90% of NHS patients are starved to death

Obviously, that\’s the most inflammatory way of writing this story:

They suggest that about 85 per cent of trusts have now adopted the regime, which can involve the removal of hydration and nutrition from dying patients.

At many hospitals more than 50 per cent of all patients who died had been placed on the pathway and in one case the proportion of forseeable deaths on the pathway was almost nine out of 10.

I get the DNR bit. I even get the not strive officiously bit. But the idea that the NHS deliberately refuses 50 – 90% of dying people a glass of water horrifies. Yes, I know JohnB will be along in a moment to say it\’s great. But this isn\’t the easing of death, this is the causing of it in the name of \”management\”.

Yes, going out in a bliss of heroin is better than many other ways (and I think it\’s even more vile that certain countries, yes, the US, we\’re looking at you, are so absurd about the war on drugs that that isn\’t possible) But think back to Ernie B and the lads after WWII. If you said to them, back then, that this NHS they were so proud of would in 60 years time, be starving half the population to death what would they have said to you?

63 thoughts on “90% of NHS patients are starved to death”

  1. Depends how you count patients, doesn’t it.

    Much easier to say “90% of dying patients die”.

    And it ain’t a glass of water, it’s parenteral hydration (drip, needle in vein). Go to your local terminal cancer ward and try and find patients capable of swallowing and holding stuff down. It’s the “artificial” thing you are missing here. These are not awake, sentient (even conscious would help) patients being callously refused a glass of water to ease their last breaths.

  2. So Much For Subtlety

    But think back to Ernie B and the lads after WWII. If you said to them, back then, that this NHS they were so proud of would in 60 years time, be starving half the population to death what would they have said to you?

    Wasn’t that my question in an earlier thread? I don’t know, but I suspect a short length of hemp would be involved.

  3. So Much For Subtlety

    JamesV – “Go to your local terminal cancer ward and try and find patients capable of swallowing and holding stuff down. It’s the “artificial” thing you are missing here. These are not awake, sentient (even conscious would help) patients being callously refused a glass of water to ease their last breaths.”

    That is 90% of people the doctors deem likely to die. 90%. That is a hell of a lot more than the number of people dying of cancer. A lot more. It is people dying from all causes. And yes, many of them are not awake. Because the doctors have filled them with hard drugs to make sure they are not awake. That does not mean they would not be awake – and perhaps not even in pain – if they were not in a drug-induced coma.

    So these are patients who may not even die – the doctors can’t be sure – and who in many cases would be able to eat and hold conversations, but whom the doctors have decided should die slowly of dehydration.

    This is vile.

  4. So Much For Subtlety

    JamesV – “you have the right to withdraw consent to treatment at any time.”

    I have no problem with anyone withdrawing consent for treatment any time they like. If someone wishes to go home and die among their roses I would be delighted if they did so. I would pay an extra five pence on the pound in income tax so that they could have proper palliative care when they did so.

    But that is not what we are talking about. We are talking about doctors being told they have to select people who are probably dying of some other cause, in order to collect their pieces of silver and free a bed, drugging them up so that they cannot consent to a damn thing, and then leaving them to die of thirst. Often without telling their families.

    How does this differ from another well known programme for the mentally ill just a few short hours away from Britain by Lancaster bomber?

  5. A simple test to apply to claims such as
    ‘Last night the Department of Health insisted that the payments could help ensure that people were “treated with dignity in their final days and hours”. ‘

    Would the number of patients killed alter if hospitals had to pay a fee for each one?

  6. “… starving half the population to death what would they have said to you?” Ernie B might have been horrified. But if you meant Aneurin B, he’d have said he was happy as long as they were Tory vermin.

  7. People are not “dying of thirst”, these are by definition patients incapable of getting and/or keeping anything down – due to their disease, not their treatment. Had no one invented the drip (and this is ultimately an argument about the use of technology to prolong life) they would be long-since dead.

    Please, Tim, get this “refusing dying patients sips of water” out of your head. These patients are not capable of sipping water.

    Being dependent on 24/7 artificial hydration (in humans you can’t do it in bolus as you can with cats and dogs) is also not a fucking walk in the park. It is not something you want for long. It is difficult to control fluid balance as there is no functional thirst mechanism. You can end up “diluting” your patients this way. Perhaps we should test serum electrolyte levels every 30 minutes? And try interpreting those in someone with diffuse metastatic cancer or multiple organ failure. Wake up Mrs Miggins, the doctor wants some more blood.

