Self Discharge: Know Your medical legal rights!
An Englishman's home is hiis castle!" -err, Was!
Having decided that all I actually needed for my eye irritation was advice, reassurance, and basically some-one with more knowledge than me to discuss it with. I did go to a nurse practitioner, she sent me to casualty.
Casualty decided to test my blood. And in so doing I met a nurse who explained enough to reassure me. So, whilst waiting for the results. I asked if there was a discharge form. Told No. Pointed out I was busy and could only wait about 20 mins. All in all I told 3 people I had to go. The Sister in charge said "So, if you're not here when the doctor comes, we can assume you're at home."
Believing this to be so my results could be sent and advice given etc. I said Yes. I ignored what appeared to be a look on her face. Dismissing it at the time. Now, I wonder because the police turned up!
Potasium was high, and usually is on the second day, before the next dialysis but I had them stood at my door 15 mins. before I could get rid of them.
Here is some ideas of what needs to be done. And needless to say, I sent a letter to relevant departments stating in no uncertain terms that I do not want police involvement in my medical care. And they must not be sent to my door under any circumstances.
A Patients right!
Proposal for Best Duty of Care Procedure change
with A&E in mind.
1. Nurse should offer patient form, if patient asks to leave. Arrangements to be agreed, if doctor has cause to speak to patient.
Text or GP. If not urgent.
But a list of common urgencies should be given. And opt out form, if not already completed and checked to be given.
The Department must phone with message, if allowed to.
The Opt Out Form upon self check out
Under No circumstances contact me. yes/no.
If no, please make sure some-one knows where you are, and arrange to contact them or vice versa within ..../24 hours.
delete as appropriate:
I may be contacted by phone, and if necessary leave a message with whomever answers /______________________ or on the answer phone.
1. Under extreem cases where the possibility of fatality is considered by the doctor. The doctor after trying and failing to make contact by phone, may call the police. yes/no.
2. If yes to #1. The Police on recieving No answer by any body at the named address or by person's with access to that named address may use force to gain entry. yes/no -I prefer to wait while key bearer can be found. (This must be given)
state if different to address: The place, I am currently most likely to be at is: _______________________________________
If different or further to Next of Kin:
The Key bearers name is: /are... __________________________
contact/s details ________________________________________etc.
Please allow me _________________ hours/.... to get home/ to above location.
Signed .............................. Date ..................
When The Police came knocking!
Incident of 30th March 2012. Where Police called At approx. 8.45 to 9pm.
After a seemingly over worked nurse practitioner sent patient to A&E rather than discuss modes of the eye "They have a special machine that can see the back of the eye.". The patient duly went though only putting it off in order to get some housework done as this was/is piling up.
On arrival patient struggled to get across his exact concerns, and perhaps in part due to his ignorance on the subject matter, and the triage nurse's ignorance of the patient need for reassuring information, and that a little time for people might save some pointless work! He didn't seem interested when I went back to try to point out what look to be many bite marks of various sizes on my lower legs. And just said "yeh, ..." repeating that I go wait in the waiting room and the nurse would see me." She didn't give me the time either!
-(You will know a triage nurse as the second receptionist employed so you can go in and say the same thing to the whole que and waiting room, if you want then get to say it again more privately. Just to have said "sore eye" might've resulted in the Spanish inquisition.
The receptionist can then prioritise for further questioning with b/p check. ("Pff!"). In all this my eye wasn't looked at again!
"I'm going to send you for a blood test to check your blood chemistry because you're saying you think the insect is still in your eye and that's not usually possible." with that I felt dismissed by his demeanor as he turned away etc. "If You wait in the waiting room!"
He took me a bit too exactly. It could've been debris from such an attack, or repeat occurrence while I slept. I didn't know and just wanted to make sure for peace of mind! (Clearly too much to ask that lot!). The suggestion seems to have been that I was hallucinating; I don't add anything that might cause anything like this to my prescribed list, nor have I ever hallucinated on high potassium before! It has been a very long time, years, since I needed Tramadol for pain -And that was quite different experience/s!!! So, I'm wondering -still- What was going on that day?
So, having not ever seen this triage nurse before /as often as the nurse practitioner, and so having not built up any repertoir of trust/understanding to the same level. It was hard, much harder to actually take her advice and say exactly what I'd said to her.
