Martha's Rule: a plea for a legal duty to listen and respond to parental concerns

by Sarah Barclay, Director, Medical Mediation FoundationSarah Barclay

No-one who has read or heard Merope Mills telling the story of her daughter Martha’s avoidable death from sepsis in 2022 can fail to be shocked that multiple attempts by her and her husband Paul to raise concerns about Martha’s deteriorating clinical condition were not listened and responded to as a matter of urgency by the health professionals responsible for her care.

The Government has now backed their call for the NHS to adopt Martha’s Rule, giving parents the legal right to a rapid and independent second opinion if their concerns are not being heard. Currently, patients and families can ask for a second opinion but in practice it can take weeks to arrange. Martha didn’t have weeks. She had days and in the end, hours for her life to be saved. Her parents needed to be listened to, not dismissed, as her mother apparently was, as being overly anxious. 

Underpinning Martha’s Rule is a plea to make listening to parental concerns as mandatory for health professionals as washing their hands. And to support them with the skills and confidence to respond appropriately when faced with overwhelming pressures and intense parental emotions.

This week, the Nuffield Council on Bioethics publishes its recommendations to Government on managing disagreements in the care of critically ill children. Recommendation 6 is a request that the Department of Health and Social Care should "require NHS Trusts to provide all staff working in environments where children are treated, including all support staff, with access to regular training and continuous professional development in relationship-building skills and in identifying and managing disagreement.   

At MMF we believe passionately that supporting families and supporting health professionals to listen to each other and handle challenging conversations constructively is key to avoiding unnecessary conflict, distress and potential clinical harm or, as in Martha’s case, an avoidable, tragic death.

Our courses are designed to support health professionals in managing conflict and challenging conversations. For NHS staff, our new interactive e-learning course in understanding and managing conflict developed in partnership with NHS England is available free to staff working in NHS hospitals and hospices.  See our introduction to the course here

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Associated external links:

Read more about Martha's Rule from Merope Mills 

The Guardian article by Merope Mills

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