    You aren’t, by and large (Lourdes cases aside, of which the papers will go and find one), going to get another 10 years to see your great grandkids if you are incapable of getting stuff into your stomach. Prolongation of life is of a matter of hours to days of close-to-zero-quality life. And again, it is the patient’s (or their attorney’s) if it’s worth the extra hours or days of zombie existence for the 1 in 10,… chance of being a Lourdes case.

  8. But the idea that the NHS deliberately refuses 50 – 90% of dying people a glass of water horrifies.

    Tim, you are wrong about this. There is no health policy that countenances refusing a dying patient a glass of water.

    You’re mixing up two things here. One is the question of whether the LCP is a good way to care for dying patients. If you want to comment on that, you need to find out what the LCP is and what the clinical thinking behind it is. Otherwise, you should leave the subject alone.

    The other is to what extent the LCP is being applied inappropriately to some (elderly) patients, and what the reasons are that this happens. If you’ve got some evidence that financial incentives are a problem in this respect, let’s discuss it.

  9. Whatever the merits and demerits of the LCP, it’s a bit mendacious to use it a stick to beat the NHS given that the Pathway is also more or less standard in UK private healthcare.

    The headline could with equal justification have read “90% of BUPA patients are starved to death”. There’s an underlying bias in this post which I think needs to be recognised.

  10. So we’re visiting this again & there’s the usual string of comments commending the LCP. The LCP may indeed be a perfectly sensible & acceptable exit door but that’s not the point. The point is the financial inducements made to put patients on the treatment & the suspicion they have been, without the knowledge & consent of the patient or failing that the families. Sorry, but whatever the circumstances, the patient is not some piece of hospital property to do with as is convenient or economically efficient to the NHS. Either you’re going to have socialised medicine or your not. The theory behind the Health Service is you all pay in so if & when you need treatment it’s available free at the point. If what’s suspected had been going on in the private sector, they’d be people facing murder or at least manslaughter inquiries by now. Perhaps it’s time to level the playing field.

  11. VftS has the best suggestion I’ve yet seen on breaking this deadlock. The fact that PaulB and JamesV have scrupulously avoided addressing it tells me all I need to know…

  12. JuliaM: I ignored VftS’s question because, as posed, it doesn’t deserve an answer.

    But I’ll answer the better question “is the number of patients dying on the LCP sensitive to financial incentives offered to hospitals to put patients on it”. I suppose it is.

    Jim: that’s a remarkable recovery. But what do you think the doctors did wrong? Apparently she was suffering from fluid accumulation in the abdomen as a result of right-sided heart failure: her problem was too much fluid, not too little.

  13. FWIW, the article doesn’t say that the financial incentives are necessarily to get more people on LCP:

    “… in some cases trusts are given specific targets to ensure that a set number of people who die in their hospital are on the LCP.
    Elsewhere the targets relate to how the pathway is operated or monitored.”

    And 38% said they used LCP, without getting or expecting payments for it.

    The biggest LCP related award the article comes up with (£1m) was given to a hospital that had no target for number of LCPs. It was for monitoring/consulting patients (hard to say exactly what it was for).

    So it looks like hospitals are (increasingly) using it without being incentivised to do so.

    Is what is really going on that plenty of hospitals/doctors had their own informal versions of DNR/not striving officiously to keep alive, and now they’re moving to a standard version of it? If so, at least that means the extent can be monitored.

  14. Jim>

    Shipman means we should ban GPs, right? If you’re being consistent, that is…

    The opposition to the LCP comes from a very odd mindset, reading the comments here. Opponents seem to be simultaneously holding two contradictory ideas: that doctors are capable of infallible diagnosis and treatment, and that they are too incompetent to know when a patient is dying. Well, makes as much sense as their arguments…

    Oh, on top of that we have the contention that (at least the vast majority of) doctors are so evil that they’d happily murder the elderly to gain a few extra pounds for their NHS Trust – not even for their own pocket. That’s completely bonkers, of course.

  15. “But what do you think the doctors did wrong?”

