End of LifeFri Nov 30, 2012 - 4:31 pm EST
Doctor admits starving or dehydrating 10 babies in UK neonatal unit; cancer care questioned
LONDON, November 30, 2012, (LifeSiteNews.com) – Two stories appearing this week in the Daily Mail have shown that the Liverpool Care Pathway, (LCP) a palliative care protocol adopted now in nearly all NHS hospitals, is being used to end the lives of sick babies and children and cancer patients who could benefit from treatment. In one, a doctor has admitted starving and dehydrating 10 babies to death in a neonatal unit in a London hospital.
The Mail also reports on concerns from the Royal College of Physicians that doctors have prescribed the LCP for patients with cancer admitted to emergency rooms when they could benefit from further treatment.
In an article appearing in the British Medical Journal the anonymous physician wrote that parents often give permission to put their sick child on a recently revised version the LCP in hopes that there will be less suffering and no “visible changes” to their child while he dies.
“Survival is often much longer than most physicians think,” the physician wrote. In his experience, “the median time from withdrawal of hydration to death was 10 days” and even physicians are “unprepared for the sometimes severe changes that they will witness in the child’s physical appearance as severe dehydration ensues”.
He adds, “I know, as they cannot, the unique horror of witnessing a child become smaller and shrunken, as the only route out of a life that has become excruciating to the patient or to the parents who love their baby.”
While public suspicion is growing over misuse of the LCP, the Mail reports that its inventors, the Marie Curie Palliative Care Institute in Liverpool, have moved forward and developed a version for sick children which includes “tick boxes” to be filled in by physicians or nurses to detail which treatments, including food and hydration, are being withdrawn.
The report by the Royal College of Physicians on the care of cancer patients admitted to emergency rooms, said doctors have been adopting a “nihilistic approach” to the care of cancer patients that has resulted in some not receiving proper care.
“There are concerns that sometimes an unnecessarily nihilistic approach to management may be adopted, particularly where the patient has evidence of secondary spread from the cancer and assumptions about futility of active treatment are made,” the report said.
It also warns that cancer patients are being put “at the back of the queue” four routine services like x-rays and antibiotics, and that in some cases physicians have failed to administer adequate pain medication.
The Mail highlights the case of one 56 year-old man who was put on the LCP immediately after his diagnosis with lung cancer when intensive care physicians decided his case was terminal. The decision went against the advice of cancer specialists who had recommended a life support machine when part of his lung collapsed and he was struggling to breathe.
The Mail quotes Bernadette Lloyd, a hospice paediatric nurse who wrote expressing her concerns to the Cabinet Office and the Department of Health, saying that parents often “feel coerced,” to put their sick child on the pathway at a traumatic and vulnerable time.
“It is very difficult to predict death,” Lloyd wrote. “I have seen a ‘reasonable’ number of children recover after being taken off the pathway,” she added. “I have also seen children die in terrible thirst because fluids are withdrawn from them until they die.”
She described the “agonising” death of a 14 year-old boy from dehydration who died with his tongue stuck to the roof of his mouth. “This is euthanasia by the backdoor,” she said.
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When it was introduced in the late 1990s, politicians and patients’ rights groups were told that the Liverpool Care Pathway for the Dying Patient, was intended to relieve suffering in the last hours – days at most – of terminal illness. It allows the refusal or withdrawal of food and hydration as well as the suspension of anything but comfort care and the administering of sedatives that can hasten death. In cases where a patient is so close to death that his organs are failing, fluids cannot be processed and ethicists agree that sedatives to ease pain and distress are warranted.
Since then, however, the LCP has come under increasing criticism as stories continue to emerge of the protocol being used to dehydrate and starve to death vulnerable patients who would otherwise recover and live if given proper care and treatment. In most cases that come to light, families and patients are not told by hospital staff that the LCP has been initiated.
Last month, the Association of Palliative Medicine (APM) announced it had ordered a review into the concerns, to be organised by the National End of Life Care Programme, an NHS affiliate who have recently defended the LCP. Health Secretary, Jeremy Hunt, says he plans to make it a legal right for patients and their families to be informed of end-of-life care decisions, as part of changes to the NHS Constitution.