The NHS guideline gap that refused her TPN and let her starve
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The NHS guideline gap that refused her TPN and let her starve
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The NHS guideline gap that refused her TPN and let her starve
In this episode, we recount the case of Maeve Boothby O'Neill and the clinical decisions, policies, and historical research that shaped her care. The episode follows the medical timeline and the institutional gaps that left a treatable route of nutrition unprovided - what led to that absence?
Person: Maeve Boothby O'Neill
Age: 27
Date of death: autumn 2021
Cause of death recorded: malnutrition
Treatment withheld: total parenteral nutrition (TPN)
- Maeve developed severe ME/CFS that progressed until her body could not tolerate oral nutrition, a documented feature of the condition.
- TPN, a standard intravenous nutrition used when oral intake is impossible, was available but not provided to her care team.
- At the Exeter and Devon coroner's inquest, NHS director Dr. Anthony Hemsley testified there was no national policy or facilities for severe ME/CFS treatment in the UK.
- The medical debate traces back decades: a 1970 paper by McEvedy and Beard declared outbreaks hysteria without examining patients, influencing later perceptions.
- Subsequent cultural and academic voices, like Elaine Showalter’s 1997 book, further propagated non-clinical framings that shaped how ME/CFS was treated in practice.
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