    They started to play God, thats what they did wrong. They assumed she was a goner, so put her on a treatment pathway which 999 times out of 1000 will kill you, even if you were strong enough to survive with the correct treatment.

    It is not the role of doctors (or district nurses) to decide when some one is going to die, and therefore make it happen. It is their role to keep people alive. Once they step over that line they are as good as murdering a % of their patients, and it matters not if that % is very small. Its still murder.

    I’m not surprised the NHS has come to this. As in all socialist creations everything is explained by ‘the ends justifies the means’ and ‘its all for the greater good of the majority’.

    I’m glad its out in the open. It shows the NHS up for what it really is, a dystopian socialist hellhole, where the individual has no rights, and can be disposed of at the whim of the collective.

  16. “On top of that we have the contention that (at least the vast majority of) doctors are so evil that they’d happily murder the elderly to gain a few extra pounds for their NHS Trust – not even for their own pocket. That’s completely bonkers, of course.”

    Oh is it? Do you think that once a NHS Trust has a target, and that target is not met, and money is lost as a result, that there might be consequences for the people making the decisions at the sharp end?

    Lets take two doctors, one who has a conscience and refuses to put people on the LCP willy nilly because he disagrees with it, and tries to keep people alive as far as possible, and another who signs them off left right and centre. Can you not conceive that the first one might be leant on by management to increase his usage of the LCP, and that the second be possibly given promotion over the first because of his adherence to the management line?

    If what is happening in the NHS was occurring in a private business, that they were gaining a financial advantage by using methods which might help most of their customers, but were actually killing a very small percentage of them, there would be merry hell to pay. People would be going to jail and companies wound up and dissolved over it. It would be a scandal of epic proportions. I mean we banned DDT right, and it was only killing animals, while saving the lives of millions.

    But because its the socialist NHS doing it, its all OK because they mean well, and therefore by definition, can never be evil.

  17. “Lets take two doctors, one who has a conscience and refuses to put people on the LCP willy nilly because he disagrees with it, and tries to keep people alive as far as possible, and another who signs them off left right and centre.”

    Let’s take two IT staff, one of whom has a conscience and refuses to murder difficult clients, and the other who is happy to murder them left, right, and centre. If the former is threatened with the loss of his job if he refuses to go a-murdering, is he a) going to shelve his conscience and start killing, or b) report his murderous employers to the police, newspapers, and so-on?

    Would you kill people just to keep your job?

    The idea that a large proportion of doctors are willing to do so is dependent either on it being a career which psychopaths select – which the evidence is strongly against – or that the population as a whole would be willing to kill in the same proportion. Clearly, either option is nonsensical; the whole concept is preposterous.

  18. “If what is happening in the NHS was occurring in a private business, that they were gaining a financial advantage by using methods which might help most of their customers, but were actually killing a very small percentage of them”

    Come to think of it, that’s actually the case in very many businesses. A good example would be the manufacturers of various kinds of (medical) drugs, but the same is also true of the manufacturers of such diverse goods as refrigerators, cars, batteries, fireworks, and so-on.

  19. It is not the role of doctors (or district nurses) to decide when some one is going to die, and therefore make it happen.

    Jim: Quite true, and there’s nothing in the Liverpool Care Pathway documentation about making death happen. “The LCP neither hastens nor postpones death”.

    In the case you link to (comment #15) the doctors, quite reasonably from the information given in the report, decided there was no effective treatment they could give to an 82-year-old with heart failure and a broken hip, and that she was very likely to die soon. Properly, they told the relatives. The relatives noticed a spontaneous improvement and informed the doctors, who properly resumed treatment, with the happy outcome that the patient recovered. Again, what have the doctors done wrong?

    The report on the other case you link to (comment #16) is extraordinary. The quotes from the nurses look pretty implausible to me. Let’s see what the promised enquiry turns up.

  20. Thou shalt not kill but need not strive, officiously, to keep alive.
    The outrage is because the LCP, in practice even if not in theory, goes beyond this.
    When I was 22 I was saddened, almost horrified that my great-uncle was made to die very slowly under painkillers that took away his brain function so that he could not recognise me or even his sister. If I get to a comparable condition I shall refuse painkillers (yes, I know that will hurt): but the NHS has been exposed, when saying it is applying LCP, as refusing water to someone dying. Where is Gunga Din?

