Legacy Matters

The "Death Pathway"

From the U.K. leading doctors alarmed that patients with terminal illnesses are being made to die prematurely.

Sentenced to death on the NHS.

In a letter to The Daily Telegraph, a group of experts who care for the terminally ill claim that some patients are being wrongly judged as close to death.

Under NHS guidance introduced across England to help doctors and medical staff deal with dying patients, they can then have fluid and drugs withdrawn and many are put on continuous sedation until they pass away.

But this approach can also mask the signs that their condition is improving, the experts warn.

As a result the scheme is causing a “national crisis” in patient care,
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“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."

The warning comes just a week after a report by the Patients Association estimated that up to one million patients had received poor or cruel care on the NHS.
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The scheme, called the Liverpool Care Pathway (LCP), was designed to reduce patient suffering in their final hours.
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It has been gradually adopted nationwide and more than 300 hospitals, 130 hospices and 560 care homes in England currently use the system.

Under the guidelines the decision to diagnose that a patient is close to death is made by the entire medical team treating them, including a senior doctor.

They look for signs that a patient is approaching their final hours, which can include if patients have lost consciousness or whether they are having difficulty swallowing medication.

However, doctors warn that these signs can point to other medical problems.
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He added that some patients were being “wrongly” put on the pathway, which created a “self-fulfilling prophecy” that they would die.

He said: “I have been practising palliative medicine for more than 20 years and I am getting more concerned about this “death pathway” that is coming in.

“It is supposed to let people die with dignity but it can become a self-fulfilling prophecy.
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He said that he had personally taken patients off the pathway who went on to live for “significant” amounts of time and warned that many doctors were not checking the progress of patients enough to notice improvement in their condition.

Prof Millard said that it was “worrying” that patients were being “terminally” sedated, using syringe drivers, which continually empty their contents into a patient over the course of 24 hours.
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“Guidelines like the LCP can be very helpful but healthcare professionals always need to keep in mind the individual needs of patients.
“There is no one size fits all approach.”

The stories told by some of the commenters  - like dragon are truly horrifying.  Another commenter, Andrew Straughan wrote this:

'Whilst sitting through the night in Scarborough by my dying sister's hospital bed six years ago I witnessed a dying, desparately fragile old lady lying prone in a cot, begging for water repeatedly in a faint anguished little cry. This continued for hours. The night staff were a few yards from her bed reading newspapers, playing cards or chatting about trivia. Not one went to this poor soul's bed to touch her hand or speak a word of comfort to her. My sister slept throughout the night as I sat there listening. The memory of such inhuman indifference is etched on one's mind. "