Britain's New End of Life Protocol = Death
Sentence for British Patients
Practice causing "national wave of discontent" as family members watch
loved ones killed by dehydration.
A group of British physicians specializing in palliative and end of
life care has sounded the alarm that some terminally ill patients are
being killed under an ethics protocol recently approved by the
country's health care rationing body. Patients in Britain are being
misdiagnosed as "close to death" and sedated and dehydrated to death
the doctors said in a letter to the Daily Telegraph this week.
Under a National Health Service (NHS) protocol called the Liverpool
Care Pathway, patients are being labelled as dying "without regard to
the fact that the diagnosis could be wrong" the physicians said in
their letter. Under the guidelines, the diagnosis that a patient is
close to death must be made by the entire medical team, including a
senior doctor. This diagnosis, under existing rules, then allows a
patient to be sedated and to have food and hydration and other
treatment, such as antibiotics, withdrawn until death.
Under the Pathway protocol, patients can be diagnosed as "close to
death" if they become confused or have difficulty swallowing. But the
doctors warn that these symptoms can be caused by the sedating
medication and dehydration, creating a self-fulfilling diagnosis.
In the letter, Professor Peter Millard, Emeritus Professor of
Geriatrics at the University of London, Dr. Peter Hargreaves, a
consultant in Palliative Medicine at St Luke's cancer centre in
Guildford and four others, said that the practice is causing a
"national wave of discontent" as family members watch their loved ones
killed by dehydration.
John Smeaton of the Society for the Protection of Unborn Children
commented that the "practice of consigning vulnerable patients to a
death pathway" is the result of years of changes to the legal system
that is building up to the effectively legalisation of euthanasia.
"The government's 2005 Mental Capacity Act," Smeaton said, "extended
the possible scope of this practice. The inherent right to life of all
patients, whether they are terminally ill or not, must be defended in
the face of the government's war against the weak."
Barbara Wilding, Britain's longest serving female chief constable, said
last month that the growing public approval of assisted suicide is a
threat to elderly people. Wilding said that "a growing rift" between
the generations is becoming a significant challenge for police who are
concerned that increasing relaxation of assisted suicide laws could be
exploited by families to kill "burdensome elderly relatives".
Wilding told the Daily Telegraph, "From a policing perspective we need
to be very careful on this to make sure it does not become a way of
getting rid of a burden. I will be watching any change in legislation
The Liverpool Care Pathway, described by its formulators as a
"template" to guide the care of the dying, was approved in 2004 by the
notorious National Institute for Health and Clinical Excellence (Nice),
the Government's health scrutiny body in charge of rationing health
services. The NICE is known to be heavily biased in favour of
dehydrating patients to death, as was revealed in the case of Leslie
Burke, a British man who attempted unsuccessfully to obtain court
guarantees that he would not be killed by this method once his motor
neurone disease had rendered him unable to communicate.
The Pathway has been adopted nationwide with more than 300 hospitals,
130 hospices and 560 care homes in England using it to allocate health
In August, the BBC reported that some physicians in Britain and abroad
are concerned with the increasing use of "continuous deep sedation" in
treating the terminally ill. Deep sedation, in which a patient is kept
continuously unconscious or at a low level of consciousness, is
ethically used in cases where pain is treatable by no other means. It
can have the effect of reducing life expectancy by suppressing
respiration but classical ethics allows this if it is an undesired and
unintended secondary effect to the relief of pain.
But reports from the Netherlands show that the use of continuous deep
sedation until death was becoming more widespread in that country where
direct euthanasia is legal. In 2001, researchers found that in six
European countries deep sedation was used in 8.5 percent of all deaths
in patients with cancer and other diseases. In most cases patients
under deep sedation were also denied fluids.
In the Czech republic, where assisted suicide is illegal, it was
revealed that some doctors were using large doses of morphine to kill
patients in order "not to prolong" patients' suffering.
Date: September 3, 2009
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