Hilary White

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Tighten controls on UK’s end-of-life protocol over abuse concerns, says group of 20 medical bodies

Hilary White
Hilary White
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LONDON, October 10, 2012 (LifeSiteNews.com) – A group of 20 medical bodies has said that the UK Department of Health needs to tighten controls on the controversial Liverpool Care Pathway, a medical protocol that pro-life campaigners have said is often used as a method of passive euthanasia.

After a consultant neurologist said in June that the LCP is being used to “clear” elderly patients out of scarce hospital beds, a ‘consensus statement’ by 20 UK medical bodies said that from now on, two doctors, one of whom is to be the most senior on staff, must sign off on the use of the protocol. The statement also said that the protocol does not require the removal of food and/or hydration from every patient placed on it.

The LCP was developed by a group of British bioethicists in the 1990s, and under the current rules it allows a single doctor to decide when a patient is in “the final days or hours of life” and to remove “medical treatment,” including food and hydration, while the patient is heavily sedated.

The statement comes from an array of interested groups, including the Royal College of General Practitioners, the Royal College of Physicians, the National Council for Palliative Care, pressure groups including Age UK and the Alzheimer’s Society, and the Royal College of Nursing.

“It is not always easy to tell whether someone is very close to death,” says the statement. “[A] decision to consider using the pathway should always be made by the most senior doctor available, with help from all the other staff involved in a person’s care. It should be countersigned as soon as possible by the doctor responsible for the person’s care.”

“The pathway,” the statement said, “does not preclude the use of clinically assisted nutrition or hydration – it prompts clinicians to consider whether it is needed and is in the person’s best interest.” The Pathway, they said, is “not in any way about ending life, but rather about supporting the delivery of excellent end-of-life care”.

Dr. Patrick Pullicino told a meeting of the Royal Society of Medicine in London that as many as 130,000 people had died under the LCP and that there is often a “lack of clear evidence” that a patient is dying when he is put on it. Far from being a last resort in the last possible extreme of terminal illness, the Pathway is often invoked as an “assisted death pathway rather than a care pathway,” he said.

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Steve Doughty of the Daily Mail quoted him saying that “pressure on beds and difficulty with nursing confused or difficult-to-manage elderly patients” are frequently-used criteria. He said that in one case in his own practice, a 71-year-old patient was admitted to hospital suffering from pneumonia and epilepsy, was put on the LCP, without his family’s consent, by a doctor on a weekend shift. Pullicino, Professor of Clinical Neurosciences at the University of Kent, said that he took the patient off the Pathway and when treatment was resumed the patient recovered fully and lived more than a year.

“Very likely many elderly patients who could live substantially longer are being killed by the LCP,” he said. “Patients are frequently put on the pathway without a proper analysis of their condition.

“Predicting death in a time frame of three to four days, or even at any other specific time, is not possible scientifically.”

Dr. Peter Saunders of the Care Not Killing Alliance, which supports the LCP in theory, warned that Pullicino’s statements could lead to misunderstandings. He said that an audit of 4000 LCP patients’ records in 2009 found that they are “receiving high quality clinical care for the last hours and days of life”.

Saunders wrote, “If a patient is judged to be imminently dying and is placed on the LCP and dies within hours or days one can be virtually certain that the death was caused by the underlying condition.” 

In cases where the patient is placed on the Pathway and dies ten to fifteen days later, Saunders added, “there must be a very real question about whether the withdrawal of hydration actually contributed to the death. But to put a patient on the LCP for this length of time is quite inappropriate.”

The LCP requires that patients only be judged eligible if they are within hours, or at most days, of death. They must be monitored and checked every four hours and if any improvement is seen, the protocol requires that treatment be resumed.

Other voices have been raised more strongly in warning against the LCP. In a July letter to the Daily Telegraph, seven doctors, including the heads of the Medical Ethics Alliance and the group First, Do No Harm that champions traditional medical ethics, warned that the LCP can be misused through several means.

“Other considerations” than those purely medical issues laid out in the Pathway protocol could easily be influencing doctors’ decisions, “not excluding the availability of hospital resources,” they warned.

“The onus of proof that the pathway is safe and effective, or even required, is upon its authors, who should furnish their evidence.”

They said, “The combination of morphine and dehydration is known to be lethal, and four-hourly reassessment is pointless if the patient is in a drug-induced coma. No one should be deprived of consciousness except for the gravest reason, and drug regimes should follow the accepted norms as laid down in national formularies.”

The physicians added that “informed consent is another major consideration” and that it is “not surprising” that patients are including a written refusal of the Pathway in legally binding “advance directives,” or “carrying cards refusing this form of treatment, as a measure of self-protection”.