  21. “The doctors, quite reasonably from the information given in the report, decided there was no effective treatment they could give to an 82-year-old with heart failure and a broken hip, and that she was very likely to die soon. ”

    But not necessarily die soon!!!! Likelihood is not certainty. They do not know in all cases. And the LCP does bring on death. Of course it does. If you stop feeding someone, and giving them liquids, they are going to die, end of story. If you do feed them, they may go on living for considerably longer, some may even recover (as documented). And it if it wasn’t for the tenacity of that old lady’s family she would be dead. The doctors had decided she was going to die, and die she would have, if they had not been persuaded to change their minds.

    Can you not see its a self fulfilling prophesy? This person is going to die, so we’ll put them on the LCP, and lo and behold, they’ve died. We were right!

    The mere fact ONE person has been put on it and survived means the entire thing is rotten to the core. How many more patients without family to fight their corner might have made it, but were never given the chance?

  22. Geez, there’s some serious bullshit on this thread.

    There is no health policy that countenances refusing a dying patient a glass of water.

    Hush now – don’t let the facts get in the way of a good ol’ NHS bashing.

    the idea that the NHS deliberately refuses 50 – 90% of dying people a glass of water

    Frankly speaking, your oh-so-outraged tone is laughable – if you are going to spout off like this, at least learn to distinguish between oral and intravenous fluids. In emergency surgery, we regularly see patients for whom (regrettably) nothing can be done, beyond keeping them comfortable & pain-free – at no point have the bastard heartless nursing staff refused them a sip of water.

    Much as the Daily Mailograph would love to believe that we are bumping patients off left, right & centre to hit targets & thereby reap the lucrative financial rewards, the truth is rather mundane. The LCP is like any other protocol/pathway/SOP (see ACS, stroke, whatever) – it exists to
    standardise practice (there’s a whole ‘nother debate about pathways and their application by the rigid-of-thinking – see the much-missed NHS BlogDoc – but let’s not get into that here). In other words, trusts are being encouraged to adopt [insert protocol/pathway/SOP here], so as to formalise what they are (hopefully) already doing – i.e. to a set & agreed standard. In the case of the LCP, it simply sets out a proper standard of end-of-life care (managing pain, keeping them comfortable) – it does not provide some kind of carte blanche for killing patients in order to meet targets – nor does it prevent a change in management if they rally. Now, that’s not to say that there aren’t serious issues concerning DNAR decisions, the merits (or futility) of active treatment, communication /involvement of next-of-kin (the central issue, IMO) – but that’s been the case ever since Hom Sap figured out how to prolong life & relieve pain.

  23. “it does not provide some kind of carte blanche for killing patients in order to meet targets – nor does it prevent a change in management if they rally. ”

    They’re not going to ‘rally’ are they, once you’ve taken away food and drink from very sick people?

  24. They’re not going to ‘rally’ are they, once you’ve taken away food and drink from very sick people?

    It’s bullshit like this that makes me long for national service on the wards. I’ve not long (shift before last) seen somebody (yes! she was on an end-of-life care pathway!) slip away, surrounded by her family, full of drugs to keep the excruciating pain at bay. I’d fcuking love it if you walked in and fed her a sandwich, you moralising twat.

    To borrow from Goldie Lookin’ Chain: “Guns don’t kill people… LCPs do.”

  25. Jim>

    I suggest having a good read of the stuff on the relevant website:

    http://www.liv.ac.uk/mcpcil/liverpool-care-pathway/

    http://www.liv.ac.uk/media/livacuk/mcpcil/migrated-files/liverpool-care-pathway/updatedlcppdfs/LCP_V12_Core_Documentation_FINAL_(Example).pdf

    I wouldn’t dream of saying that everything about the LCP is uncontentious – care of the dying is a difficult ethical problem. Your claims, though, bear no relation at all to reality and are entirely incorrect.

  26. Jim>

    “They’re not going to ‘rally’ are they, once you’ve taken away food and drink from very sick people?”

    That simply doesn’t happen. There seems to be this idea that the LCP means withdrawing nutrition and fluids from patients so they starve to death or die of dehydration, but that isn’t actually what it entails in any shape or form. End of that line of argument, please.

  27. Jim,

    Ok, so I lost my rag a bit there & I apologise. But, tbh, you are way off the mark. Do some reading, as suggested above.

