Statement by ALERT Against Euthanasia

GOVERNMENT END OF LIFE CARE STRATEGY

Open to misinterpretation?

From reliable evidence, including official enquiries, it seems that some hospitals and care homes sometimes get things wrong where the elderly are concerned. The government's new "Quality Markers" have been sent out for consultation. Could they be misinterpreted, perhaps by staff influenced by the new official spokesman for the elderly, Joan Bakewell, who thinks that there are too many of them?

The need to ensure adequate hydration appears nowhere in the End of Life Care Strategy, and adherence to the Liverpool Pathway (or equivalent) is demanded. Without fluid elderly patients can deteriorate quickly, even if they were not dying to begin with. Median survival of people put on the Pathway is 33 hours, according to a study by the Royal College of Physicians in 2006/7.

Below are some of the official instructions and how they may be misunderstood.

PCTs to demonstrate that all health care providers have processes in place to:

1.3.1   Identify those who are approaching the end of life.

       Sort out the useless eaters.

1.3.4   Ensure that patients are offered a care plan. This is an advance wishes document which not only encompasses a patient's needs and preferences, but also funeral arrangements, finance, etc.

       Encourage patients to sign their own death warrants. (They wouldn't want to be kept alive artificially, would they?)

1.6.1   All care providers to adopt a common approach to care for people in the last days of life.
       Measure: Numbers/proportion of providers adopting a standardised approach (e.g. Liverpool Care Pathway or equivalent).

       It doesn't do to get sentimental.

All GP practices to demonstrate that they:

2.5     Adopt a care pathway arrangement approach when people are in the dying phases (e.g. through use of the Liverpool Care Pathway or equivalent)
       Measure: Use of LCP (or equivalent) for patients dying in their homes.

       Death from dehydration in their own homes can be arranged.

"All acute hospitals to demonstrate that:

3.10    "They assess the needs of carers and relatives and provide them with appropriate support......"

       Tell them what you like to make sure they don't make trouble. Cracked lips don't mean the patient is thirsty.

3.14    They have educational programmes for relevant staff groups related  to end of life care.

       Make sure none of the staff turn into whistle-blowers.

Annex B

The Markers map on to the different elements of the End of Life Framework which have been set out in the National Strategy. These include:

       Raising public awareness about death, dying and end of life care issues.

       Make old people ashamed of being alive if they need care.

       The end of life care pathway - identifying people  who are approaching the end of life and starting the conversation.

       See the above.

COMMENT BY ALERT:

There are many wonderful suggestions for excellent care in the documents. It is tragic that recommendations for proper pain relief come as part of a package for shortening life. Universal adoption of the Pathway (or equivalent) could make death-by-dehydration inescapable.

23rd November 2008

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