Care pathway concerns must be challenged

[naomi24]

For Em, and anyone else rightly worried about this practice.

http://www.telegraph....ed-says-minister.html

[woofgang]

I do think that it is very sad that a document that was designed with the intention of making sure that people ended their lives in comfort as far as is possible and that should be reassuring to the patient and their loved ones has been perverted in this way.

[youngmafbog]

It has to be remembered that this is something new. There will be problems as the practice beds in.

What we must not do is allow a few cases to hijack them by people who have an ulterior political or religious motive.

My father withdrew his own drugs when dying of cancer as he had simply had enough. He was not forced, no one gained at all by his death except him as he gained the relief he sought.

[Duncer]

Perverted by whom woofgang. Should the doctor's oath now be named the hypocritc oath? If I starved a pet in it's last few days because it was ill then I would be prosecuted.

I have no doubt that the pathway was originally designed to be used for good but in a cash poor NHS I have grave concerns about it's current usage and the potential for a vile expediency when it comes to freeing up beds. If I am on my way out then I'll have a great big injection of something warm and squiggly please, rather than three or four days of starvation and being ignored.

[naomi24]

youngmafbog, other people have had different experiences to yours - and it isn't just a few. This practice is not confined to Liverpool where it began - it is now widespread.

[jake-the-peg]

I think you have to be careful about emotive language like starved Duncer

This from McMillan's web site

This phase may last only a few hours or can continue for a few days. At this stage, food and drink aren’t necessary as their body no longer needs them. Moistening their lips or mouth is all that’s needed. Once a person stops drinking, they usually only live for a few days.

http://www.macmillan....ays.aspx#.UJjOc4Z2MmA

[naomi24]

Jake, //you have to be careful about emotive language like starved Duncer //

I'm not so sure. Someone I know who recently died was unable to eat normally due to the nature of the disease - but no other solution was suggested. She went hungry - and she told me she was hungry.

[jake-the-peg]

Well that's why I said you have to be careful - I didn't jump on my high horse and start assuming that my experience was a general case applying to all cases.

I'm merely pointing out that in some cases at some times people get to this point in their dying where they stop taking food and water.

I think pretty much anybody I've ever met who've had anything to do with McMillan would say what a brilliant organisation they are and I'd certainly trust their opinions.


I'm sure there have been cases where things have gone wrong perhaps with good intentions perhaps not but I'd not jump to conclusions based on a newspaper story - even in the Telegraph

[naomi24]

Jake, I agree, Macmillan is a brilliant organisation - and I have plenty of experience with it - but I'm not jumping to conclusions - I'm speaking from recent experience and very recent experience. Things have changed drastically over just the past few years.

[Prudie]

For those who have not had experience of this please note that it is not all that new and is not just used for clearly terminal ill patients (which was its noble purpose). I believe it's being used in NHS hospitals to alleviate their burden of elderly patients they don't have the resources or inclination for. Because of personal experience I consider it legalised selective euthanasia under a different guise.

[jackthehat]

I am very confused by this.

One the one hand, the majority of the medical profession seem to be very vocally against 'death by commission' (euthanasia)......whilst tacitly encouraging 'death by omission' (LCP).

Their application of this seems to be both hypocritical and duplicitous.

[jno]

jack, I think "death by omission" can also be seen as simply letting nature take its course. People may fully recover from disease; the knowledge that they're not going to recover from dying of old age - only at best postpone it - makes it something of a special case. Very few doctors, apart from Shipmans, would want to kill a patient; many feel, from good motives, that postponing death to no purpose may be wrong.

It's only when money enters the question that things become tricky. (Or trickier, to be honest - treating the dying is always tricky.)

[naomi24]

Exactly, Jack.

[naomi24]

//It's only when money enters the question that things become tricky.//

I think that's the problem - money has not only entered the question - it's become the deciding factor.

[ummmm]

I'm quite shocked by this. When I first heard about it I understood it was intended for terminally ill patients that had days or just a few weeks to live.

[naomi24]

Ummmm, as far as I'm aware, it is.

[Sqad]

JTP

\\\One the one hand, the majority of the medical profession seem to be very vocally against 'death by commission' (euthanasia).\\\

That has not been my experience and various polls have suggested percentages ranging from 40--70% of doctors supporting "euthanasia".

[Sqad]

^^^..JTH ..NOT JTP

[ethandron]

This has been going on for years and years, at least 30 to my certain knowledge. It just didn't have a name.
Four much loved members of my immediate family died under such circumstances, and I'm very thankful for it.

[naomi24]

ethandron, this isn’t about administering a high dose of morphine to alleviate suffering and help the dying to a dignified and peaceful end – which has, indeed, been going on for years – and I agree with that too. This is about denying the dying care, hence hastening death.

[jake-the-peg]

Right - I'm confused now about what is alleged to be going on

If treatment is being withdrawn from non-terminally ill patients against their wishes as Prudie alleges that's incredibly serious - criminally so but I don't see that in the article so I'd like some evidence of that.

It seems that the process appears to be accepted as best practice but that there is a financial reward for it

Is that the issue?

What's the problem with paying people to conform to best practice?

If people who shouldn't be on this program are getting put on it where's the evidence of this?



Making accusations of this type without evience is very irresponsible it must cause considerable distress to relatives probably unnecessarilly in most cases