    I’m off home – evening all.

  28. @lost_nurse:Of course I don’t mean a cup of tea and a sandwich. How stupid do you think I am? I’m talking about the withdrawal of nutrition and hydration from people who are unable to physically eat, but might survive with intravenous drips, and suitable care.

    I have read all the bumf on the links, and its all wonderful. Of course its only on paper, not what actually happens in reality. And it does (in coded language) effectively say that the withdrawal of nutrition and liquids is part of the LCP. It specifically says that patients will fed while they can physically eat, but after that nutrition may be withdrawn if considered necessary, and specifically tries to tell the relatives that this is all ‘ok’, and that the patient has no desire for nutrition or hydration.

    I notice that there is mention of ‘decisions being made for the patient’ but no mention of the relatives being given any right in all of this – all the power resides with the medical staff. They hold the whip hand – the power of life and death.

    Its obvious that on the ground the general policy is ‘This person looks on the way out, they can’t eat unaided any more, lets whack the sedatives up, cut off the drips, they’ll be dead within 48 hours’. Job done, another bed free.

    You can write it up in fancy words as much as you like but thats the reality of it.

  29. might survive with intravenous drips, and suitable care

    I’m going to be quick. Once again, if this is the case: they will not be on the LCP. Of course active treatment is a grey area – my fave example being an elderly man who an entire surgical team thought was a goner, but who was sat up a week later eating porridge (though the best thing we could do for him was to get him home, to die in his own bed – a better outcome than dying in hospital, certainly) . But it strikes me that your world view is pretty much straightforward: whack up a drip & they’ll live, right?

  30. Jim>

    “it does (in coded language) effectively say that the withdrawal of nutrition and liquids is part of the LCP”

    No, it says, explicitly, the exact opposite: that withdrawal of nutrition and/or hydration is not necessarily part of the pathway.

    “It specifically says that patients will fed while they can physically eat, but after that nutrition may be withdrawn if considered necessary”

    No, it says something very different: that nutrition and hydration may (and should be) removed only once withdrawal will _not_ have any effect on lifespan. When someone’s so close to dying that they won’t have time to become dehydrated, it’s a kindness to remove the drip so they have one less tube poking into them as they die.

    “I notice that there is mention of ‘decisions being made for the patient’ but no mention of the relatives being given any right in all of this – all the power resides with the medical staff.”

    Rubbish. The LCP explicitly requires full informed consent from whoever takes that role in the patient’s care.

    “Its obvious that on the ground the general policy is ‘This person looks on the way out, they can’t eat unaided any more, lets whack the sedatives up, cut off the drips, they’ll be dead within 48 hours’. Job done, another bed free.”

    No, it’s not obvious at all. What is obvious is that you seem to think all medical staff are evil monsters. Do you really believe there are thousands of doctors who care so little about their patients’ lives that they’d murder them?

    That’s not even a conspiracy theory, it’s just thoroughly insane.

  31. It is generally accepted where I live in New Zealand that, should you fall ill in the UK, you come back to New Zealand for treatment. Whilst we have a reciprocal health agreement with the UK so that there are no costs for treatment in the UK; the whole system is so corrupted from what most people view as health care that it is important that, wherever possible, you make the 24 hour flight and get back here.

    My Nan broke her hip on holiday in London a couple of years ago but positively refused to get into an NHS hospital for fear of being killed off. Instead she suffered the pain of a flight back to New Zealand for treatment.

    This is what the LCP leads to. No matter how much BS is spouted by the murderers promenading as doctors.

  32. “withdrawal of nutrition and/or hydration is not necessarily part of the pathway.”

    Not necessarily maybe, but most often is.

    “nutrition and hydration may (and should be) removed only once withdrawal will _not_ have any effect on lifespan”

    And who gets to decide whether they will not have any effect on lifespan? Some omniscient being, who can predict the future, and is never wrong? Or a human being, who often is wrong, and should not be put in a position to decide who dies right now and who is given a chance to live a little longer, and maybe even recover?

    “The LCP explicitly requires full informed consent from whoever takes that role in the patient’s care.”

    Where is that stated? I have re-read the entire documents linked to and nowhere can I see one mention of consent being required from relatives. I see mention of information being given to them about the decision already made, and the need to explain things, but zero about getting their explicit consent, or that the relatives may withhold that consent if they see fit.

