Patients with terminal illnesses are being made to die prematurely under an NHS scheme to help end their lives, The Daily Telegraph has reported.
Under a scheme designed to reduce patient suffering in their final hours and recommended by NICE in 2004, the decision to diagnose that a patient is close to death is made by the entire treating medical team, including a senior doctor. Patients can then have fluid and drugs withdrawn and many are put on continuous sedation until they pass away.
However, in a letter to The Daily Telegraph, a group of expert doctors in the care of the terminally ill claim that some patients are being wrongly judged as close to death.
This approach can mask the signs that their condition is improving, warn the experts who include Professor Peter Millard, Emeritus Professor of Geriatrics, University of London, Dr Peter Hargreaves, a consultant in Palliative Medicine at St Luke’s cancer centre in Guildford, and four others.
“Forecasting death is an inexact science,” they wrote. Patients are being diagnosed as being close to death “without regard to the fact that the diagnosis could be wrong.
“As a result a national wave of discontent is building up, as family and friends witness the denial of fluids and food to patients.”
Under the scheme, known as the Liverpool Care Pathway, the medical team look for signs that a patient is approaching their final hours, which can include losing consciousness or having difficulty swallowing medication. However, the doctors warn that these signs can point to other medical problems; patients can become semi-conscious and confused as a side effect of pain-killing drugs such as morphine if they are also dehydrated, for instance.
When a decision has been made to place a patient on the pathway doctors are then recommended to consider removing medication or invasive procedures, such as intravenous drips, which are no longer of benefit.
If a patient is judged to still be able to eat or drink food and water will still be offered to them, as this is considered nursing care rather than medical intervention.
