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NHS scheme helps patients with terminal illnesses end their lives prematurely, warn leading doctors
Article Published: 4th September 2009
Official guidelines of the NHS used in UK hospitals are sentencing terminally ill patients to a premature death, leading medical experts have warned.
A group of experts who care for the terminally ill patients wrote a letter to The Daily Telegraph saying that some NHS patients are being wrongly judged as close to death. Under NHS guidance, introduced across England and designed to reduce patient suffering in their final hours, doctors and medical staff can withdraw fluid and drugs from terminally ill patients and put them on continuous sedation until they pass away.
The letter has been signed by palliative care experts including Professor Peter Millard, Emeritus Professor of Geriatrics, University of London, Dr Peter Hargreaves, a consultant in Palliative Medicine at St Luke’s cancer centre in Guildford, and four other experts. It says the new treatment pattern of palliative care, based on experience at a Liverpool hospice is being rolled out into hospitals and nursing homes.
Under the scheme, known as the Liverpool Care Pathway, the medical team look for signs that a patient is approaching their final hours, which can include losing consciousness or having difficulty swallowing medication. However, the doctors warn that these signs can point to other medical problems; patients can become semi-conscious and confused as a side effect of pain-killing drugs such as morphine if they are also dehydrated.
‘If you tick all the right boxes in the Liverpool Care Pathway, the inevitable outcome of the consequent treatment is death,’ the experts wrote.
‘As a result, a nationwide wave of discontent is building up, as family and friends witness the denial of fluids and food to patients’.
Dr Hargreaves said that some patients were being ‘wrongly’ put on the pathway, which created a 'self-fulfilling prophecy' that they would die.
'I have been practising palliative medicine for more than 20 years and I am getting more concerned about this 'death pathway’ that is coming in,' he said.
‘It is supposed to let people die with dignity but it can become a self-fulfilling prophecy. Patients who are allowed to become dehydrated and then become confused can be wrongly put on this pathway.’
‘What they are trying to do is stop people being overtreated as they are dying. It is a very laudable idea. But the concern is that it is tick box medicine that stops people thinking,’ he added.
He said that he had personally taken patients off the pathway who went on to live for 'significant' amounts of time and warned that many doctors were not checking the progress of patients enough to notice improvement in their condition, The Daily Telegraph reported.
Professor Millard expressed his worries that patients were being 'terminally' sedated, using syringe drivers, which continually empty their contents into a patient over the course of 24 hours.
It is reported that in 2007-08 16.5 per cent of deaths in Britain came about after continuous deep sedation, according to researchers at the Barts and the London School of Medicine and Dentistry, twice as many as in Belgium and the Netherlands.
The experts’ warning comes just a week after a report by the Patients Association estimated that up to one million patients had received poor or cruel care on the NHS.
A spokesman for the Department of Health defended its approach as 'an evidence-based framework to help delivery of high quality care for people at the end of their lives.
'Many people receive excellent care at the end of their lives. We are investing £286 million over the two years to 2011 to support implementation of the End of Life Care Strategy to help improve end of life care for all adults, regardless of where they live.'
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