3.9.09

NHS, or the approach to terminal patients

Although the current Administration has repeatedly denied that the US is moving toward a British system of Health Care, the circumstances, being the same the outcome can only be the same...

When doctors decide who is worthy of life then no one will be worthy of life.

Terminally-ill care scheme is 'death pathway', warn experts
By Daniel Bates
1:18 PM on 03rd September 2009


NHS doctors are prematurely ending the lives of terminally-ill patients, experts warn today.

They say patients are wrongly being assessed as close to death, then denied food and fluid and sedated with a ' chemical cosh' until they die.

This 'tick box' approach can make it harder to see signs of improvement, creating a 'self-fulfilling prophecy' that they will die.

Meanwhile, relatives have to endure the agony of watching their loved ones being refused food and drink.

The claims come in a open letter from six experts in palliative care.

The warning involves a scheme called the Liverpool Care Pathway, designed to limit the suffering of patients in their final hours.

It was developed by the Marie Curie cancer charity and has been extended to other medical conditions and adopted by hundreds of hospices, care homes and hospitals.


But the experts, led by Professor Peter Millard, Emeritus Professor of Geriatrics at the University of London and Dr Peter Hargreaves, a consultant in palliative medicine at St Luke's cancer centre in Guildford, claim the scheme is causing a 'national crisis' in patient care.

They say they have personally taken patients off it and seen them live for 'significant' amounts of time.

The letter, published in the Daily Telegraph, will renew the debate about doctors 'playing God' with lives.

Under the LCP, a patient's medical team looks for signs that he or she is approaching-their final hours, including losing consciousness and being unable to swallow medication.

The letter writers warn that these signs can point to other problems. Patients can become semi-conscious as a side-effect of pain-killing drugs.

Dr Hargreaves said the scheme, which he called the 'death pathway', depended on constant assessment, but many doctors were not checking the progress of patients enough to notice improvements.

A spokesman for Marie Curie said: 'The letter talks about death being an inexact science and that is absolutely right. The Liverpool Care Pathway is not about ticking boxes, all decisions are made by a multi-disciplinary team so they're constantly reviewed and any decisions are made by a range of experts in palliative care.

'The Liverpool Care Pathway we know has already improved the end of life experience for thousands of people.

'The approach, this letter, will case serious alarm and fear for families and patients facing an end of life care experience.

'Marie Curie is working to reduce the estimated 100 million people each year who die without access to "high quality palliative care".'

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

'The Liverpool Care Pathway is an established and recommended tool that provides clinicians with an evidence-based framework to help delivery of high quality care for people at the end of their lives.

'It has been recommended in the Supportive and Palliative Care Guidance issued by the National Institute for Health and Clinical Excellence (NICE).'

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Dieu Le Roy!
Brantigny

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