Thursday, 1 August 2013

Liverpool Care Pathway - Horrific And Costly In Lives

A policy of convenience, at once deadly and effective, promoted by government and by its network of proxies.

The great liberal reformers of the 19th century would have proclaimed: "How well we care for the poor, the vulnerable, the sick, reflects how we care as a society"

This is e-Hospice in the 21st century -
"How well we care for our dying reflects how we care as a society"
What Jeremy Hunt described as a fantastic step forward has been more in line with another gentleman's great leap forward, both horrific and costly in lives.

This is NCPC:
End of life care accounts for a high proportion of NHS spending. The Demos think tank has estimated it as at least a fifth of NHS costs and a total of about £20 billion
There is considerable scope for improvement using interventions such as early identification triggers, advance care planning, co-ordination of care and effective multi disciplinary team (MDT) working.
[Commissioning End of Life Care]
The emphasis in this statement is on a concern that costs are as much as one fifth of the total budget, amounting to some £20 billion.

According to e-Hospice, hospices in Wales are to get £2.4 million as part of a £6.5 million funding package for specialist palliative care services. This ties in with the Welsh government's dangerous presumed-consent policy on human organ harvesting.

"The Welsh Government has declared that hospices play an essential part in its aims to reduce 'inequalities' in end of life care and to maintain the dignity of an individual in their last days of life, as set out in the Delivering End of Life Care Plan, published in April 2013."

How do you spend money to save money?

Science Business says -

A £3.2 million grant has been made to establish a Palliative and EoLC Chair at University College London (UCL). 

How do you spend money to save money? 

Cutting costs means cutting care means downsizing care means downsizing care expectations, achieving the impossible by making it desirable. 

Dying is a positive life choice.
Let's talk about it...

To promote this concept costs money but, to achieve such an outcome, spending money to save money really does make sense.

The Government published its NHS National End of Life Care Program in 2008 and invited the NCPC to groom the British public into accepting the idea of dying as a positive life choice. Out of this was formed the Dying Matters Coalition. The NCPC has led the Coalition since 2009. The EoLC Program was effectively outsourced to the NCPC.

The Department of Health committed to investing 286 million pounds over the two years to 2011 to support implementation of its National End of Life Care Strategy.

"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.”- The Telegraph
Best interests...

   It is not in their best interests to 'keep them going'.
   It was 'for the best' that the patient should have died.
   It was better that 'she should not suffer'.
   The patient would not have wanted to 'live in a wheelchair',
   or 'be a vegetable',
   or have to stay in hospital 'with wires coming out of her',
   or 'be a burden to her family'.
   If they were animals, they would be put down.

That last comment about 'they would be put down' might appear overly blunt or insensitive, but it is one that has been commonly expressed by respondents on the subject in on-line comments columns.

Are these sentiments, then, not worthy and in accordance with the humanitarian and enlightened approach espoused by the proponents of euthanasia and assisted suicide? Lord Faulkner might even applaud.

The really worrying thing is that such 'best interests' decisions may be used by some physicians and medical practitioners to bury their misdemeanours.

These sentiments are, in fact, those expressed by Dr.Harold Shipman.

The Independent reported -

The caring killers: Death by night shift

For years, nurses illegally administered morphine and other powerful drugs. Hospital patients died. Now the story can be told. Nina Lakhani reports

The report reveals that night nurses at the hospital in Keighley, West Yorkshire, openly gave patients drugs such as morphine intravenously for many years, despite the practice being illegal.

A showcase hospital that won the Government's highest three-star rating allowed nurses to prescribe illegally and administer powerful drugs which police believe killed three patients and injured many more.

A damning report into "systemic failures" at the Airedale NHS Trust reveals that night nurses at the hospital in Keighley, West Yorkshire, openly gave patients drugs such as morphine intravenously for many years, despite the practice being illegal and against hospital rules.

Nobody has ever faced trial or been struck off as a result. One nurse at the heart of the inquiry, Sister Anne Grigg-Booth, was charged with three murders, one attempted murder and more than a dozen lesser, related charges but died of an overdose in 2005 before the case came to trial. Her death meant the allegations against her were never tested. No motive has ever been suggested for her actions.

NNPs took verbal orders for medicines from doctors over the phone to save them coming to the ward. They also administered morphine and other opiates intravenously. Neither was allowed under hospital or professional regulations. Grigg-Booth, and at times other NNPs, also prescribed opiates such as pethidine and diamorphine for patients. This was risky and unlawful as they can hasten or cause death.

The doctors were complicit also; the Night Nurse Practitioners (NNPs) took verbal orders over the phone...

It was the NNPs who were charged.

These are the caring killers of the LCP...

Mail Online
This is Mail Online -

This was why the LCP had to be rolled out. This was how Shipman got away with it for so long.

'Best interests' withhold hydration?

From the BMJ archives -

"... It matters not whether we discuss continuous deep sedation or a lesser degree of sedation. Any level of sedation, even a small dose of morphine in the frail elderly, can result in dehydration that may prove fatal if left untreated for days. Unfortunately palliative carers tend to overlook this basic fact. They prefer to discuss sedation and hydration as separate issues without linking the two in their minds. In doing so they are in danger of missing or evading the point, which is that sedation without hydration kills."

They have downsized care expectations. The policy of determining care to be 'futile' and downsizing care expectations has worked. A system has been rolled out. It is in place. It is working.

- Mail Online
All policies, ultimately, have consequences. These are now apparent and plain for all to see.
Result? Excess deaths...!
Healthcare Analysis & Forecasting (HCAF)
The BBC reports -
130,000 LCP deaths a year...
How many of those 130,000 would have lived on to make up the missing numbers?
The policy is a global policy.
The right to die is a right to 'self-determination'.
Yonhap News Agency reports -
S. Korea asked to legislate on patients' right to self-determination
By Kim Kwang-tae
SEOUL, July 31 (Yonhap) -- 
A presidential bioethics committee on Wednesday called for a special bill that would allow patients in the final hours or days of their lives to determine whether to receive treatment that could prolong their lives. 
The move represents growing calls in South Korea for patients nearing the end of their lives to be well-informed of their exact conditions and to be able to decide whether to sustain their lives through equipment or treatments such as respirators, hemodialysis, cardiopulmonary resuscitation and anti-cancer drugs.
The patient is determined to be in their "final hours or days of life". How is that determined? What does that mean?

Any patient, without receipt of appropriate medical treatment to remedy their situation, might be considered to be in their "final hours or days of life".

What criteria determines that such appropriate medical treatment in this case is 'futile' but, in that case, is not futile?

It is determined by the physician's subjective  perception of a life considered worthy of life and of a life not so adjudged worthy of life. It is to do with health care rationing and the intrusion of the Communitarian ethos into the mainstream.

It is doctors abandoning traditional ethics.

It was once unthinkable to permit an action that would cause or permit death. Today, doctors don death caps and sit in judgement of their patients worthiness to live. The right to life, the right to live, has been submerged beneath a tidal wave that demands the right to die.

With the LCP, this has gone further. Patients, diagnosed not with a life-limiting or terminal illness but to be 'dying', have had their lives taken, terminated abruptly. The so-called review did not 'review' these deaths. The so-called review did not 'review' those deaths on the LCP not recorded as such because the the Trusts do not know and the documentation  is not there.

The review is a shambles and a cover-up to bury the truth.

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