Besides I had much to do, it was quite a long journey and I'd been worried for at least a few weeks when I first noticed some little black thing land in my eye and seem to roll round with my eye lid as I lay on my back resting. Nor did it seem that easy all of a sudden to tell them in that cold clinical arena how for years the place I live was neglected by its Housing Association and that only now after much work to get them to see it are they making the necessary changes -though it still hasn't been cleaned! And as a result it seems that vermin got in, and while rats etc. don't seem so apparent. It's hard getting rid of and keeping away what appears to be fleas. -though these have been kept down to minimum by constant use of sprays etc. This is costing hundreds of pounds! -All because a Housing Association doesn't check it's contractors.
So, A&E nurse took my b/p. And I managed to ask her a bit more. I pieced bits together, and feeling a bit stupid realised my eye could feel heavy because in my worry I'd been rubbing it! So much that I couldn't understand why the nurse practitioner hadn't told me this. She seemed to believe that A&E have a special machine that can check behind the eye, but when I got to A&E I was told that "it's impossible for insects to get round the back of the eye."
Having been sent back round to the waiting room after the blood test. I began to wonder what the heck I was waiting for. What would the doctor say that the nurse hadn't already? So, I spoke to the receptionist and told her how busy I was and would give it another 20 minutes but then really had to go.
She simply said. "Go round, have a word with the nurse." She coldly said "So, if you don't answer when we call you, we can assume you're at home."
I thought You can assume I'm on the moon for all I care, so simply said "Yes.". And although I had asked for them to text me with the blood results. She argued "No. we won't do that. " and she paused though at the time I thought nothing of it... "We'll contact your GP."
fine. I thought. As I went back to the waiting area. And after duly giving just over 20 mins. I went to the reception again on my way out. I asked "Is there a form for me to sign?" He said "No." as he shook his head. So, having slowly walked down the corridor out in case my name was called, I went on my way. I rued the thought of how hard it was to say exactly the same thing word for word twice in two different places, without rehersal.
As I explained to the shocked dialysis patients the morning after. I took my time getting home. So, it seemed to me that the particular doctor in question is a 'little Hitler', whom in his Omnipotence decided thast because he hadn't discharged me then he would try to scare me and force me into going back. There was no message on my answer phone. I don't believe that story about "We don't know who else is there!" -I have often been asked in various departments "Do You live alone?" And while it sounds easy for some-one who might on some occassion come across my case and read this between the lines as "Vulnerable, Out for hospital visits hey..." -Now deny this all you want, it won't wash with me though I tend in such circumstances to get rid of the person ranting on at the dumb assumption/belief that by some magical prowess "All nurses are saints." -This is a ridiculous assumption and only serves to hide the criminality that must exist among a people selected from society which by definition is wide ranging in its variety. So, if you choose to preach on the lines of "People are carefully selected now", Hmm, by whom??? Don't be surprised if you simply get mild mannered agreement to get rid of you because you only know your point of view and I clearly won't pursuade you of any other. Clearly proof is a burden as it can be hard in the bringing etc. So lets not bother talking about the dangers long term patients in particular, are under.
Though I am making a very loud protest indeed, if necessary at this ridiculous carry on I was put through on the night of Friday 30th March 2012 by this poorly thought out law. I am lucky, on this occassion the police took longer than me to arrive at my flat!
The Policeman's initial argument was of his, their perception on the face of it as to how the doctor felt who had called them to drag me away from the relative peace and quiet of my own home with the excuse on the lines of:-
"Some-one's obviously concerned for your welfare, and doing all they can to help you. Why else would they call us?"
"You don't know them how I know them, and have come to know them over the last 8 years. Our positions and perspectives are Not the same!..."
I only came out with one answer on the spur of the moment. Now, I can think of three or four. I will list them in no particular order, as follows:-
1. Convenience, if the doctors had bothered to ring me and leave a message -And by this I mean with a number I could've and would have got back to as soon as I arrived and checked. They might have felt obliged, or I might have asked for transport. This, their department has to pay for. So much easier then to get a freebee from The Police! Now, as much as it is not really my business how The Police force allows itself to be used as puppetts etc. by the medical profession. I do believe that The Police aren't themselves immune from these government cuts, and therefore would perhaps appreciate not being used this way -so casually etc.
And 2. Shock and Awe tactics. Having, albeit a long while ago refused a doctors phone call for high potassium, even believing in myself that I'd explained about dialysis quite well etc. I now believe going from the way some doctors can be with patients; I felt that some kind of report, written negatively about me -as many of these people aren't all that positive!- That must have prompted the current doc to taking these drastic draconian measures.
