Tuesday, January 01, 2013

This Sceptered Isle - Part CCXXV

From the London Telegraph, here’s new, yet more depressing news about the British National Health Service:

60,000 patients put on death pathway without being told but minister still says controversial end-of-life plan is 'fantastic’

In part, this is an old dispute about whether the Liverpool Care Pathway (LCP) is a gentle and dignified end of life treatment – similar to what America calls hospice – or instead is a “death pathway” designed to finish people off.  An estimated 130,000 patients per year are put on LCP. 

According to the Telegraph article. “The pathway involves withdrawal of lifesaving treatment, with the sick sedated and usually denied nutrition and fluids. Death typically takes place within 29 hours.”

But the new issue is not about speed.  The new issue is about ethics. It appears hospitals are not careful to advise conscious patients when they are placed on LCP or what will then happen to them.  It also appears family members and even family physicians are not being advised.

This new issue became public following a recent national audit of LCP conducted by the Marie Curie Palliative Care Institute in Liverpool and the Royal College of Physicians.  As though the scary numbers were not enough, the U.K. Health Minister Jeremy Hunt belittled the audit findings by saying “I would be very sad if as a result of something that is a big step forward going wrong in one or two cases we discredited the concept”

Wrong in “one or two cases”, would make Jeremy “very sad”.  Indeed.

From the article: “The national audit . . . examined a representative sample of 7,058 deaths between April and June last year. The figures were scaled up to give a national picture. It found that in 44 per cent of cases when conscious patients were placed on the pathway, there was no record that the decision had been discussed with them.”

Well then, Jeremy, 44% would be more than one or two.

Also according to the article, the audit “revealed that one in three families did not receive a leaflet to explain the process.”

Got it.  In the U.K. at least it appears that the National Health Service permits government functionaries to withdraw food and medicine from patients  - whom the functionaries also select  - without knowledge of the patient, the patient’s family, or even the family physician.

No need for mum to know that she's been put on the Liverpool Care Pathway at St. Lucifer General.  It's all the better to care for her.  No need for you to know about this either, it will only upset you.  So just fold your hands and relax.  All is under control - our control.

O brave new world that hath such people in’t.
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