    You all seem to think because all of this is written down, in guidelines and protocols, thats exactly what happens in reality. It doesn’t. Look at the law on abortion. In theory its to protect the ‘physical or mental health of the mother’. In reality its abortion on demand. No-one ever gets turned away for an abortion if they want it. And the same applies here. On paper its a civilised and humane way for the terminally ill to die. In reality its a way for the NHS to get rid of dying people in a economically efficient manner. Only not all of them might have died there and then if they hadn’t been pushed over the edge first.

  33. I can explain it to you, but I can’t understand it for you. You realise there are loads of documents on that site? I struggle to believe you read them all carefully in the time you’ve taken. Clearly if you did read them all you did so in such a cursory manner that you missed the answers to your ‘questions’.

  34. Dave: you made a statement: “The LCP explicitly requires full informed consent from whoever takes that role in the patient’s care”. Please point me to where in the documentation this is detailed.

  35. Ah ha, found it:

    http://www.liv.ac.uk/media/livacuk/mcpcil/documents/LCP%20FAQ%20August%202012.pdf

    Quote “Does the patient or relative need to give written consent to use the LCP?
    No, the LCP is not a treatment but a framework for good practice, therefore, written consent
    is not required. However,  identifying that someone is in the last hours or days of life and
    agreeing a plan to support care in the last hours or days of life should be discussed with the
    patient where possible and deemed appropriate and always with the relative or carer.”

    Written consent is NOT required, all that is required is that the relatives are ‘consulted’. They have no right to refuse the implementation of the LCP.

    Still want to stand by your statement above about consent?

  36. It’s not true that relatives have to consent to use of the LCP – it’s a framework, not a treatment. However, consent is needed for the use of medication.

    Jim: back to your comment#26: “And the LCP does bring on death. Of course it does. If you stop feeding someone, and giving them liquids, they are going to die, end of story. If you do feed them, they may go on living for considerably longer, some may even recover (as documented).”

    No one is going to die quickly from a lack of IV nutrition. And in the particular case we were talking about, the patient was reportedly suffering from a build-up of abdominal fluid – she didn’t need more fluid intravenously. All she needed was her mouth keeping moist, for comfort. The nurses would have done that, but the family wanted to take over – good for them. And, unexpectedly, her heart function improved to the point where she became responsive, so the doctors resumed treatment. Nothing bad happened.

    The Daily Mail is trying to spin this “the doctors could not deny the positive response”, but there’s nothing factual in the story to suggest that they weren’t delighted about it.

  37. Jim>

    All medical treatment requires consent. What you’re doing is like saying that the LCP doesn’t specifically mention prohibiting cannibalism of living patients, so it allows it.

    I suggest you re-read the flow-chart in the LCP example PDF (about half a dozen pages in). It clearly includes consultation with patients and/or carers.

    One step is “Discussion with the patient, relative, or carer to explain the current plan of care and use of the LCP”, and the grounds for a full reassessment and review include “concerns expressed regarding management plan from either patient, relative, carer, or team member”.

    A patient cannot be put on the LCP without consent. The LCP must be re-assessed as soon as any improvement is seen, or if anyone expresses the slightest concern, or if the patient survives 72 hours.

    Whilst we’ve got that document open again, by the way, I’d direct your attention to the bullet point on the page above the flow-chart, which states:

    “A blanket policy of clinically assisted (artificial) nutrition or hydration, or of no clinically assisted (artificial) nutrition or hydration, is ethically indefensible and in the case of patients lacking capacity prohibited under the Mental Capacity Act (2005).”

  38. so the banks mis-sold endowment mortgages…and PPI….and interest rate swaps……but the medical industry never mis-sells anything because every doctor reads the Guardian and is in love with Polly Toynbee and Richard Murphy.

  39. There is a right in law to refuse treatment, but not to demand treatment. With an unconscious patient, doctors are supposed to make decisions in the best interests of the patient. Relatives have no legal right to refuse treatment on the patient’s behalf unless they have been given a Lasting Power of Attorney.

    The truth is that if doctors were engaged in a determined mass conspiracy to kill everyone who enters hospital there’d not be a lot to stop them.