Saunders said that his group regards the LCP itself to be “a great clinical tool” but warned, “we also do need to be alert to doctors and other health care professionals, either through negligence, ignorance or perhaps even malicious intention, misusing a perfectly good care tool to speed the deaths of patients who are not imminently dying.”

“Any misuse of the LCP must be exposed and dealt with,” he said.

The slide towards the routine use of withdrawal of food and hydration has been going on a long time. It started with the 1993 case of Tony Bland, a man who had suffered brain injuries and was in a coma. The hospital, with the support of his family, applied successfully to the courts to remove his hydration, an act that was uniformly described in the press as “allowing him to die with dignity.”

A physician with the Royal Hospital for Neurodisability later wrote that this decision was a major turning point in the history of medicine, in that “instead of considering the futility of the treatment, the burden of the treatment ... the decision for the first time considered the worthwhileness of the patient, and the burdensomeness of the patient himself.”

The Mental Capacity Act 2005 codified the definition of food and hydration as “medical treatment” that could be removed if a doctor decided a patient’s future expectations did not warrant him being kept alive. Since the Bland case, doctors who have petitioned the courts to remove food and hydration have never been refused.

A 2004 letter from the Bill Policy Officer in the Mental Capacity Bill legislative Division, to the Association of Lawyers for the Defence of the Unborn said the government has no intention of overturning Bland. Since the Bland decision, courts have sanctioned “around 36 cases” of deliberate killing by withdrawing assisted food and fluids, “and the Government does not disagree with it,” the letter said. 

This legal history is the atmosphere in which the Liverpool Care Pathway was developed and in which it was decided that patients who are judged to be nearing the end of their lives could be refused food and hydration. In a 2008 article in the British Medical Journal, Dr. Adrian Treloar a geriatrician, said that the eligibility criteria “do not ensure that only people who are about to die are allowed on to the pathway”.

“For instance,” he warned, “patients with dementia, in whom dying can take years, and those who are bed-bound and unable to swallow may be eligible.”

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David Bereit of 40 Days for Life, on the right.
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All one fight: Why the leader of 40 Days for Life says he may become active in the fight for marriage

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By Dustin Siggins

WASHINGTON, D.C., April 27, 2015 (LifeSiteNews.com) – Just eight years ago, 40 Days for Life was founded as a pro-life Christian ministry. This year, it reached 252 cities in 19 countries.

Now, says founder and National Director David Bereit, he's discerning whether to expand his personal activism to marriage.

"The various moral issues we confront in our culture today are all intrinsically connected," Bereit told LifeSiteNews at Saturday's March for Marriage. “When you look at the various factors that lead to the breakdown of nations and civilizations, they are moral factors," Bereit said. "It's the devaluing of human life, it's the abandonment of religious belief and practice, it's immorality -- the increase thereof – and it's the breakdown of the family."

"They're all tied into this moving away from God, and America was founded as a nation with Christian principles and ideals that used to say 'In God We Trust.' And the further we've turned away from that, the more we have fallen,” he said. "I believe that with man, turning the tide in our culture is not possible, but with God, all things are possible."

Bereit stressed that his attendance at the March for Marriage, as well as his ongoing process of discernment, was representative only of his own circumstances -- not those of 40 Days for Life, which remains an abortion-focused ministry.

Bereit did not shy away from questions that are often raised about what President Barack Obama called America's “tragic” history.

"America was built on Judeo-Christians principles,“ he said. “There are still fallen people that make up our churches and our communities."

"The question is, will people of faith and conscience turn back to God and do their very best to align themselves with the principles that formed our nation and made our nation such a great place in history?"

Click "like" if you want to defend true marriage.

The third annual March for Marriage, which was organized by the National Organization for Marriage and exclusively livestreamed by LifeSiteNews, drew thousands of people, mostly minorities, just three days before what is being billed as the definitive U.S. Supreme Court hearing on the issue of same-sex "marriage."  

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‘Persecution plain and simple’:  Franklin Graham fundraises for Oregon bakers after GoFundMe shuts them down

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By Ben Johnson

BOONE, NC, April 27, 2015 (LifeSiteNews.com) – First, they were fined $135,000 for refusing to bake a wedding cake for a homosexual “marriage” ceremony. Then, a rival business owner convinced GoFundMe.com to stop Christian bakers Aaron and Melissa Klein from raising money to pay the fine on the grounds that, since their religious beliefs violate state law, they are common criminals.

Now, one of the nation's most well-known Christian ministers and philanthropists is coming to their aid.

An administrative law judge fined the Oregon bakers, proprietors of Sweet Cakes by Melissa, $135,000 to pay for the emotional suffering of Rachel and Laurel Bowman-Cryer – a lesbian couple who say they feel the Kleins “mentally raped” them.

