Friday, November 02, 2012
U.K. doctors are putting patients on 'death lists' and denying them treatment
Or in this case, a pound.
Being placed on the registers means those patients have been singled out "to be allowed to die in comfort rather than be given life-saving treatment in hospital," Britain's Daily Mail reported.
Some 3,000 doctors are expected to draw up lists of patients they expect will die within a year, according to Department of Health data the paper reviewed, noting that the registers were part of an unpublicized program that has been endorsed by government ministers.
Physicians who are general practitioners "have been encouraged to make lists - officially known as End of Life Care Registers - of people they believe are going to die soon and should be helped to do so in comfort," the paper said.
Doctors were asked specifically, according to the report, to pay particular attention to elderly patients who develop signs and symptoms of frailty or deterioration during routine consultations for surgery.
Worse, those who have been identified and put on the registers don't even know about it; the paper said despite the fact that 7,000 patients have been added to the lists, there doesn't appear to be any obligation for physicians to inform their patients of the decision.
So much for the time-honored tradition of a doctor doing no harm.
Do British physicians have crystal balls that can predict the future?
But what to expect, really? This is how a broke, overextended, over-promised 21st century Western-style government solves part of its budget problem: By denying the very benefits taxpayers (who are still paying for them, by the way) were guaranteed, just when they need them most.
Fortunately for English patients, some medical professionals in Britain still have some scruples; they are going public with their concerns (though they were prompted to do so after an earlier Daily Mail report disclosing that the country's National Health System requested doctors to put one in every 100 of their patients on the death registers).
Dr. Peter Saunders, of the Christian Medical Fellowship, warned about drawing up "quotas" for some patients. What, for instance, if they were wrong about the expected "death" timetable?
"We all know that doctors' estimates of patients' life spans can be sometimes accurate but sometimes wildly inaccurate," he said. "A skilled doctor can in the great majority of cases assess when a patient is within a few hours or days of death. However, once we start to talk about weeks or months we know that we can often be right, but equally very badly wrong."
The NHS is apparently pushing for the lists at a time when a cornerstone of the services' "end of life strategy," the Liverpool Care Pathway, "has come under fierce criticism from leading medical figures and families who believe their loved ones have been wrongly picked out in hospitals as dying," said the paper.
Another critic of the Pathway, NHS consultant Prof. Patrick Pullicino, called it a self-fulfilling prophecy and amounts to little more than assisted death.
Lame excuses - 'It does not mean they are automatically' going to die
Guidance for physicians says patients placed on the registers should be asked if they want to die at home instead of in a hospital so NHS can save even more money.
Patients are also being encouraged to create "living wills," which tell doctors to withhold feeding tubes if they become too sick to speak. Such patients are "less likely to be subject to treatments of limited clinical value," physicians have been told.
The end-of-life program director, Prof. Sir Mike Richards, said in the report that the campaign to enlist general practitioners "has reached its midpoint target of 1,000" as of August 2012.
"Patients can be placed on the GP End of Life Care register without their knowledge. However, being on this register purely means they have been identified as needing an end of life care plan," said the Department of Health. "It does not mean they are automatically placed on an end of life pathway. It does not mean they will not receive treatment."
The report said by the end of March, doctors had registers in operation that contained 7,723 names, of which 2,534 were diagnosed with illness other than cancer, while 3,531 patients had agreed to "advanced care planning," which can include agreeing to a living will.
A separate report by the paper said British hospitals spend less to feed patients than is spent by the government to feed prisoners.