3. Funding for Operations and Proceedures. As I said to The Policemen, "It's more obviously that some-one has seen an opportunity to waste more of the NHS funding and cause more debt for the sake of spending to their own department on a matter that is already going to be fixed first thing in the morning!" -They knew about my dialysis because prior to taking my blood, the nurse asked "Do You have your blood taken in dialysis...How often are your monthly bloods...&..When was your last?"
4. I also felt that some little hitler had decided that just because s/he hadn't discharged me then I better come back -or else!- and then even the smallest mole hill excuse was made into a mountain to the unsuspecting, less medically educated police! In effect forcing his treatments -I remember as an adolescent desperate to play football. Getting into trouble with neighbours whom on occassion contacted the police. I had perhaps to learn that I couldn't do something just because I wanted to. I feel it is long since time doctors like this and any-one who supports such draconistic practices against patients should grow up too!
5. I later considered Ignorance of the modes of dialysis by those medics who aren't trained in the subject. Having discussed this with Dr. Ackroyd, Palliative Care Consultant. I feel that the A&E doctor would have had access to information and advice from an on call Dialysis doctor. Now, either this proceedure was ignored, or the dialysis specialist isn't that well trained either. In any case why aren't these people taking any interest in what I, the patient want/s or don't want to do? Why is there still little or no consideration by 'professionals' for how much a patient may know with no wish at all to find out? And yet they call themselves "Caring"!
Police: Duty of Best Care
First. May I have full details of this that I may copy and send to hospital departments, magazines etc. As I do strongly believe that this should be made known to the general public, particularly patients, carers etc. May I also know whether, and under what medical grounds a person can be arrested -Is a Warrant needed if the person is in their own home; (even if this is owned by Council, or Housing Association, etc.)?
In full consideration I strongly believe that the best care is the least invasive, and is the option causing the least inconvenience to the patient; their routine, mood, b/p etc. And in so doing is always the patients choice without so much persistence from police/medical staff.
In this specific incident.
I got the strong impression that The Police were so overly concerned with the thought of getting into trouble with The Coroners Court that if I did not make it through the night what might happen to them etc. So much that they failed to hear my lengthy experience of my illness.
For Over 8 years I have dialysed. Tests suggest, and common sense prevails that for most dialysis patients Potassium (K.) levels will rise, and be high/er than 'normal' between dialysis sessions. Particular in the part of the week with the second day off -which it was due to a re-arrangement for a funeral.
At no point in these 8 years have I ever had any of the symptoms that I had to list to demonstrate knowledge to the policemen. 1. Heart could stop, 2. Stroke. It shows that just because they are risks doesn't necessarily force them to happen. And if by default I had to go to hospital between sessions every time to treat potassium; well, it would be a ridiculous set up. I'd never be out of hospital long enough to live any kind of half decent life! And worse still the hospitals would be crippled, full of dialysis patients having special k. treatments! -Therefore it is hypocritical that one patient be singled out, worse when the complaint was totally unrelated!
Problems with Procedures
I have no evidence that the A&E phoned me before sending out The Police. I took my time going home, having a meal on the way -why shouldn't I?- and missing two buses having walked part of the way. The Police didn't seem to know whether the department called me either. Well, they should do! I believe it is there duty to check that proceedure has been followed, and that the patient clearly said they could be contacted at home if urgent. And that the proceedure should be agreed by every-one, patients included -Including Individually!- And clearly understandable. For Instance. Drop the question do you live alone, to "Can You manage if sent home whilst not quite fully recovered -ie. Will some-one come to look after you/can you visit them? (Note: This is a Yes /No, and not a delete as apt.!) A question would be needed on the lines of Can we contact this person this visit?/ Does any-one know your here? Next of Kin might be different to Acute Carer. It should be offered to the patient whether they allow answerphone and/or personal messages to be taken.
I don't appreciate traps!
First. The nurses "So, if you don't answer us when we call you, we can assume you're at home?"
I just murmured "Yes.", thinking you can assume I'm on the moon for all I care! What I should've said was "No. You must assume I'm no longer available and discharge me!"
Second, Nor did I like the way the policeman tried in a subversive and subtle manner to try and get me to say in a way that I was wrong and he was right. First: A patient doesn't have to take best care, if that were true 1. a lot of medical staff would be out of work! 2. The commercialism of medication would be banned and we'd all have to take the same generic label!