The Kleins have since closed their Portland-area business and lost substantial income. After hearing of the fine on Friday, Melissa said the amount would financially crush them.

The family opened a GoFundMe page and, within hours, they collected more than $109,000.

Then Lisa Watson, the co-owner of Cupcake Jones in Portland, began lobbying the website to banish the couple's appeal.

“The amount of money they have raised in a matter of a few hours by thousands of anonymous cowards is disgusting,” Watson wrote on Facebook. She added that the website's “terms of service address hate speech, bigotry, criminal activity, and sexism among other things in their campaign.”

GoFundMe then suspended the Kleins' fundraising.

“While a different campaign was recently permitted for a pizzeria in Indiana, no laws were violated and the campaign remained live,” GoFundMe said in a statement. “However, the subjects of the 'Support Sweet Cakes By Melissa' campaign have been formally charged by local authorities and found to be in violation of Oregon state law concerning discriminatory acts. Accordingly, the campaign has been disabled.”

The day after the announcement Watson, who operates her business with husband Peter Shanky, posted a photo of her 2015 Equality Advocate Award “for outstanding leadership to advanced lived equality for all LGBTQ Oregonians.”

The Kleins hope the website will reconsider. “We have told GoFundMe that the money is simply going to be used to help our family, and there is no legitimate breach of their terms and conditions,” the Kleins wrote on Facebook.

That's when the Reverend Franklin Graham and his ministry Samaritan's Purse stepped in, allowing those who wish to alleviate the couple's suffering to donate on its website.

"The fund was created to help persecuted Christians in the U.S., including Aaron and Melissa Klein,” an employee at Samaritan's Purse told LifeSiteNews today. “It was only activated over the weekend and the organization has not yet announced any numbers. Currently, Samaritan's Purse is focused on the earthquake in Nepal and providing relief supplies to people impacted by the disaster.”

Graham praised the Kleins' steadfastness in the face of legal challenges. “They have taken a stand for the Word of God, and they should not have to stand alone,” the ministry's founder and president Franklin Graham said. “I believe that Christians across our nation will rally around Aaron and Melissa and their five children. Please pray for Aaron and Melissa, and pray for our nation. When our judges are punishing Christians for practicing what they believe, that’s persecution, plain and simple.”

“God bless Reverend Franklin Graham,” AFR Talk radio host Bryan Fischer said today. 

Click "like" if you want to defend true marriage.

The Kleins will still receive the money raised by GoFundMe, in addition to any supplemental funds raised by Graham's international charitable ministry.

Conservative author Dan Calabrese wrote that “Melissa's Sweet Cakes will not have to go into bankruptcy and the family won't personally be ruined. And what a disappointment that must be to the gay mafia, whose agenda is to intimidate all gay marriage opponents into not just silence but compliance, for fear of just such” an outcome.

Christians have risen to the challenge before. Memories Pizza raised more than $840,000 after the Indiana pizzeria was harassed into closing its doors for saying it would cater a same-sex “wedding.”

Calabrese warns that these victories may lead to more intense anti-Christian persecution.

“When put in an untenable position like this, Christians and others who support their right to operate their business as they see fit will come to their aid. So the gay mafia will take it up a notch, attempting to intimidate the fundraising organizations from cooperating with the effort,” he said.

If that fails, “Maybe they can persuade friendly Democrat lawmakers (or terrified Republicans) to legislate them out of business.”

Readers can donate to the Klein family here.

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John-Henry Westen John-Henry Westen Follow John-Henry

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Opposition to same-sex ‘marriage’ – a deeper love

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By John-Henry Westen

April 27, 2015 (CNSNews.com) -- Same-sex “marriage” – the legal recognition of same-sex relationships – is one of the most contentious issues in America. Laws, constitutional interpretation, and the future of religious liberty may well rest on what nine justices decide two months from now.

Many observers seem to believe that the Supreme Court will rule in favor of redefining marriage. And while many on all sides of the debate, especially those who are undecided, believe this will bring cultural peace, evidence around the world points in the exact opposite direction.

Rather than settle animosity and ease cultural tensions, the advent of same-sex “marriage” will lead to the repression of religious freedom and determination to root out dissent to the gay rights doctrine. At LifeSiteNews, we have watched this play out for nearly two decades in 17 countries around the world – and America is next.

A prime example is Canada. Same-sex “marriage” passed in 2005. Similar to European countries which have done so, there has been a relentless pursuit of the minds of children against the wishes of their parents. Schools, both public and private, were first mandated by law to have gay-straight alliance clubs under the auspices of anti-bullying. Then, sex-education, teaching the normalcy of homosexual sex, was given to children without parents being permitted to opt their children out of the classes.

