Tag Archives: Liverpool Care Pathway

Over 75? NHS wants you to sign a Do Not Resuscitate order

nhs

Daily Mail: Doctors are being told to ask all patients over 75 if they will agree to a ‘do not resuscitate’ order. New NHS guidelines urge GPs to draw up end-of-life plans for over-75s, as well as younger patients suffering from cancer, dementia, heart disease or serious lung conditions.

They are also being told to ask whether the patient wants doctors to try to resuscitate them if their health suddenly deteriorates.

The NHS says the guidance will improve patients’ end-of-life care, but medical professionals say it is ‘blatantly wrong’ and will frighten the elderly into thinking they are being ‘written off’.

In some surgeries, nurses are cold-calling patients over 75 or with long-term conditions and asking them over the phone if they have ‘thought about resuscitation’. Other patients have spoken of the shock of going in for a routine check-up and being asked about resuscitation.

The extraordinary new guidance has been brought in despite the outcry over the use of ‘do not resuscitate’ orders under the Liverpool Care Pathway (LCP).  The discredited pathway was scrapped last year after the Mail revealed that doctors were placing ‘DNR’ notices on patients without their knowledge and depriving them of food and fluids.

The guidelines – which also recommend patients should be asked if they want to die at home – have been drawn up by experts advising NHS England, the organisation which runs the health service. One expert said the guidance was ‘the thin end of the wedge of assisted suicide’.

Professor Patrick Pullicino, who spearheaded the campaign against the LCP, said: ‘What is most blatantly wrong is trying to get someone to agree to a ‘do not resuscitate’ order before they are even sick. For somebody who is perfectly well, or has got a mild or not a serious illness, that would be totally out of place.’

Roy Lilley, a health policy analyst and former NHS trust chairman, said: ‘It will give some older people the impression that no-one wants to bother with them. It looks as though they’re being told: ‘You’re old, how do you want to die because you’re in the way’. It’s a very clunky thing to do – it’s completely unnecessary.’

Roger Goss, of Patient Concern, said: ‘There will be some people who will be put out, disconcerted and think they are not going to get the best available care. They might think this is a way of saving money for the NHS. Other patients will be prepared to talk about it and think it sensible.’

A ‘do not resuscitate’ order is meant to stop a patient suffering unnecessarily where their lives are likely to be extended for only a short period of time. Resuscitation can be traumatic and cause broken ribs or damage to organs, including the spleen. Doctors estimate that only 10 to 15 per cent of patients are brought back to life and some suffer permanent brain damage.

But asking patients to make such a decision when they may have many years to live will prompt concerns that the NHS is writing them off. In some parts of England, practice nurses have been instructed to cold-call patients and fill out an advance care plan for them over the phone.

Ruth Nicholls, a palliative care nurse in the South East, told how her brother-in-law, who has a heart condition, was contacted immediately after he had a hospital appointment.

In an interview with Nursing Times, she said: ‘He came back from an outpatient appointment having not had very good news and later that afternoon got a phone call from one of the practice nurses at his GP surgery.

‘She said: ‘Hello, we’re ringing all our patients with chronic conditions to see how you are and whether you have thought about resuscitation. This conversation was absolutely out of nowhere. My brother-in-law was shocked and my sister was distraught.

She also said an elderly patient was asked about resuscitation by a district nurse he had never met during a routine visit. ‘One of the first questions he was asked was whether he wanted to be resuscitated,’ she said. ‘People are being left in great distress.’

The controversial Liverpool Care Pathway was phased out last year following harrowing reports that patients were being left so dehydrated they were left to suck on wet sponges given by relatives because nurses had banned water.

Dr. Ezekiel Emanuel

Dr. Ezekiel Emanuel

No doubt Ezekiel Emanuel is thrilled with this:  He declared his desire to die at age 75 (and is a chief architect of Obamacare).

See also:

DCG

Will there be death panels in Obamacare?

Shovel ready Obamacare

Despite House Speaker John Boehner’s huffing and puffing, Obamacare (Patient Protection and Affordable Care Act) is a reality.

The Nov. 6, 2012, elections reelected Obama to the White House and not only retained, but added to the Democratic majority in the U.S. Senate. Even before that, the Supreme Court in a 5:4 decision, already had ruled that Obamacare is constitutional and that the requirement of Americans to obtain health insurance or be penalized is merely a tax.

So, unless you’re in deep denial, Obamacare is a reality. FOTM has published posts on the Obamacare taxes coming our way. But what about another grave concern of ours — that of Obamacare death panels? Is the notion mere political hyperbole, or is it a real threat?

To answer that question, let’s look at two pieces of information.

ONE

The first is a statement by former president of the American Medical Association (AMA) Dr. Donald Palmisano, that Obamacare death panels are not a fantasy, but that such rationing panels pose an “immediate danger to seniors.”

