British Experts Say Terminally Ill Patients Pushed by NHS to Die Prematurely

Bioethics   |   Steven Ertelt   |   Sep 2, 2009   |   9:00AM   |   WASHINGTON, DC

British Experts Say Terminally Ill Patients Pushed by NHS to Die Prematurely

by Steven Ertelt Editor
September 2
, 2009

London, England ( — A group of experts in England have published a letter to the London Telegraph newspaper saying that terminally ill patients are being pushed by the nation’ government-run health system to die prematurely. The letter is already being used to talk about the problems of the U.S. moving in the same direction.

The letter says some patients wrongly have food and water taken away are placed on terminal sedation until they are dead.

They say the approach masks the improvement some patients show and that they should be given proper medical care and treatment. The letter, they say, is meant to spotlight what they consider a "national crisis."

Professor Peter Millard, an Emeritus Professor of Geriatrics at University of London, and Dr. Peter Hargreaves, a consultant in Palliative Medicine at St Luke’s cancer center in Guildford, wrote the letter with four others.

“Forecasting death is an inexact science,”they say. Patients are being diagnosed as being close to death “without regard to the fact that the diagnosis could be wrong.

“As a result a national wave of discontent is building up, as family and friends witness the denial of fluids and food to patients," they write.

The letter specifically concerns the Liverpool Care Pathway protocol that was designed by the Marie Curie charity for cancer patients in hospice but it is now used with most any patient considered to have a terminal illness. The newspaper indicates 300 hospitals, 130 hospices and 560 care homes in England currently use the protocol.

Under the guidelines, when doctors subjectively determine that patients are no longer responding to medicine, physicians are told to consider removing medication or invasive procedures.

But the letter says some patients were being “wrongly” put on the pathway, which created a “self-fulfilling prophecy” that they would die.

“I have been practicing palliative medicine for more than 20 years and I am getting more concerned about this ‘death pathway’ that is coming in," Hargreaves said specifically, according to the Telegraph.

“It is supposed to let people die with dignity but it can become a self-fulfilling prophecy," he explained. "Patients who are allowed to become dehydrated and then become confused can be wrongly put on this pathway.”

“What they are trying to do is stop people being overtreated as they are dying," he added. "It is a very laudable idea. But the concern is that it is tick box medicine that stops people thinking.”

He said some patients he took off the protocols lived for :significant" amounts of time afterwards and warned that doctors need to be more thorough in checking patients.

According to the newspaper, 16.5 percent of all deaths in England come after the use of terminal sedation and twice as many die that way in Belgium and the Netherlands.

“If they are sedated it is much harder to see that a patient is getting better,” the letter said.

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