Tighten controls on UK’s end-of-life protocol over abuse concerns, says group of 20 medical bodies
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.”
Donald Trump says he will promote LGBT ‘equality’ as president
CONCORD, New Hampshire, February 8, 2016 (LifeSiteNews) – Does Donald Trump support the gay agenda or oppose it? On the eve of the New Hampshire primary, observers are still scratching their heads about where the GOP frontrunner actually stands.
Trump has repeatedly and consistently said he supports the natural definition of marriage, but can a President Trump be relied on to promote it resolutely and cogently? It is this question that has many marriage activists expressing concern about his increasingly likely hold on the GOP nomination.
In fact, the National Organization for Marriage has gone so far as to say that Trump has “abandoned” the pro-marriage cause.
Trump himself underscored the problem on the weekend when he told a New Hampshire television station that from the White House he would push “equality” for homosexuals even further forward.
A cable news reporter self-identifying as a lesbian asked him last Thursday after a rally in Exeter, "When President Trump is in office, can we look for more forward motion on equality for gays and lesbians?"
“Well, you can and look - again, we're going to bring people together. That's your thing, and other people have their thing,” Trump told Sue O’Connell of New England Cable News. “We have to bring all people together. And if we don't, we're not gonna have a country anymore. It's gonna be a total mess.”
Following the comments, Trump appeared Sunday on ABC’s This Week program with George Stephanopoulos and would not commit to appointing Supreme Court justices who’d overturn Obergefell, though that would be his “preference.”
“We’re going to look at judges. They’ve got to be great judges. They’ve got to be conservative judges. We’re going to see how they stand depending on what their views are. But that would be my preference,” he told Stephanopoulos. “I would prefer that they stand against, but we’ll see what happens. It depends on the judge.”
Trump’s comments follow his statements during a Fox News Sunday interview last week, when he said, “If I'm elected, I would be very strong on putting certain judges on the bench that I think maybe could change things, but they've got a long way to go.”
“[Marriage] should be a states rights issue,” Trump continued. “I can see changes coming down the line, frankly.”
When asked by Fox if he “might try to appoint justices to overrule the decision on same-sex marriage,” Trump replied, “I would strongly consider that, yes.”
The real estate mogul criticized the Supreme Court for the Obergefell decision imposing homosexual “marriage” on all 50 states last June, but then later in August, Trump voiced support to NBC News for banning companies from firing employees on the basis of sexual orientation. “I don't think it should be a reason” to fire workers, he said at the time on Meet the Press.
The National Organization for Marriage (NOM) and a number influential evangelicals have endorsed Senator Ted Cruz in the race for president. The Texas senator has not only committed to appointing pro-marriage justices, but says the president and the states can rightly defy the “fundamentally illegitimate” ruling just as President Lincoln defied the Dred Scott decision.
NOM has also been highly critical of Trump, saying he has “abandoned” their cause. The organization said in its January 27 blog post just prior to the Iowa Caucus that “Donald Trump does not support a constitutional amendment to restore marriage to our laws. Worse, he has publicly abandoned the fight for marriage. When the US Supreme Court issued their illegitimate ruling redefining marriage, Trump promptly threw in the towel with these comments on MSNBC: ‘You have to go with it. The decision's been made, and that is the law of the land.’”
NOM had said the week before that Trump “has made no commitments to fight for marriage, or the rights of supporters of marriage to not be discriminated against and punished for refusing to go along with the lie that is same-sex 'marriage.'”
New Hampshire voters have been tracked as showing support for homosexual “marriage,” as a poll last February showed 52 percent of Republican NH primary voters saying opposing gay “marriage” is unacceptable.
The latest CNN/WMUR tracking poll shows that overall 33 percent of likely Republican primary voters support Trump, giving him a growing 17-point lead over the nearest GOP contender. RealClearPolitics polling average in the state puts him at 31.0 percent support, with Marco Rubio second at 14.7, John Kasich third at 13.2, and Ted Cruz fourth at 12.7.
The unravelling of Chris Christie
February 8, 2016 (LifeSiteNews) -- I'm a member of the clergy and for the past eight years have lobbied the powerful in Trenton, covering the administrations of both Governors Jon Corzine and Chris Christie. I did much of my work on behalf of the New Jersey Family Policy Council, associated with Tony Perkins' Family Research Council. I am currently the President of the Center for Garden State Families.
Those of us who are engaged in the fight to secure the right to believe, speak, and practice the Christian faith in America were all heartened by the election of a Pro-Life Governor in 2009. Not only did Chris Christie run as an open Pro-Lifer, but he adopted a position in support of natural marriage in the course of the campaign. And when legislative Democrats attempted to pass same-sex marriage in the lame duck session, so they could have outgoing Governor Corzine sign it into law, Chris Christie rallied opposition and stopped it. Those were the early, hopeful days; but as Governor, Chris Christie has presented himself in an inconsistent, even scatterbrained way, often making decisions that go against earlier stated beliefs.
One of his first decisions was to make a liberal Democrat the state's Attorney General. Once approved by the Senate, and she was, the Attorney General could not be fired by the Governor, as was the case with other cabinet officers. This gave a liberal Democrat enormous power and she used it to join up with liberal Massachusetts Attorney General Martha Coakley in filing a brief against Christians in a case called Christian Legal Society v. Martinez. Just one day after being sworn in, the newly appointed state Attorney General took the most aggressive legal posture available to defend former Governor Corzine’s one-gun-a-month handgun rationing law, moving to dismiss an NRA lawsuit to overturn the law, and later vigorously opposing the NRA’s motion for a preliminary injunction in the case. Because of this appointment, New Jersey did not join in the lawsuits to overturn ObamaCare.
