Maeve Boothby O'Neill - articles about her life, death and inquest

Kitty said:
would have been impossible for the coroner to say that Maeve's death might have been prevented, or
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Why do you say that? (Also addressing others who have said this is what they expected / no other outcome would’ve been possible).

A woman died of malnutrition. She died of not getting enough nutrition into her. She died of this malnutrition despite being admitted to hospital 3 times, precisely to help with her malnutrition and to get her fed. She died despite wanting to be fed. Despite going into hospital those 3 times, and despite constantly asking, she did not actually get any feeding support except a small trial of an NG tube (while being asked to sit upright which she could not do). She also was not given NJ, PEG, TPN despite wanting further help. She also was not given the *conditions* to be able to cope in hospital without deteriorating.

How can people come to the conclusion that this was not the fault of any one doctor or that there’s nothing they could have done? Every doctor who passed through her care and who made the decision not to help her, could have done something. As someone else said, people don’t (or shouldn’t) die of malnutrition in a first world country. They each made that decision (either through their own dodgy risk assessment, or because they didn’t want to “medicalise” a “functional” illness), not to help her.
 
Key issues that determined this outcome;

- parents did not have legal counsel other parties did, which put them at a huge disadvantage
- the drs all seem to have been coached
- coroner suggested Alistair Miller as expert witness (preinquest)
- no documentation found on the safeguarding Maeve requested (multiple times, if I remember correctly)
- there was no gastro expert, the consultant’s remarks were taken as truth (while he was covering for his decisions)
- dr Weirs testimony was rejected, imho the only real expert on ME
- strange that dr S concluded nothing could have been done to change the outcome (and suddenly has a nice new shiny NHS job)

Is there a possibility for appeal?
 
I see a lot of twitter or X links.

The issue with links is that tweets can be removed, the link can change, X can cease to exist etc etc and so we could lose important information.

my question; can we please screenshot them, like mr Magoo?
 
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Nightsong said:
A coroner's inquest isn't a civil trial; there aren't carefully chosen expert witnesses for each side.
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Ok, but there must be some truth-finding involved. You can't just take someone's word for it if they say they did not screw up and did everything right.

From summaries that people tweeted, it seems that the Coroner is saying that the death was of natural cause, that nothing more could have been done to prevent it, that a NJ tube would not have helped if a NG tube was not tolerated, etc. What exactly are those statements based on if no independent experts were consulted?
 
It can’t be correct to say there wasn’t any more the hospital could do as a general statement by them. At the first attempt to get help from them they refused to do anything, then eventually weeks later did try the nasal tube. They have made changes now to how they deal with people with very severe me. Their own actions disprove their “line to take” which is an attempt to fudge.
 
When Dr's talk about palliative care they often use the term 'over medicalise' to refer to a situation when somebody is dying and they end up being aggressively medicated and being in a hospital when they don't want or need to be, when they would rather be at home and not be on so many drugs (I note that Meave was asking for intervention).

Perhaps it is possible that the above was what they meant when they said 'medicalise' ...or perhaps it isn't what they meant, but the coroner and others will interpret those notes in that was, therefore missing a sign that the consultants didn't believe ME was a physical illness.

If they did mean it in the same way as the term/sentiment is used in other palliative settings, would that still mean they had a different opinion on what Meave needed (as opposed to Meave's opinion on what she needed, and what she was asking for).
 
MSEsperanza said:
From skimming it seems that the coroner only considered the effect of ME on nutrition but not the other way round.

Maybe that was also the reasoning of the hospital staff, social service etc.: No reason to improve nutrition before improving the patient's ME/CFS?

Did neither the consultants nor the coroner consider that also nutrition can have an effect on ME -- i.e. malnutrition can make the illness worse, providing adequate nutrition could prevent further decline?

Didn't they consider that even if providing better nutrition and hydration could not improve ME/CFS or prevent its progression, it still would be a reasonable thing to do as in every other illness, and in the terminal phase at least give palliative care?

Still not sure if I understood correctly that

a) the hospital staff seemed to base their reasoning on "all tests were normal" when Maeve's weight loss certainly wasn't normal and even drinking was often (later mostly) too exhausting,

b) a person in charge was afraid to "medicalize" Maeve -- didn't provide her with NG tube early on, which if had failed at that time could have been followed by NJ/ PEG/PEJ and/or even PNT at a time when she had still been able to tolerate the hospital environment for initiating these measures,

and c) there were no support by the social service, zero care by community nurses at home?
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A very very important point, @MSEsperanza.
 
lunarainbows said:
Why do you say that? (Also addressing others who have said this is what they expected / no other outcome would’ve been possible).