    On the other hand, all the doctors I know want to help patients, not kill them. And they want to accommodate the wishes of relatives, because they’re not looking for conflict and they certainly don’t want to spend their time responding to complaints.

  40. “the patient was reportedly suffering from a build-up of abdominal fluid – she didn’t need more fluid intravenously.”

    Accumulation of fluid in your abdomen is not the same as overhydration, unless it’s in the stomach. If you have a build-up of fluid in your lungs, you don’t stop drinking water.

    “It clearly includes consultation with patients and/or carers… A patient cannot be put on the LCP without consent.” Does not follow. “Consultation” is not “consent”.
    Also, regardless of the rules, the articles are about people who HAVE been put on the LCP without consent.

    Also, LOL at all the people saying “the doctors had determined that the patient wasn’t going to survive anyway, so withdrawal of food and water didn’t kill them”. If they’re so confident the patient is going to die, then why withdraw food and water to make certain of it? In cases where the doctors made a mistake, and the patient would have otherwise survived, the doctors killed the patient by withdrawing food and water.

  41. “One step is “Discussion with the patient, relative, or carer to explain the current plan of care and use of the LCP”, and the grounds for a full reassessment and review include “concerns expressed regarding management plan from either patient, relative, carer, or team member”.”

    None of that is consent. The hospital make the decision, based on their clinical assessment, that the patient should be put on the LCP. The patient probably is not compos mentis at this point, so actively giving consent to be killed is pretty unlikely (which presumably would be illegal – you cannot consent to murder, as seen by all the court cases involving ‘locked in’ syndrome sufferers). So the only people who can give consent are the relatives. And it is completely clear from all the documentation that they are only to be informed of the decision already taken, that any questions they have should be answered, and that the ‘care plan’ (what weasel words for ‘we’re going to kill Granny’) can be reviewed in the light of concerns expressed by relatives.

    NONE OF THAT IS CONSENT.

    Which bit of that don’t you get? The hospital make the decision, and even if the relatives kick up, there is nothing in the LCP documentation that they can force the hospital to do. They can make the hospital ‘review’ their decision, but that review can come to the same conclusion as the original decision, even in the face of relative lack of consent. The ultimate power lies with the hospital.

  42. If what is happening in the NHS was occurring in a private business, that they were gaining a financial advantage by using methods which might help most of their customers, but were actually killing a very small percentage of them

    Like businesses that use cars, or vans, or trucks, or trains, or aeroplanes?

  43. The LCP involves ever-increasing dosages of morphine, and the withdrawal of food and water.

    If it’s just palliative care for someone who is dying, why the ever-increasing dosage of morphine? Why not a constant dosage?

    Why does the LCP withdraw food and water? The only element that has anything to do with palliative care is the morphine. But the LCP withdraws food and water, which has nothing to do with palliative care.

    Ever-increasing dosages of morphine and the withdrawal of food and water. The LCP is designed to kill people.

    Ask yourself this: has anyone ever survived the LCP? No. If it was just palliative care, the answer would be yes.

  44. James James: pretty well everything you say about the LCP is false. Read the documentation. The intention is to give up on attempts to prolong life, in the interests of making the dying patient as comfortable as possible.

    Ask yourself this: if your system were failing to the extent that water was oozing out of your veins, would you want more water pumped into you? If osteolytic metastases were eating into your ribs and spine, with similar effects on your nervous system to a dentist drilling into your teeth, all the time, would you want a lot of pain control, even if it was likely to shorten your life?

    And yes, people survive the LCP – if they show signs of recovery, they get taken off it.

  45. “Like businesses that use cars, or vans, or trucks, or trains, or aeroplanes?”

    If a van driver goes out one day and kills someone that is a tragedy. And yes, I guess you could say that given the number of vans on the road in any one day, eventually someone somewhere will be killed by one, completely through no fault of their own. We as a society accept that the good vans (and all other forms of transport) bring to us all outweighs the dangers to a few.

    If the supporters of the LCP want to argue the case for it on ‘greater good’ grounds, please, be my guest. I just don’t think elderly people being admitted to the NHS will be very happy that there’s a one in whatever chance they will be bumped off unnecessarily, but thats ok because it helps lots of other people. And their relatives might not be too happy either.

