Human Exceptionalism

Centralized Healthcare Hurts the Dying

We should look with great trepidation at the experience of the NHS for what Obamacare’s centralized control is bringing our way–I mean beyond bitter societal division currently tearing the country apart.

The care of the dying vividly illustrate my point. Years ago, too many dying people on the NHS were allowed to die in agony. So well  meaning palliative care experts created the Liverpool Care Pathway, a compassionate care plan for the dying that sought to ensure patients were treated like individuals and given the pain control, etc. they needed.

But then the centralized controllers reduced a care plan to a bureaucratic memo, resulting in the Pathway becoming a sclerotic practice-medicine-by-the-numbers mess that sustantially lost the idea of treating patients as individuals and not only opened the door to back door euthanasia, but also saw non terminally ill people put into comas and dehydrated to death.

After a public outcry and bureaucratic defense, the Pathway was finally euthanized and consigned to the bureaucratic burial ground.

Now, a new (obvious) 5-point plan is emerging. From the British Medical Journal report:

The five priorities for care listed in the response were:

– The possibility that a person may die within the next few days or hours should be recognised and communicated clearly, decisions about care should be made in accordance with the person’s needs and wishes, and these should be reviewed and revised regularly.

– Sensitive communication should take place between staff and the dying person and those important to them.

– The dying person, and those identified as important to them, should be involved in decisions about treatment and care.

– The people important to the dying person should be listened to and their needs respected and met as far as possible.

– An individual plan of care, which includes food and drink, symptom control, and psychological, social, and spiritual support, should be agreed, coordinated, and delivered with compassion.

Why do we keep remaking the wheel? Dame Cecily Saunders showed the way with hospice care.

Whatever. And here comes the bad news:

The National Institute for Health and Care Excellence plans to develop new clinical guidelines on the care of dying adults and end of life care for children. These guidelines will inform the development of a quality standard for end of life care for children and an update of the current standard for adults. From October 2014, inspections by the Care Quality Commission will incorporate the priorities as part of the inspection of end of life care.

Sigh. Centralized planners never learn. The answer isn’t more bureaucracy! It is reinvigorating the medical professionalism that centralized control over health care has done so much to enervate.

This is the kind of “medicine” that Obamacarians have planned for us. Beware.

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