A woman died of malnutrition. She died of not getting enough nutrition into her. She died of this malnutrition despite being admitted to hospital 3 times, precisely to help with her malnutrition and to get her fed. She died despite wanting to be fed. Despite going into hospital those 3 times, and despite constantly asking, she did not actually get any feeding support except a small trial of an NG tube (while being asked to sit upright which she could not do). She also was not given NJ, PEG, TPN despite wanting further help. She also was not given the *conditions* to be able to cope in hospital without deteriorating.

How can people come to the conclusion that this was not the fault of any one doctor or that there’s nothing they could have done? Every doctor who passed through her care and who made the decision not to help her, could have done something. As someone else said, people don’t (or shouldn’t) die of malnutrition in a first world country. They each made that decision (either through their own dodgy risk assessment, or because they didn’t want to “medicalise” a “functional” illness), not to help her.
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No one should die of malnourishment and starvation in any land or country at all.

But all the rest of it yes @lunarainbows. This was preventable. There is ample evidence of this plain fact. The coroner could have reached a different conclusion.

What Maeve’s parents were trying to avoid was asking questions that might be allowed to hit one doctor or other HCP which could allow the hospital the healthcare commissioners the NHS and the medical culture off the hook. So they carefully targeting the system as a whole.

Systems protect themselves coroners are of the establishment and tend to back it even while pointing to specific failures within it. Through constraints that the process puts on them, which favour the establishment, of course, and through their framework for viewing the world based on establishment values.

The victim & family have no legal representation. The institutional parties questioned over their involvement in the death have. They also have institutional knowledge of the process. The bar for pointing out failure is set very high indeed.

The bereaved individuals are at multiple disadvantages.


However coroners can and do find institutional failures and point out systemic issues. So this may have been expected by many, given our history of poor treatment within and by the state, but it wasn’t inevitable.

A different coroner would have come to different conclusions, might have been even worse, could have been much more humane.
 
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Chestnut tree said:
I see a lot of twitter or X links.

The issue with links is that tweets can be removed, the link can change, X can cease to exist etc etc and so we could lose important information.

my question; can we please screenshot them, like mr Magoo?
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The forum has a standing request that
Trish said:
Please from now on if you post a tweet include in your post:

- the name of the tweeter
- and a copy of the text in the tweet so everyone can see the content.
[Edit: or a screenshot of the tweet]
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ME/CFS Skeptic said:
Ok, but there must be some truth-finding involved. You can't just take someone's word for it if they say they did not screw up and did everything right.

From summaries that people tweeted, it seems that the Coroner is saying that the death was of natural cause, that nothing more could have been done to prevent it, that a NJ tube would not have helped if a NG tube was not tolerated, etc. What exactly are those statements based on if no independent experts were consulted?
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Yeah.

As everyone keeps saying she isn’t a medical professional but a lawyer, I guess maybe she did ask but, just asked only people in medicine of a similar level of ignorance and intransigence and shruggyness as the hospital lot?


Wouldn’t surprise me if the NHS has a ‘too far on let them die’ policy across the board for patients with chronic illnesses who might need longer term feeding as compared to those with acute illnesses who still have a high chance of being killed by the system but who are at least theoretically considered worth making every effort to save.
 
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Haveyoutriedyoga said:
When Dr's talk about palliative care they often use the term 'over medicalise' to refer to a situation when somebody is dying and they end up being aggressively medicated and being in a hospital when they don't want or need to be, when they would rather be at home and not be on so many drugs (I note that Meave was asking for intervention).

Perhaps it is possible that the above was what they meant when they said 'medicalise' ...or perhaps it isn't what they meant, but the coroner and others will interpret those notes in that was, therefore missing a sign that the consultants didn't believe ME was a physical illness.

If they did mean it in the same way as the term/sentiment is used in other palliative settings, would that still mean they had a different opinion on what Meave needed (as opposed to Meave's opinion on what she needed, and what she was asking for).
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Yeah I don’t think so. Maeve wasn’t dying when she went into hospital.

Over medicalisation has been taken on as a regular thing to say about anyone with a chronic illness that the system declines to investigate or treat.

If the coroner didn’t know that ‘over medication’ is both a matter of practical possibility in medical settings and end of life situations, and a matter of healthcare politics and medical prejudice, she certainly should have. Not least because we’re a long way into the public argument that long COVID shouldn’t be ‘over medicalised’ and those people living with it we are told aren’t dying just a wee bit anxious, and therefore over focusing on symptoms.
 
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