    Indeed if that was what it was being sold as – a way of easing the majority of deaths, but accidentally killing a few along the way, then I wouldn’t have a problem. Because no-one would buy it. It would be howled down in a sea of public outrage.

    So instead its wrapped up in lovely cuddly language, ‘care pathway’ sounds so warm and tender, who could possibly be against a care pathway?

    The reality, as increasing numbers of families are finding out, is entirely more gruesome. People being sedated and starved to death because they aren’t dying within the NHS’s allotted timeframe.

  46. “Indeed if that was what it was being sold as – a way of easing the majority of deaths, but accidentally killing a few along the way, then I wouldn’t have a problem. Because no-one would buy it. It would be howled down in a sea of public outrage.”

    Rubbish. What you’ve described just the standard medical trade-off.

  47. a way of easing the majority of deaths, but accidentally killing a few along the way

    Well we already use medicines that alleviate pain, but accidentally kill a few people along the way (for example anaesthetics, asprins).

  48. People being sedated and starved to death because they aren’t dying within the NHS’s allotted timeframe

    Jim, with respect, I don’t think you really grasp what end-of-life care involves, what it means or what it looks like. I’m not sure how much experience you have of death (er, in other people, that is), but I’m willing to bet that it’s rather limited. Besides which, your starting premise appears to be that the evil NHS is full of roaming killer-medics, using the LCP as a weapon to free up beds. It simply isn’t like that.

    I would – seriously – suggest that you undertake some voluntary work at your local hospice.

  49. “we already use medicines that alleviate pain, but accidentally kill a few people along the way (for example anaesthetics, asprins).”

    And do the users of these thing get to choose whether they use them, or are they administered without consent?

  50. Jim: you mean that governments never promise populist measures that have almost no effect on what actually happens?

    According to the Mail, Hunt is proposing that “patients can’t be put on end-of-life regime without consulting relatives”. And as we’ve discussed, the LCP already says that relatives should be consulted.

  51. Having temped in a hospice, and watched 8 inconvenient patients being f##ed in one go to clear the beds for a Bank Holiday, its fairly obvious that the morphine/sedatives they give a) do kill, b) are intended to kill but c) they can’t admit it, as they’d be sued for manslaughter.
    This LCP has just shone a light into the hospice movement…they don’t really like that.
    If someone is in agonising pain, and consents, who cares if they’re ‘put to sleep’? No one …its just that sooo many elderly patients who are not even remotely near the end of life, and are not terminally ill, or in pain, have been discovered unconcious by relatives in NHS wards, and nurses/doctors have simply told the relatives that ‘its the disease taking its course’.

    Its the consent issue….without it , its murder.
    Just get a consent form signed up front ….

  52. They’ve already started to roll this out in UK prison system for lifers….just like in Nazi Germany mate…the Prison Ombudsman allows the Primary Care Trust (PCT) to review the clinical care the prisoner gets…they say it was fantastic ..so he writes a report to HM Coroner saying no jury inquest is required. Google ‘death of a prisoner + HM Garth’ …one bloke only became terminal because the prison ‘forgot ‘ to arrange his hospital appointments….no inquest, its a ruddy death penalty…..
    And as for Rabbi Neuberger’s ‘impartial ‘ review… ‘impartial’! B####s!
    The LCP was written by John Ellershaw. He works at Marie Curie HQ in Liverpool..his department ‘accidentally ‘ killed a non terminally ill guy in 2009 (And in case you forgot – HIS unit killed a non-terminally ill man in 2008, and settled out of court to avoid the publicity that would have cost him his job, but would have saved tens of thousands of other non-terminally ill elderly people’s lives…http://www.dailymail.co.uk/news/article-1219853/My-husband-beaten-cancer-doctors-wrongly-told-returned-let-die.html) and settled out of court . If they cant even tell who is terminally ill, why do they expect a nurse to get it right?

    And guess who endorsed the original LCP paper published by the creep in charge (Ellershaw)?? Why, none other than BARONESS NEUBERGER!! http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1126595/

  53. people survived Hadamar…people survived Auschwitz…they hadn’t the ‘special treatment’ yet….doesnt mean morphine and sedative overdoses don’t fu##ing kill , does it?
    ‘Nurse Consultants’…what a fu##ing joke!

Leave a Reply

Your email address will not be published. Required fields are marked *