Friday, January 26, 2007

Prostitute for hospice patient; some blog posts

Well if you are not regularly reading this blog (you should be if you are in hospice or palliative medicine...), I figure I can at least get your attention if I put 'sex' in the title of the post.

The Oxford Mail (UK) reports on a recent complicated case at the Douglas House, the world's first hospice designed specifically for young adults. A 22 year old resident suffering from Duchenne's Muscular Dystrophy wanted to have sex before he died. His solution was to find a prostitute since his prospects at developing a loving relationship in such a short amount of time to have a meaningful sexual encounter was unlikely given his condition. He brought his request to the staff and they debated in their ethics committee whether or not they should honor his request. The debate centered on providing for the patients safety and helping fulfill his wishes. They had concluded that he would have to use his own money, it could not be in the hospice house, and that they would have someone present in his home (in a separate room) in case he needed assistance. Sister Frances Dominica made a lot of great comments about the debate on the Douglas House website. Apparently this conundrum is also featured on the BBC2 in a series about the Helen (children) and Douglas (young adult) House. Nick Willis, the patient in discussion even wrote a very mature and important column in the Guardian. He states very wisely here:

Strangely, talking to people - especially parents and carers - about death and dying may be easier than talking to them about sex.

It is a very fascinating read regardless of what you may think about his actions. I must say that this situation has never come up in my career in hospice thus far, but at least now thanks to Pallimed I have at least one case study to refer back to. A final quote from his column:
My experience taught me a lot and gave me a sense of normality to a degree. It also helped me to realise that I could make things happen if I really wanted them enough. But it did not give me what I most want. I continue to hope that I may be able to establish a relationship with the right person. The same as any other "dude", as my older brother Tom would say, I want to be able to hold hands with someone, to love and be loved.

2) A new blog to interest those in the nursing home and hospice world is: Hospice and Nursing Homes. The first two posts look promising. We'll keep an eye on it and post it on the links on the right if the quality continues.

3)I enjoy reading first person accounts of hospice experiences. I like to think it may be a family member of someone under my care and I am getting a glimpse into how they are thinking/feeling. A blogger 'named' Solitary posted a well-written account of her Grandfather's death. I will occasionally post one of these every few weeks if there is something outstanding about the story or writing.

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