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Human Exceptionalism

Life and dignity with Wesley J. Smith.

UK Hospitals Paid To Put Patients on Death “Pathway”



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Death panels on the march!  The Telegraph is reporting that UK hospitals are paid to put patients on the Liverpool Death Care Pathway. (The Pathway is supposed to sedate patients whose pain cannot otherwise be controlled. But serious charges have been made that it is actually sometimes used when not needed medically, in other words, as backdoor euthanasia, including of the non terminally ill.) From the story:

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 majority of NHS hospitals in England are being given financial rewards for placing terminally-ill patients on a controversial “pathway” to death, it can be disclosed. 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.

And the statistics show that the Pathway has indeed become backdoor euthanasia:

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.

This is very bad. Only a small minority–maybe 2%-5%–need to be sedated because it is the only way to control pain, and moreover, that the amount of sedation can be raised and lowered as needed–as I detailed here. Instead, centralized bureaucratic control has turned it into a checklist on the ”to do list”–with money apparently offered as an incentive because it supposedly represents “excellence” in care–which results in sedation clearly being applied whether patients need it or not, and when less aggressive measures would suffice. 

That cheats patients and families of their last time together. It is the destruction of individualized end-of-life care–indeed, one that ignores hospice altogether where the emphasis is on living, not dying quietly in a corner. And it seems to be a method–intended or not–of backdoor euthanasia that can save costs.

There is a warning here for us under Obamacare, in which bureaucrats also plan to create similar bureaucratic incentives to induce particular approaches of providing “excellence.” Indeed, many Obamacarians look to emulate the UK method of centralized control cost containment/care provision regimes.  We will come to rue the day if we allow Obamacare to remain on the books.



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