UK embraces being “cared to death”

I have posted earlier about the disturbing ethical questions with the “Care Pathways” in the UK  which operate in the grey zone between euthanasia and execution.

But it is more than just disturbing when UK hospitals run by NHS trusts apparently get financial benefits if they increase the number of terminally-ill patients who are put onto the so-called “Care Pathways”. Once someone is “put on a Care Pathway” they are effectively written off. Medication may be withdrawn, water and food may be withheld and any chance of continuing to live or of any recovery are removed – intentionally – from the equation.  “Care” is provided but now with the intention of causing death. The sooner such patients die the better the use of resources!

I cannot see how any “Care Pathway” where there is an incentive to ensure that a patient dies and dies quickly can be anything other than an intentional termination of life. But is it euthanasia or is it murder or is it an execution?

Where the patient truly wishes to die it is effectively euthanasia. But where the patient would wish to live if he could only get better we get into a dangerous zone between euthanasia and execution. Can all attempts to “make the patient better” be abandoned by a hospital because someone other than the patient has decided that the patient cannot get better? When it is relatives who are pushing to get the patient onto a “Care Pathway” it comes close to murder. And when it is the hospitals or the hospital staff who are “incentivised” to get the patient onto the “Care Pathway” it gets close to being an execution. The decision to put someone onto a “Care Pathway” is itself then an irrevocable sentence of death. Why not – having passed sentence –  just give them a quick, quiet lethal injection after putting them on a “Care Pathway”? Why go through the charade of care while ensuring the patients rapid demise? The 33 hours these patients survive on average after being put on a “Care Pathway” could be reduced to zero. Why not provide incentives to hospitals to

  • maximise the number of patients put onto a “Care Pathway”, and then
  • minimise the amount of time spent on such a Pathway?

This could get rid of many hundreds – if not thousands – of problematic and elderly patients who only absorb resources, no longer provide any useful contribution to society and are just a pain for their relatives. It would not be a very large step to converting the corpses to Soylent Green.

The Telegraph: 

The majority of hospitals in England are being given financial rewards for placing terminally-ill patients on a controversial “pathway” to death…

Almost two thirds of NHS trusts using the Liverpool Care Pathway have received payouts totalling millions of pounds for hitting targets related to its use, research for The Daily Telegraph shows.

The figures, obtained under the Freedom of Information Act, reveal the full scale of financial inducements for the first time.

They suggest that about 85 per cent of trusts have now adopted the regime, which can involve the removal of hydration and nutrition from dying patients.

More than six out of 10 of those trusts – just over half of the total – have received or are due to receive financial rewards for doing so amounting to at least £12million. 

At many hospitals more than 50 per cent of all patients who died had been placed on the pathway and in one case the proportion of forseeable deaths on the pathway was almost nine out of 10.

Last night the Department of Health insisted that the payments could help ensure that people were “treated with dignity in their final days and hours”.

But opponents described it as “absolutely shocking” that hospitals could be paid to employ potentially “lethal” treatments. ……

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2 Responses to “UK embraces being “cared to death””

  1. argylesock Says:

    Thank you for this. It’s an issue that I care about very much but I avoid discussing it on WP. Instead I started a thread on ‘Friendly Crips’. a disability community I run Several people had opinions. I’m going now to post a link to that comm about what you’ve just said.

  2. Do not resuscitate! A case of an “institutionally mandated execution”? « The k2p blog Says:

    […] the light of the recent criticisms of the Care Pathways in the UK, this case of the “Do Not Resuscitate” orders by doctors – against the […]

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