The trick question "Do You accept though that We have your best interest at heart!?" -If 'yes' would allow them to assert more pressure and perhaps repeat the waffle about not taking things seriously. When in fact I am unaware -again- as above- of any law that says A person must get the best care, treatment possible. It's good there isn't for this would take away free choice from the individual.
(I realise an acute exception exists to the rule for certain mental/... patients.)
In this case it is hard to say what puts the patient under most danger. Being left to ones own devices as has been the norm, and what the patient agrees with and has easily managed with for years/ since starting dialysis.
Suddenly pouncing on the patient and dragging them off to face treatment/s that have their dangers anyway, and at a time when a person was about to rest has to endure the public limelight, is unlikely to get much sleep or rest now having suffered all this upheaval. Then without much time, if any to settle has to get home to make the rendezvous with the transport (that AGAIN! could call the police to break in if they aren't there!!!) And what if in the meantime the A&E doctor takes more blood, so the patient is on a knifes edge wondering all night if they are to make their second marathon (equivalent) or suffer MORE humiliation at the hands of the so called "Caring" profession? Whilst waiting for the blood test results whicch the doctor would by form do. Not knowing that the patient has lost quite a lot of blood over the last few weeks due to several Blood Leaks (these are supposed to be rare -So, are they trying to pick on me?!) So, these routine blood tests could cause Haemoglobin levels to drop. This in turn may require Blood Transfusion/s! And what if getting stressed that there's so much to do at home -And Thwe Policeman even saw there was!- that this pushes b/p up. And so the doctor piounces on it ... "We'll have to keep you in" comes the order that has already been backed up in force by the law.
(By God! The patient thinks, if I go now I'll be a fugitive! There'll be tracker dogs, hellicopters, the whole ... force out..!!!)
Now do you see why the patient needs the right to say what their best care is, and empower the officer to do his duty according to what that patient feels to be best for themself on that given day. If patient doesn't know the risks these are easily explained rather than used as a claim of "Argument won, therefore Must Adhere" etc. How hard is it to question? ..How much harder to question orders???
Thinking about alternatives now, it might have hurt him /them less had I said "No, but I can accept that you think you have. Unfortunately, you are deluded as it would have been better for me had you not interupted my schedule tonight as I dialyse as usual in the morning anyway."
Something like the last bit had been said at some point because I remember them earlier saying "Do you know what will happen to us, if You don't go?"
I said "Go on."
They told me "Coroners Court!", and after a pause went on "We could be in serious trouble...."
So, my right answer about my supposed 'best interest at heart' was "NO! You've already said, you're trying to avoid getting yourselves into trouble. And with that in mind I have told you I will sign a disclaimer form.."
He said, he didn't have a form "but with that in mind, could I come with them and do something on those lines at the hospital?"
I replied "No. " On the grounds, "Why didn't they provide a release form at the time? -I asked for a form at reception when I finally left..." I even gave them 20 minutes, at the time of speaking to that nurse.
I got angry at their persistence and repitition. All this did was have him assert his authority by ordering me to calm down. I managed to bring my self back the first time he said it. After that I said "I'll calm down if you leave!"
To my dismay, he refused. Having gone through my major points again I added and I want you to leave npow. Again he said no, still sticking to his "Duty of Care", I don't know how many times in the 15 minutes -that seemed like hours!- I said words to the effect of "Well, if your talking about Best Care. Best Care is the least invasive and does thwe least to disrupt a person/patients routine."
"You potassium is high."
"Potassium" also listed as Vitamin K. "gets high for most, if not nearly all haemodialysis patients between sessions. (esp. as 3x week for four hours). -And especially after the second day off!"
Somewhere in this exercise in going round and round, he said "Do you know the risks of not having treatment though?"
I retorted "Yes."
"What?" he challenged.
"My heart could stop, or I could suffer a stroke." -I don't however appreciate being over reminded of this due to the mantra effect..
So when he started off on his retorhic "Yes, so..."
I imposed "Yes, then I won't have to dialyse!"
He had what I felt was the nerve to then say "I don't think you're taking this seriously."
"You what!", I blasted getted very annoyed! "Do You know how hard dialysis is?"
"I'll tell you. For a start people can die on it anyway! It's the equibvalent strain on the human heart etc. as running a marathon. And that's not just me saying it, it's what I'm told by the so called experts."
"Oh, yes I can understand all that."
Again I interupted "And I'll tell you something else. I have A will, A Living Will and because I couldn't get proper Insurance due to having this illness I saved up and paid for my own service! -So, Don't You dare tell Me I'm not taking this seriously!"
