Merope Mills and Paul Laity, the parents of Martha Mills who tragically passed away at the age of 13 in August 2021 at King’s College hospital in London, have been grappling with not only the heart-wrenching loss of their beloved child, but also the knowledge that her death may have been preventable. Martha’s chances of survival would have significantly increased had she been moved from the Ray of Sunshine ward to the paediatric intensive care unit where a bed was available, instead of receiving treatment for her pancreas injury sustained from a bicycle fall. This painful reality will forever haunt them.
Ms Mills, a senior editor at The Guardian, and Mr Laity, are now advocating for Martha’s Rule, a legislative reform that would grant relatives the right to seek a second opinion if they are concerned about a patient’s lack of progress while in the hospital. Like other bereaved individuals who have suffered due to institutional failures, Martha’s parents hope to derive something positive from their tragedy. The crux of their proposal revolves around empowering patients by obligating the NHS to establish and promote a system through which families can seek expertise from other hospital departments, such as critical care teams, if they feel that the current treatment plan is not yielding favorable results.
A similar system is already in place at the Royal Berkshire NHS Trust, and comparable examples exist in other countries. Evidence suggests that such systems lead to improved clinical outcomes. Although the NHS theoretically allows for seeking second opinions, a report from the think tank Demos highlights the prevailing challenges in many hospitals, where a culture of infallibility surrounding senior doctors hinders both junior staff and the public from questioning their decisions.
The delicate and challenging dynamics between healthcare professionals, patients, and families, as stated in the report, disempower patients when respect evolves into unquestioning reverence towards healthcare providers. This tendency is more likely to occur when individuals are desperate for assistance, and healthcare staff need to recognize this. Medical training should emphasize effective communication, particularly active listening. Trust must be earned rather than assumed.
While Martha’s Rule alone cannot solve all patient safety issues, it addresses long-standing problems that require sustained attention from policymakers, potentially including regulatory changes in our healthcare system. The duty of candour, introduced a decade ago to promote transparency in the aftermath of serious errors and discourage defensive tactics, has understandably not proven to be a remedy for all ills. Severe workforce shortages also contribute to unnecessary risks. Although this was not a factor in Martha’s case due to the well-resourced Ray of Sunshine ward, effective oversight of patients can only be accomplished when there are sufficient, experienced staff members to implement it.
Martha’s Rule, however, serves as a crucial signal and provides patients and their advocates with a new tool. There should be a consensus regarding the need to address the shortcomings revealed in this case, extending beyond the specific events leading to Martha’s tragic death at King’s College hospital. The initial positive response from both the government and Labour is an encouraging indication that Ms Mills and Mr Laity are being listened to.
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