Sunday, December 2, 2012

Almost half of dying patients placed on the controversial Liverpool ...

The new disclosures demonstrate just how routinely hospitals are placing patients on the pathway without informing them that steps which could hasten their death have been taken. The national audit found:

? In 44 per cent of cases when conscious patients were placed on the pathway, there was no record that the decision had been discussed with them.

? For 22 per cent of patients on the pathway, there was no evidence that comfort and safety had been maintained while medication was administered.

? One in three families of the dying never received a leaflet they should have been given to explain the process.

Critics of the pathway ? which can involve the withdrawal of drugs, fluids and food, and the administration of powerful pain relief ? say it is being used to hasten the deaths of the terminally-ill and elderly, in a form of ?back-door euthanasia?.

Other doctors, nurses and charities for the dying have come to the defence of the approach, which they say is intended to help ensure that people can die in dignity and comfort, instead of enduring invasive and painful treatment.

In recent months, there has been mounting concern over cases in which family members said they were not consulted or even told when food and fluids were withheld from their loved ones.

Earlier this month, Mr Hunt pledged to strengthen laws to protect patients, making it illegal to put anyone on the pathway ? which leads to death in an average of 29 hours ? without consulting them or their families.

It comes as the Government prepares to launch a new ?vision for nursing? this week which will attempt to instill compassion in the profession, amid deepening concerns about the quality of care being provided on hospital wards.

Last night Mr Hunt said the evidence would be examined as part of an independent review of the practice, which will report back to him in the New Year.

He told?The Sunday Telegraph: ?It is totally unacceptable for people to be put on the pathway without consent where they are able to give it ? that is why we are looking at what goes on in practice to make sure this doesn?t happen.?

Mr Hunt said he was concerned that families and patients were not being sufficiently informed, but suggested the approach to end-of-life care had been mischaracterised by some of its critics.

?We need to be much better at ensuring we are giving people dignity in their final few hours and the Liverpool Care Pathway has played a really important role in improving the standard of care in hospital, to hospice level,? he said.

Earlier this month, the Department of Health began a three-month consultation on changes to the NHS constitution, which would give patients and their families a legal right to be consulted on all decisions about end-of-life care.

The rights will mean patients and relatives could sue if the requirements are not met, and doctors could be struck off if they fail to consult properly.

In a hard-hitting speech last week Mr Hunt expressed concern about the culture of the NHS, warning that too many patients were forced to experience ?coldness, resentment, indifference? and ?even contempt?.

He warned that in the worst institutions a ?normalisation of cruelty? had been fostered.

The family of Arthur Oszek, 86, say they did not find out he had been put on the Liverpool Care Pathway last year until he was left begging for a drink, having been taken off his drip.

After almost a day of discussion with medical staff, treatment was resumed, but it was too late, and Mr Oszek died within 24 hours last August.

Ann Murdoch, Mr Oszek?s stepdaughter, said: ?We asked the doctors why he was taken off his drip and we were told he was on the Liverpool Care Pathway. We did not even know what it was.?

?There is no way that should have happened without asking us. We kicked up a fuss and demanded he be put back on his medication and eventually they agreed about 20 hours later.?

NHS Ayrshire and Arran said they could not comment on individual cases, but discussed their assessments with patients and families wherever possible. On other occasions, patients placed on the pathway because doctors judged that they were nearing the end of their life went on to recover.

Patricia Greenwood, 82, was put on the pathway in August, after being admitted to Blackpool Victoria Hospital with heart problems, and then suffering a fall.

Doctors told her family that they had taken her off feeding tubes because she was not expected to last more than a couple of days.

After her son, Terry, 57, defied the hospital?s orders and gave her sips of water through a straw, Mrs Greenwood, a former pub landlady, rallied, and doctors agreed to put her back on a drip.

She is now back at home and has made plans for a world cruise. The hospital trust said it had not received a complaint about her care.

A survey of 22,000 recently-bereaved Britons found relatives of those cared for in hospices rated the care far better than those whose loved ones spent their last months of life in hospital.

Less than half of families felt hospital nurses had always treated their relative with respect, compared with 80 per cent of those whose loved ones were treated in hospices.

One in six respondents said decisions were made about care which the patient would not have wanted.

Overall, health services in London were rated worst for quality of care, featuring most regularly in the bottom 20 per cent, as rated by the bereaved, while those in the South West scored most highly.

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Sick children are being discharged from NHS hospitals to die at home or in hospices on controversial ?death pathways?.

Until now, end of life regime the Liverpool Care Pathway was thought to have involved only elderly and terminally-ill adults.

But the Mail can reveal the practice of withdrawing food and fluid by tube is being used on young patients as well as severely disabled newborn babies.

MailOnline - news, sport, celebrity, science and health stories

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One doctor has admitted starving and dehydrating ten babies to death in the neonatal unit of one hospital alone.

Writing in a leading medical journal, the physician revealed the process can take an average of ten days during which a? baby becomes ?smaller and shrunken?.

The LCP ? on which 130,000 elderly and terminally-ill adult patients die each year ? is now the subject of an independent inquiry ordered by ministers.

The investigation, which will include child patients, will look at whether cash payments to hospitals to hit death pathway targets have influenced doctors? decisions.

Medical critics of the LCP insist it is impossible to say when a patient will die and as a result the LCP death becomes a self-fulfilling prophecy. They say it is a form of euthanasia, used to clear hospital beds and save the NHS money.

The use of end of life care methods on disabled newborn babies was revealed in the doctors? bible, the British Medical Journal.

Earlier this month, an un-named doctor wrote of the agony of watching the protracted deaths of babies. The doctor described one case of a baby born with ?a lengthy list of unexpected congenital anomalies?, whose parents agreed to put it on the pathway.

The doctor wrote: ?They wish for their child to die quickly once the feeding and fluids are stopped. They wish for pneumonia. They wish for no suffering. They wish for no visible changes to their precious baby.

?Their wishes, however, are not consistent with my experience. Survival is often much longer than most physicians think; reflecting on my previous patients, the median time from withdrawal of hydration to death was ten days.

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The use of end of life care methods on disabled newborn babies was revealed in the doctors? bible, the British Medical Journal

?Parents and care teams are unprepared for the sometimes severe changes that they will witness in the child?s physical appearance as severe dehydration ensues.

Read more:?http://www.dailymail.co.uk/news/article-2240075/Now-sick-babies-death-pathway-Doctors-haunting-testimony-reveals-children-end-life-plan.html#ixzz2Dupioj6h

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Source: http://johnib.wordpress.com/2012/12/02/almost-half-of-dying-patients-placed-on-the-controversial-liverpool-care-pathway-are-never-told-that-life-saving-treatment-has-been-withdrawn/

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