In a Daily Caller column, Palmisano wrote that Obamacare’s Independent Payment Advisory Boards (IPAB), tasked with keeping Medicare expenses under control, would have little oversight as they deal with the disproportionate cost burden from elderly Americans with greater medical needs. The result “will essentially mean rationed care” for America’s elderly.

Palmisano wrote: “The 15 officials who will make up the board will not only be empowered to make what is expected to be billions of dollars’ worth of cuts to Medicare every year, but will be required to do so when spending exceeds targeted rates. IPAB’s recommended cuts will become law unless a supermajority in Congress vetoes the board’s proposal and creates its own cost-cutting proposal of equal size — an unlikely scenario even in the most harmonious of political times.”

Although the panels are expected to focus on cutting payments to the doctors themselves, Palmisano said that Medicaid providers are already being sucked dry, and warned that a more brutal form of rationing, using adjustments based on “quality of life” as already practiced in Great Britain, was likely in store.

“IPAB may eventually be allowed to resort to Great Britain’s chosen rationing methods and refuse to provide certain effective treatments to patients who need them based on costs and patients’ remaining ‘quality adjusted life years.’ Though the law currently forbids IPAB from engaging in such behavior, there is little reason to believe these rules won’t be changed — or at least stretched — down the road as costs continue to balloon and political dynamics change,” he wrote.

Palmisano warned that unless Congress undertakes a full repeal of Obamacare instead of piecemeal efforts, the most dangerous parts of the law, such as IPAB, will not be excised: “[I]f Congress misses what could be its last chance to eliminate IPAB — one of the most egregious aspects of the law — it will be doing a disservice to seniors who need good medical care now and in the near-term future.”

TWO

In his column, Palmisano warned that Obamacare’s IPAB “may eventually be allowed to resort to Great Britain’s chosen rationing methods and refuse to provide certain effective treatments to patients who need them based on costs and patients’ remaining “quality adjusted life years.” Here’s a recent shocking example of “death panels” in the UK — the Liverpool Care Pathway.

Brad Mattes, the executive director of the pro-life educational group Life Issues Institute, writes for LifeNews.com, Dec. 7, 2012:

There’s no crystal ball where we can see our future of national healthcare under Obamacare. However, there’s a very close model in the United Kingdom’s National Health Service (NHS). In fact, while we ponder the future of death panels and rationing of healthcare in the US, the UK is living it—and in many cases dying from it. So we can look at the NHS to see our future under Obamacare. […]

The Liverpool Care Pathway (LCP) in the UK is a healthcare service that’s used when death is imminent, and it incorporates heavy doses of morphine to deal with what would otherwise be uncontrolled pain. It may seem to be a compassionate and empathetic notion, until you realize the system is being abused to serve as a fast-track pipeline to euthanize the most vulnerable patients.

What began as an effort to relieve suffering is now ending lives at a frightening pace. Here’s how the numbers play out:

  • Only 2–5% of patients require this level of sedation to control pain.
  • Yet, the LCP has been involved in the deaths of 130,000 patients who were elderly, terminally ill, or seriously ill but not dying. This is 29% of the 450,000 NHS deaths each year.
  • At many hospitals, over 50% of the patients who had died had been put on LCP.

[…] Assumptions are being made about what treatments are considered “futile” […] as a way to save money by limiting care to those who need it most.

The evidence is disturbing. Cancer patients are being put at the back of the line for routine services like x-rays and antibiotics. Surgeries for hip replacements, cataracts, and varicose veins are being rationed. Doctors are resorting to prescribing drinking water for neglected elderly patients to stop them from dying of thirst in the hospital. This method of dehydration and starvation has been used to end the lives of babies in a neonatal unit. There are numerous cases where patients are being killed who would otherwise be able to recover and live if only given proper treatment and essential nourishment.

When you follow the money trail, it leads to over $19 million that has been given as awards to trusts for hospitals that have hit their targeted number of patients put into LCP. It’s simply a fact that the centralization of healthcare will inevitably lead to dangerous rationing of care and perilous decisions surrounding quality of life.

Don’t believe for a moment that this couldn’t happen to you in America. The US Supreme Court upheld the constitutionality of Obamacare, and the re-election of Barack Obama ensures this government-controlled behemoth will soon be breathing down your neck. It’ll likely be even worse considering proponents of Obamacare admitted from the beginning that the government isn’t close to funding all the healthcare expectations of Americans.

If you don’t want faceless government bureaucrats make life-or-death decisions for you, Mattes urges us to do two things:

  1. Take a firm stand against Obamacare by warning others about the real dangers of government-controlled healthcare.
  2. Make sure your family know your wishes by creating a will to live.

~Eowyn