A rock and a hard place? Ministry of Defence | Defence News | MOD confirms loss of recruitment data

[Ian Batten]

On 18 Feb 08, at 1555, Dr Adrian Midgley (In the office) wrote:

> James Cox wrote:
>> There are strong medical reasons why such information is  
>> necessary. Next of kin, anyone?
> That would:-
> a) require the contact details of the next of kin

Next of kin is a fun area, anyway.  My great uncle Tom (my mother's  
mother's brother) died last week, aged 81, in Exeter.  He has a  
surviving sister-in-law, not herself in good health, but his five  
siblings died over the last twenty years.

Even though he was one of six children, he only had five nephews and  
nieces, many of whom themselves are not in the first flush of youth.   
Tom was the fifth of the six, three born before and three after the  
1914-18 war, and those six only had a total of five children: the  
eldest three had one child each, the fourth two, the younger two none  
(they had shared a house most of their lives).

And in turn those five only have a total of eight children, of whom  
I'm one.  So it's a family tree that's a sign of the switch to  
smaller families, with a vengeance.

My mother held a power of attorney (ie the older, finances-only  
flavour) which had been used to help provide care, but my mother is  
in Birmingham and recovering from a hip resurfacing.  Her cousin,  
another niece, was helping run his affairs from Shrewsbury.  There  
were some parts of the family in Exeter, but for various reasons most  
unable to provide much help.

So, who's the ``next of kin'' in this scenario?  A sister-in-law?  Or  
pick one of five nephews, one of whom holds a power of attorney (not  
medically relevant), one of whom has MS, most of whom are  
geographically remote.   My mother, as the only child of the eldest  
sibling, and holder of the power-of-attorney, ended up fulfilling  
that role, deciding on care plans, negotiating with the social  
services over payments and help, etc, etc.  But for all James' claims  
of the simplicity of the situation, had another nephew or niece  
wished to disagree, who knows what happens?

The concept of next of kin pretty much assumes that at any time you  
have a parent, a child who is over eighteen or a sibling alive.   
Sure, cousins and nephews and nieces are fine for intestacy  
adjudication, but for dealing with care when you're not capable of  
doing so there's no obvious way to decide.  The court of protection  
is the nuclear option: my mother's mother hadn't provided a power of  
attorney before her stroke, and my parents had to apply to the court  
of protection to deal with her affairs: complex, expensive,  
inefficient, and it delays the provision of care the patient can  
clearly afford (Mum's an only child who was residual beneficiary and  
known to both the solicitor and the GP and was cut some slack, it's  
much harder in general).

In a society which is becoming more atomised, in which people are  
living longer, in which people are having children later if at all,  
and then in smaller numbers, people who have no living `close'  
relatives will become more and more common.  Blithely assuming that  
`next of kin' will be available and benevolent is naive in the  
extreme: my parents happen to be in a position where a fifth of the  
assets of a single home-owning man aren't a major draw, but cases in  
which beneficiaries begrudge `their' money being spent are hardly new.

As a privacy issue, the NHS can't cope.  They appear to assume that  
anyone sat at the patients' bed with a plausible relationship is next  
of kin.

ob.crypto: who controls your keys, when you can't?

ian