Tuesday, July 31, 2012

Liverpool Care Pathway allows U.K. hospitals to starve and dehydrate patients in order to speed up death

I call heaven and earth to record this day against you, that I have set before you life and death, blessing and cursing: therefore choose life, that both thou and thy seed may live: Deuteronomy 30:19

Surely some future historian, surveying our times, will note sardonically that it took no more than three decades to transform a war crime into an act of compassion, thereby enabling the victors in the war against Nazism to mount their own humane holocaust, which in its range and in the number of its victims, may soon far surpass the Nazi one. It is significant that, whereas the Nazi holocaust has received lavish TV and film coverage, the humane one goes rolling along largely unnoticed by the media. Malcolm Muggeridge, Sanctity of Life, Chatelaine, December 1979, p. 138

A system of socialized medicine, is, of course, based on compassion, and would never let something so vulgar as a desire to save money enter into life-and-death decisions--or so the propagandists in countries such as Trudeaupia (formerly Canada) and the United Kingdom would have us believe. As reported by Stephen Adams of the London Daily Telegraph (which is one media outlet that's paying attention), July 8, 2012 (link to physicians' letter in original):

Tens of thousands of patients with terminal illnesses are placed on a “death pathway” to help end their lives every year. However, in a letter to The Daily Telegraph, six doctors warn that hospitals may be using the controversial scheme to reduce strain on hospital resources.

Supporters of the Liverpool Care Pathway, which allows medical staff to withhold fluid and drugs in a patient’s final days, claim it is the kindest way of letting them slip away. But the experts say in their letter that natural deaths are often freer of pain and distress.

Informed consent is not always being sought by doctors, who fail to ask patients about their wishes while they are still in control of their faculties, warn the six. This has led to an increase in patients carrying cards informing doctors that they do not wish to be put on the pathway in the last few days of their lives.

The six doctors are experts in elderly care and wrote the letter in conjunction with the Medical Ethics Alliance, a Christian medical organisation. They say that many members of the public have contacted them with examples of inappropriate use of the pathway, which is implemented in up to 29 per cent of hospital deaths.

They warn that there is no “scientific way of diagnosing imminent death.” They write: “It is essentially a prediction, and it is possible that other considerations may come into reaching such a decision, not excluding the availability of resources.”

The Liverpool Care Pathway, so called because it was developed at the Royal Liverpool Hospital in the 1990s, aims to ensure that patients who are close to death can die without being subjected to unnecessary interference by staff. In addition to the withdrawal of fluid and medication, patients can be placed on sedation until they die.

Dr Gillian Craig, a retired geriatrician and former vice-chairman of the Medical Ethics Alliance, is one of the six signatories to The Daily Telegraph letter.

“If you are cynical about it, as I am, you can see it as a cost-cutting measure, if you don’t want your beds to be filled with old people,” she said. She advised that those who did not want to be put on the pathway should carry cards made by Dr Rosalind Bearcroft, a consultant psychiatrist from Kent, and another signatory.

Last year The Daily Telegraph reported that the numbers being put on the pathway had doubled in just two years, with tens of thousands of patients now involved. But up to half of families are not being informed of clinicians’ decision to put a relative on the pathway, the report by the Royal College of Physicians found. Advocates point out that the Liverpool Care Pathway has been approved by the National Institute for Health and Clinical Excellence (Nice) and is backed by the Department of Health.

A Department of Health spokesperson said: "People coming to the end of their lives should have a right to high quality, compassionate and dignified care.

"The Liverpool Care Pathway (LCP) is not about saving money. It is an established and respected tool that is recommended by NICE and has overwhelming support from clinicians at home and abroad.

"The decision to use the pathway should involve patients and family members, and a patient's condition should be closely monitored. If, as sometimes happens, a patient improves, they are taken off the LCP and given whatever treatments best suit their new needs. To ensure the LCP is used properly, it is important that staff receive the appropriate training and support."
Fortunately, people are starting to catch on, and are signing "advance refusal" cards if they don't want to be put on the Liverpool Care Pathway. As reported by John Bingham of the Daily Telegraph, July 24, 2012 (link to physicians' letter in original):

Terminally ill patients are being issued with special cards warning doctors not to place them on a controversial “death pathway” amid fears the practice is becoming routine.

The “advance refusal” notices operate like an organ donor card, enabling people approaching the end of their life to make their wishes clear to while they still have capacity.

It comes amid a growing backlash against overuse of the “Liverpool Care Pathway” which allows medical staff to withhold fluid and drugs from a patient while they are heavily sedated, actively speeding their end.

Supporters of the technique say that it is the kindest way of letting people slip away rather than die in pain.

But leading doctors have voiced fears that hospitals are hastening the deaths of elderly patients to cut costs and free up bed space amid claims it has become a “standard” alternative to euthanasia.

The number of patients put on the pathway has risen sharply in recent years, and opponents estimate that it is now said to be associated with almost a third of hospital deaths – or 130,000 people.

Earlier this month a group of doctors wrote to The Daily Telegraph in conjunction with the Medical Ethics Alliance, a Christian medical organisation, arguing that the technique could be being abused to save costs.

They said that many members of the public had contacted them with examples of inappropriate use of the pathway, with some doctors failing to seek informed consent.

Now the anti-euthanasia charity Alert is distributing cards to patients themselves ensuring that they can opt not to be put on the pathway if they do not wish to.

Simple printed cards read: “Please do not give me the Liverpool Care Pathway treatment without my informed consent or that of a relative.”

The initiative is designed to work in a similar way to so-called “living wills” or advance directives which give patients a right to refuse treatment under the Mental Capacity Act 2005.

Elspeth Chowharay-Best, the honorary secretary of Alert, said the cards were being produced to answer “an urgent need”.

Among those who have requested a card is Leslie Burke, a former Lancaster postman who has suffered from cerebellar ataxia, a degenerative disease of the central nervous system with follows a path similar to multiple sclerosis, since 1982.

“All I want is to live my life from end to end and not have it ended prematurely under any circumstances,” he said.

In 2005 Mr Burke was defeated at the Court of Appeal after he had earlier successfully demanded that doctors continued to treat him with artificial nutrition and hydration (ANH) once he lost the ability to communicate.

Lord Phillips, the head of the panel of judges, assured him at the time that “any doctor who deliberately brings that patient’s life to an end by discontinuing the supply of ANH will not merely be in breach of duty but guilty of murder”.

But Mr Burke, 52, said that he was no terrified that starving and dehydrating patients to death in the NHS was now “becoming the norm”.

1 comment:

  1. what i cannot understand is that there are more people against this so called liverpool care pathway that are for it so therefore it should be euthanised itself stopped fullstop.

    ReplyDelete