Should hospitals be paid to hasten your death?

[pdq1]

http://www.dailymail....ool-Care-Pathway.html

It seems they are paid to do just that. By killing off a patient by one day saves £200. Some hospitals are so good at it they have exceeded their targets.

[DTCwordfan]

Good incentive for hospices then........

Or you could go the Winterbourne route and go straight to prison, do not collect your £200.

[pdq1]

I believe some hospices are also encouraged to do the same

[emmie]

good grief of course not.

[emmie]

as some families have already found out to their cost, the loved one may not have been terminally ill, just ill, and as i pointed out on another thread a while ago, DNR notices stuck on the patients bed, against any knowledge of the family or indeed wishes of the patient. MY o/h was one of those.

[Bazile]

em10 - that DNR notice - is that in agreement with the family ?

[emmie]

no, we found a DNR notice stuck on my o/h bed, no agreement from him or us at all, and if you read that report indeed some others i have read, found that many patients families have found themselves in same position, gone to the hospital to find that notice stuck on their loved ones bed. If the patient does not agree to it, it shouldn't be there.

[Mamyalynne]

The LCP is a topic close to my heart ( not all for good reasons) to see it being potentially used as a cost cutting measure is quite chilling to read.

[pdq1]

Yes the practice is very widespread. My Mother in law was admitted to hospital and we couldn't understand why her tablets had been withdrawn, no water by the side of the bed, etc. She died a couple of days later. We did not know and was not told she was on the Liverpool Care pathway which would have ended her life.

I sympathise with you Em about your other half. It shows more questions should be asked of the medical staff as the notes at the end of the bed may not show the whole picture.

[KerrAvon]

This is euthanasia, DNR is surely assisting death. There is usually a legal charard surrounding this sort of thing.

[emmie]

the whole situation was nightmarish, and no one was asked at all. I mentioned this to Naomi on another thread, she may remember, she didn't think it was possible that could happen, but it did, but now we are learning that not only are people having this happen, but they may not be terminally ill, which is tantamount to manslaughter in my eyes. I think that anyone who has a sick relative in hospital keep a close eye, as if the hospital staff withdraw water and food then it should be brought immediately to someone's attention..

[pdq1]

Surely not manslaughter em as it was for money that means murder.

[naomi24]

Em, I think the link is talking about terminally ill patients only, but that aside, I remember that conversation well. You’re quite right. In my past experience the patient was always asked – and if he wasn’t capable of making the decision, the family were asked. I was in a situation only a few years ago when, because the patient had suffered a very severe stroke, I was asked. However, as I think I said a relative of mine very recently went into hospital – the same hospital as the stoke victim - and the doctors there TOLD her – and us – that they would not resuscitate her. It was their decision and one taken without consultation – so procedures appear to have changed in that time. In that instance, since she was in considerable discomfort and nothing could be done to save her life, she and we accepted it without question. Rather than allow people to continue to suffer I believe in letting them go – and in helping them on their way if that’s the kindest thing to do - but doing it for the money is something else entirely. It’s unethical, it’s immoral, and it’s entirely wrong. Frightening in fact!

Interestingly, the article mentions a scheme that’s in operation to get terminally ill patients out of hospital to die at home. This was exactly what was being attempted for my relative. Palliative care doctors and nurses came to talk to us for very long periods several times, arrangements were made for Social Services helpers and Macmillan nurses to come into her on a regular basis, and the day after oxygen equipment was delivered to her home in readiness for her return, she died in hospital. It must have cost the NHS a considerable amount of money to action all of that - and all for nothing. She was dying and they knew death was fairly imminent, but nevertheless they continued with the plan. Madness!

Sorry, I’m waffling – but for very good reasons I have a big beef with the poor management and the appalling waste of money in the NHS – and this report does nothing to assure me that things are changing for the better. I’m convinced the lunatics are running the asylum!!

[Prudie]

I was about to post a question on Liverpool Care Pathway but found this on a search and sorry I missed it yesterday. Now this practice is hitting the news I find the guilt about my mother's death 3 years ago on this medication is nagging at me more and more. I and my family had not heard of it and just accepted the hospital advice. My mother had been out shopping and driving herself on a Monday, in a coma in hospital by Tuesday (bacterial meningitis), on the pathway by Thursday and dead by Sunday. I feel she's looking down really angry that we didn't stand up for her. Accepting that its purpose was for terminally ill no-hope patients nothing will convince me now that it isn't used as the easy way out when doctors pre-judge someone they don't know just on their age.

[naomi24]

Prudie, I really don’t think you should beat yourself up. You didn’t know. Since my last experience a few weeks ago, I now know that age is the defining factor. We waited 11 hours for an ambulance – and when it eventually arrived I asked the crew outright if age was the reason for the delay. It was.

[boxtops]

Until now, I have had huge respect for the Liverpool Care Pathway as being a way to ensure patients are not invaded with inappropriate treatment in their last hours (I always dreaded the possibility that staff would attempt CPR on my 94-year-old mother, which she wouldn't have wanted). There IS a drive to ensure that terminal patients are on LCP to ensure their treatment is individualised for them - but marketing it as an income-generating process just isn't portraying it as it should be. Every healthcare procedure has financial incentives these days, it's all Payment by Results. I am sure that the hospices would provide you with a very different view of the use of the LCP/

[boxtops]

em, LCP can be applied to patients with any terminal disease, but only comes into place once the patient is diagnosed as only having a few hours to live. http://en.wikipedia.o...for_the_dying_patient

[Prudie]

Thanks Naomi but the more I hear about the LCP the more I feel it was a 'get her off the list' procedure. She wasn't in a hospice and was on it within 48hrs of being in the local general. They even moved her from a private room on the Sunday up to the geriatric ward, full of wailing patients. She only lasted 2 hours up there and I found it undignified and horrific. This was a previously independent very active bright as a button car driving 89 year old.

[naomi24]

Boxy, //but only comes into place once the patient is diagnosed as only having a few hours to live. //

According to your link, that's incorrect -

//covering palliative care options for patients in the final DAYS or hours of life.//

...and I know from recent experience that it's incorrect.

[naomi24]

Prudie, how sad. I'm so sorry for you. It is a 'get her off the list' procedure - I've no doubt of that. With the NHS being managed by people who don't actually care, patients have become no more than statistics that must be manipulated to meet targets.

[boxtops]

You're right naomi, but different people enter the terminal stage in differing timescales. We knew my mum was dying - but she didn't actually leave us for five days. "final stages" will mean different things for different patients, IMO.