Governor Christie appointed a radical "sexologist" to run the NJ Department of Children & Families. This appointee would later resign when it emerged that she had held the top job in an organization that had supported a study advocating the normalization of some forms of adult-child sex.
His judicial appointments were also confusing. While claiming to oppose same-sex marriage, Governor Christie nominated an openly gay Republican to the state Supreme Court who supported it. Even Democrats wouldn't support this plainly unqualified appointment, and he never served. The Governor supported the advancement of a liberal Democrat to the job of Chief Justice, while refusing to support the re-appointment of a Republican and the Court's most conservative member. He also appointed a controversial defense attorney who had defended a number of Islamic extremists who had violated immigration law.
In 2013, many of those in the Christian community opposed legislation that banned young people from receiving counseling and therapy to lead them away from homosexuality. As an ex-gay myself, I could have personally attested to the benefits of such counseling, much of which is no different than what is found in contemporary twelve-step programs. However, the Christian community opposing the ban was not afforded the opportunity to meet with the Governor. Only the homosexual community with its pro-ban agenda was given that benefit.
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I don't blame the Governor for this, but I do blame his staff. As President Ronald Reagan said, "personnel is policy," and Governor Christie's choices in personnel have not advanced the policies he campaigned on, and often it was the direct opposite.
New Jersey ended up being just the second state in the country that only allows young people to receive counseling that advocates homosexuality, but bans by law counseling that advocates heterosexuality. When he signed it into law, Governor Christie embraced the made-up "science" of the propagandists, when he cited un-specified "research" that "sexual orientation is determined at birth." This is the so-called "gay-gene" trope that has baffled those engaged in the Science of Genetics because it has never been discovered.
As a candidate for Governor, Chris Christie talked the talk and raised the expectations of Christians in New Jersey. As Governor, and especially in his appointments, Christie undermined our confidence in his leadership. Christians should ask tough questions before extending our faith in him again.
Pro-life investigator hits back with new footage after judge blocks release of abortion sting videos
SAN FRANCISCO, February 8, 2016 (LifeSiteNews) -- A new video from the Center for Medical Progress (CMP) shows two National Abortion Federation (NAF) employees saying that abortion clinics would be interested in kickbacks from profits on fetal tissue and body part sales.
The video comes three days after a San Francisco imposed an injunction sought by NAF against CMP videos that one of the abortion group's attorneys said meant that "NAF's members can sleep a little easier tonight."
CMP accused the pro-abortion organization of hiding behind the court.
According to U.S. District Court Judge William H. Orrick, however, NAF "made...a showing" that release of CMP videos would harm rights to privacy, freedom of association, and liberty of NAF members.
"Critical to my decision are that the defendants agreed to injunctive relief if they breached the agreements and that, after the release of defendants’ first set of Human Capital Project videos and related information in July 2015, there has been a documented, dramatic increase in the volume and extent of threats to and harassment of NAF and its members," wrote Orrick.
Additionally, the judge found that CMP's videos “thus far have not been pieces of journalistic integrity, but misleadingly edited videos and unfounded assertions," and that nobody from the abortion industry “admitted to engaging in, agreed to engage in, or expressed interest in engaging in potentially illegal sale of fetal tissue for profit" in the CMP videos.
However, in a new video released today that is unrelated to the injunction, a NAF employee told undercover journalists that kickbacks "definitely [sound] like something some [of] our members would be really interested in," with another chiming in that money from private purchasers to abortion clinics were "a win-win" for clinics.
The undercover investigators, who had purported to be part of a biotechnology company with an interest in fetal parts, were offered the chance to be at a NAF conference. “We have an exhibit hall and then we also have the general conference. But I mean, this is a very great way to talk to our members. We have a group purchasing program through our membership,” the journalists were told. “So it seems like this would be a really great option to be able to offer our members, as well.”
This is the second ruling against CMP in recent weeks, and the second by Orrick since July. The San Francisco judge issued a restraining order against CMP related to NAF's 2014 and 2015 meetings in San Francisco and Baltimore that Friday's ruling extended.
The other recent ruling came in the form of an indictment of CMP's David Daleiden and Sandra Merritt. Merritt and Daleiden turned themselves into Houston authorities for booking and processing last week. After being released on bail, Daleiden spoke at a LifeSiteNews/Christian Defense Coalition press conference after which more than 100,000 petition signatures backing Daleiden were dropped off to the Harris County, Texas District Attorney's office.
According to Orrick, who says he reviewed the more than 500 hours of recordings from CMP, "It should be said that the majority of the recordings lack much public interest, and despite the misleading contentions of defendants, there is little that is new in the remainder of the recordings. Weighed against that public interest are NAF’s and its members’ legitimate interests in their rights to privacy, security, and association by maintaining the confidentiality of their presentations and conversations at NAF Annual Meetings. The balance is strongly in NAF’s favor.”
NAF did not respond to a request for comment about the allegations by Orrick and a NAF spokesperson that CMP's videos have caused threats and other security concerns against NAF members.