At whatever point it was I got so fed up of all the getting nowhere and hearing the same things and trying to get the same points across. So, I said I've asked you to leave. I'm telling you now you are no longer welcome in my house, I want to get back to what I was doing."
He said no throughout, shaking his head.
So I added "If you don't I'm going to call the Police!"
They seemed to smirk at this, and the people on the other end of the 999 call, just told me to hang up before they hung up on me. The policemen in the flat said "You've wasted a 999 call there."
I realise now that had I said and done something on the lines of phone a friend/relative and get them to contact a solicitor for me. This would have been more effective in dealing with the unwanted call.
I said "hang on, you by not leaving, are breaking the law. -You're Not above it!"
faces dropped again, as they seemed to do a couple of times that night -Why should it be about finding the best argument? It should be about whether I, the patient want to go or not, and making sure that if I wasn't fully informed of the risks I can be and then be asked again if I actually want to go or not.
All that drama. Down to feeling I couldn't quite do enough to demonstrate that I understood my situation, and not only had treatment already arranged but that the only thing likely to invoke the 'what could happen' was being wound up and pestered about it. As was happening by the police. -People supposedly with my best interest at heart. -I told them enough times they wouldn't have it.
New Procedure: To be Considered!
I realised having not wished to be contacted further -except via my GP. I should not have agreed that they could assume I would be at home. I would have said "You can assume I am somewhere safe but unavailable!" - My lack of realisation indicates that others won't know what may be in store for them. And as this incident proves that staff aren't being clear, therefore there should be leaflets freely available, and more information offered in various magazines; particularly those that cover long term illnesses for patients.
If contact is to be made. The department must use the phone. Also, if available the answer phone should be used by the department when the patient isn't available and no-one answers. All that needs to be said is "message for (name), Timed at (Time), Please phone (department) on (number) by (time) to avoid The Storm Troopers being sent!
It's worth noting that had I been broken into, I would have had to refuse hospital on the grounds that there was no-one else to secure the property, and I would have to wait for the locksmith. On arrival; it would've still been no on the grounds that such a destructive force can't possibly have my best interest at heart. And I would've told the media the same, -as I continue to reserve this right. I feel allowing people to break in attracts the wrong type of person to that role -including medical staff who initiated the proceedure!
Furthermore, all patients should have the right to avoid being "Stormed!" (for want of a better word), not many people know that had I not answered the door, the police were legally within their rights to break in.
There should be an option on the medical form that allows a person to opt out. The reasons don't need to be given but there's plenty to speculate on. Don't want to have more work to do carrying out repairs /waiting for people. May be ion last chance with Landlord /co-tennant/s etc. May have a personal guest etc.
If, a person agrees to name the person with the spare key (if this is different to next of kin), that person should be contacted instead of The Police. A key holder may phone back and say, Yes. I've managed to contact patient; they say they aren't interested. That should discharge proceedings. It is also the reason that the next of kin should be contacted in any case as they may be able to find the patient and ask on the departments behalf easier than the authorities alone! It may be worth adding to the form ("Person/s to contact if I am out" ...)
If Police do agree that there may be a reason to go to a call out. They should also phone first, and phone again besides knocking when the unit arrives! Their job is merely as a last resort if the person with the spare key has not been found, and the person themself is not where they said they'd be -If they've given a destination at all. And neither should they be obliged to do so! If no opt out form is signed then at some point it may be a thought to go out and have a look. (But take an opt out form as it may not yet have been tendered -doctors can be funny when they don't want you to know something.) A patient should have the right to refuse a visit over the phone.
Note. It should possibly be separate questions that allow a patient, person at any future time that they be considered a patient to be able to separately refuse being broken into, besides offering key holder and next of kin as alternatives. Or even to not have anybody pestered. A length of reasonable time for the person to return home from discharge should be placed on the form. And if the person says "1 week" that should be respected too! With this the main local hospital should be listed and if the patient is further away then an approximate extra time must be calculated and used.
Moreover, if a patient is in hospital but dies, the next of kin have to be informed. Why isn't this so if the patient is away? At least then, if they aren't at home the question can be asked "Where do they usually go -if anywhere?". The next of kin can say, if asked, "Don't break in, I /... has a key."
I am concerned about the automatic assumption that if a person doesn't answer they must be showing the symptoms that the test indicates a mere possibility of. There are other factors to consider. I walked to town, ate out and in the process that they are in different places in town missed two buses from town to home! So, if somebody rings, they must leave a message so I know they have rung, and a return number so I can say when I'm back. What is more 1 hour is a reasonable time to wait before calling anybody.
