Hospitals
'letting patients die to save money’
Hospitals
may be depriving elderly patients of food and drink to hasten their
deaths as part of cost-cutting measures to free up bed space, leading
doctors warn.
8
July, 2012
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
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."
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