Hospitals ‘letting patients die to save money’

Hospitals may be depriving elderly patients of food and drink to hasten their   deaths as part of cost-cutting measures to free up bed space, leading   doctors warn.

By , Medical Correspondent

Tens of thousands of patients with terminal illnesses are placed on a “death   pathway” to help end their lives every year. However, in   a letter to The Daily Telegraph, six doctors warn that hospitals may   be using the controversial scheme to reduce strain on hospital resources.

Supporters of the Liverpool Care Pathway, which allows medical staff to   withhold fluid and drugs in a patient’s final days, claim it is the kindest   way of letting them slip away. But the experts say in their letter that   natural deaths are often freer of pain and distress.

Informed consent is not always being sought by doctors, who fail to ask   patients about their wishes while they are still in control of their   faculties, warn the six. This has led to an increase in patients carrying   cards informing doctors that they do not wish to be put on the pathway in   the last few days of their lives.

The six doctors are experts in elderly care and wrote the letter in   conjunction with the Medical Ethics Alliance, a Christian medical   organisation. They say that many members of the public have contacted them   with examples of inappropriate use of the pathway, which is implemented in   up to 29 per cent of hospital deaths.

They warn that there is no “scientific way of diagnosing imminent death.” They   write: “It is essentially a prediction, and it is possible that other   considerations may come into reaching such a decision, not excluding the   availability of resources.”

Dr Gillian Craig, a retired geriatrician and former vice-chairman of the   Medical Ethics Alliance, is one of the six signatories to The Daily   Telegraph letter.

“If you are cynical about it, as I am, you can see it as a cost-cutting   measure, if you don’t want your beds to be filled with old people,” she   said. She advised that those who did not want to be put on the pathway   should carry cards made by Dr Rosalind Bearcroft, a consultant psychiatrist   from Kent, and another signatory.

Last year The Daily Telegraph reported that the numbers being put on the   pathway had doubled in just two years, with tens of thousands of patients   now involved. But up to half of families are not being informed of   clinicians’ decision to put a relative on the pathway, the report by the   Royal College of Physicians found. Advocates point out that the Liverpool   Care Pathway has been approved by the National Institute for Health and   Clinical Excellence (Nice) and is backed by the Department of Health.

A Department of Health spokesperson said: “People coming to the end of their   lives should have a right to high quality, compassionate and dignified care.

“The Liverpool Care Pathway (LCP) is not about saving money. It is an   established and respected tool that is recommended by NICE and has   overwhelming support from clinicians at home and abroad.

“The decision to use the pathway should involve patients and family members,   and a patient’s condition should be closely monitored. If, as sometimes   happens, a patient improves, they are taken off the LCP and given whatever   treatments best suit their new needs. To ensure the LCP is used properly, it   is important that staff receive the appropriate training and support.”

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