We have arrived at this state of affairs because of the silence of Christian pulpits on sexual matters, and the concomitant shouting from every secular pulpit, screen and book. Even the current discussion around same-sex “marriage” in the United States reveals a grave reluctance to speak about the heart of the issue – homosexual sex. Rather, arguments are made about the goodness of natural marriage, about its benefit to children, and its unchangeable character.

From reporting on the subject every day for so many years, we knew that the struggle for same-sex “marriage” has very little to do with marriage. In fact, until just recently, gay activists didn’t even want to be “married” to each other. Most had no interest in the constraints that such a formalized union would entail in terms of exclusive partnership.

However, the leaders among the activists convinced the movement that they must attain marriage as a societal stamp of approval to homosexual behavior. And, frankly, they have largely succeeded.

Today, in many of the nations where same-sex “marriage” is law, opposition to it is seen as akin to racism. It is seen falsely as an animosity against someone for who they are—an unwillingness to recognize the human dignity of a class of persons due to an immutable characteristic.

However, that false perception is due to a purposeful agenda to conflate animosity against homosexual sex acts with animosity against persons who experience same-sex attraction. The ancient Christian teaching to “love the sinner and hate the sin” is an impermissible distinction in the minds of some. It is, however, the key to understanding the majority of the opposition to same-sex “marriage.”

The plain truth of the matter is that opposition to same-sex “marriage” is rooted not in hatred and bigotry, but just the opposite – in love. Like parents who do not allow children to behave dangerously without lovingly correcting them, opponents of same-sex relationships are hoping to save people with same-sex attractions from severe physical, psychological, and spiritual harm.

Just as, out of love and concern for their children’s welfare, parents must correct and discipline, despite the protests they may get in return, any true believer in marriage, natural law and science must lovingly correct their fellow man.

In other nations, the perception that opposition to same-sex “marriage” is based upon bigotry has led to laws that violate religious liberty, parental rights and freedom of speech. This is why those who oppose same-sex “marriage” must present their reasoning as based on love and concern for the welfare of those in homosexual relationships, in addition to concerns for children and society itself. And there is ample evidence on which to base that concern in the numerous studies showing the grave harm of homosexual sex to both body and psyche.

When I’ve spoken of these findings at conferences around the world, some have questioned if the researchers who showed these harms weren’t themselves biased by anti-gay sentiment. And so I’ve taken to carrying with me on my phone the quotes of the late Canadian gay activist Gens Hellquist, whose testimony proves the harms of gay sex better than any study ever could.

Speaking a year after the passage of same-sex “marriage” into law, Hellquist was seeking more healthcare dollars for the LGBT community. "We have one of the poorest health statuses in this country,” he said. “Health issues affecting queer Canadians include lower life expectancy than the average Canadian, suicide, higher rates of substance abuse, depression, inadequate access to care and HIV/AIDS."

"There are all kinds of health issues that are endemic to our community,” he added. “We have higher rates of anal cancer in the gay male community, lesbians have higher rates of breast cancer.”

He concluded: “Now that we can get married everyone assumes that we don't have any issues any more. A lot of the deaths that occur in our community are hidden, we don't see them. Those of us who are working on the front lines see them and I'm tired of watching my community die."

Click "like" if you want to defend true marriage.

Pastors and preachers must take up this call to speak the truth in love, for without this approach, the public will be led to believe that those opposed to same-sex “marriage” are indeed haters needing to be stopped with the force of law. Love is the most powerful force in any argument, and gay “marriage” pushers have used it very effectively. As Hilary Clinton tweeted as she fought religious freedom laws in Indiana: “We shouldn't discriminate against ppl bc of who they love #LGBT”

The truth is that those who oppose same-sex “marriage” are showing a deeper love, as any parent does when instilling difficult discipline. We have enough love and concern for those with same-sex attraction to warn them not to engage in behaviors proven to be very harmful. We won’t encourage people to enter into such harmful behaviors by redefining marriage to encourage it, nor will we allow our children to be indoctrinated into regarding it as a healthy and safe alternative lifestyle.

We have failed so far to get this message of love out to the public. I will not be surprised if the Supreme Court approves of same-sex “marriage” – and I will be even less surprised to see a subsequent  crackdown on religious freedom, as already seen in states like California and Colorado.

Pope Benedict XVI predicted it a decade ago. Observing the international trends, the then-Cardinal said “very soon it will not be possible to state that homosexuality, as the Catholic Church teaches, is an objective disorder in the structuring of human existence.”

Reprinted with permission from CNS News

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