cancer @ProfMarkTaubert I'm interested: did your daughter SAY 'maximum ward-based care' - or did she just say 'maximum care' or 'all possible treatment'? Basically: did whoever completed the form, change what your daughter said?

@ProfMarkTaubert So far as I know, we haven't met: feel free to connect us! I'd love to know what he makes of my piece at

A thought about the offside rule in football - a very-simple thought, but ... @FootballAssoc

An e-mail I've just sent. How are ADRTs combined with ReSPECT forms? @rcuk @NWAmb_Kieran @ProfMarkTaubert Answers from anyone who completes ReSPECT forms, would be appreciated. And views from anyone who has got a ReSPECT form. @patientsass

@rcgp @TheBMA @theRCN @ParamedicsUK Why are clinical organisations, so reluctant to make clear that relatives and friends can be 100% capable of MAKING legally-sound Best Interests determinations: but they CANNOT IMPOSE their determinations on others?