For me, it is not so much about a race against time. But an Assurance that I won't be left alone too long if anything untoward were to happen. If I am to pass away so beit, and I feel almost certainly assured of being at Peace.
I also feel that I was lucky that I answered the Police call. At time of writing the video links aren't working/ready. And at that particular time of night a lot of idiots seem to call / mess around with the com etc. So, an extra phone call with that com call is a must! As well as some right to ignore callers in case the phone happens to be out as well.
All patients should know their rights. These should be added to starter packs as leaflets, occassional or permanent printings in magazines, including online. So that patients aren't left to guess. For Instance, Could I have been arrested?
All I knew that if I am arrested I am entitled to a solicitor, so this was the first thing I said. And that I was going to make formal complaint /proceedings because why should I or any-one be forced into treatment that I don't want. And having been in my own home I think I was entitled to demand a warrant be produced first.
So, I was very cross at being disturbed this way. It isn't just the fact that it is routine for a dialysis patients Potassium to be high between dialysis sessions, often people press the wrong buttons, or bored juveniles mess about outside...Thus, what if I'd not answered it??
Also there is the fact that sometimes some-one might need a break. If that person has given notice that they need a day off. Though I have to admmit Dialysis is more of an all in, ongoing thing sometimes we all need a break! Whether it's an hour less or a full session off. Luckily I'm at an understanding unit, but I have heard stories of past where patients were seemingly arrested to go in! This must change, but patient and staff must know the correct protocol. I've missed numerous mid-week sessions over the years quite safely as it turned out. It's only 1 extra day off from the two we usually get at the end of our dialysis week.
May I further point out that having left with nurses assumed consent I might've recieved better treatment than the above. Had I not done this they would surely have had to report me as missing which has a delayed response of three days. I am led to believe. I might've dialysed twice in this time!!! 2. A Letter could've been sent and even recieved in this time, certainly an email!
Shoe on Other foot!
If the above hasn't quite convinced you that changes do need to be made. And please find enclosed an idea for an opt out/ self release form. I wish to end with the possible, albeit unlikely scenario designed to help those who aren't quite as empathic as the role suggests they should be in any truly caring profession.
Whilst in a hospital one tends to be subject to it's ways, as in any place. But unless that place is a prision you are, should be free to leave! I do not believe media propogated rubbish spouted famously by Glen Hoddle that "ill people are being punished for sins in a prior life." If anything I believe the opposite that the more illness a person has to endure, the better their qualifications to do so! But on more practical, down to earth terms I believe illness is caused by mass greed in a population -aerosols, mass transit, cars pollute the air, sewage and other companies, tankers etc. pollute the seas, waste, mass mining etc. pollutes or weakens the land. Things are done for profit over health -including potassium being added to food!
I want to ask. Is it just a patient that is subject to a hospital. Does therefore a patient lose their human rights if a staff member / authority says they do, or simply acts in a way that diminishes or takes it away?
Suppose then if 'I' (or any-one) phone the hospital as I want /need some advice, or a prescription etc. from my doctor. And their secretary/ the answer phone tells me they aren't there.
So, having found out where s/he lives in whatever way, (as some patients do with patients by having them followed!)
So, 'I' go to their house and knock on their door; perhaps even I patiently wait a few minutes to give them chance to answer (Rare when shoe on normal foot!), but still no answer. Suppose I jump to the conclusion "OOh, something has happened to the doc.? -Well, so and so said they hated ..., has x's family blamed ... so much for their daughters death? ...Hey, I better check it out." And suppose that entity known as the word 'I' breaks in. Or worse reports to the police "Doctor ... isn't answering, I think there is something wrong!", would the policeman then question a perfectly normal explanation???
"No err, the other day ..." could happen. Or the police person tries the phone but doesn't like using answer phones! *(either learn or don't call out!)
Stormed in on, the doc having played music to headphones or simply ignoring due to a rampant session in the sack with mistress or whoever.
Just think now, of how embarrassing being broken in is. I would rather be allowed to die! -If that was happening. In the time it took to get a key, if that key is nearby I might still be salvage-able. But 1. How many are found dying? and 2. How many of these are near death /having had a reasonable life, or fed up having had a rotten life anyway???
So, to impose "Life at all costs" can be an Assault. Ready, to try my all, if required is a better motto.