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http://www.telegraph.co.uk/health/elderhealth/9343428/Elderly-patients-helped-to-die-to-free-up-beds-warns-doctor.html



Elderly patients 'helped to die to free up beds', warns doctor

NHS hospitals are using end-of-life care to help elderly patients to die
because they are difficult to look after and take up valuable beds, a top
doctor has warned.












Professor Pullicino claims some patients put on the Liverpool Care Pathway could live longer. Photo: Getty Images

















By Donna Bowater


Professor Patrick Pullicino has claimed that doctors are using a care pathway
designed to help make people's final days more comfortable as an equivalent
to euthanasia.


The Liverpool Care Pathway (LCP) is used in hospitals for patients who are
terminally ill or are expected to die imminently. Under the pathway, doctors
can withdraw treatment, food and water while patients are heavily sedated.


Almost a third of patients - 130,000 - who die in hospital or under NHS care a
year are on the LCP.


Professor Pullicino said he believed the LCP was being used as an "assisted
death pathway" with patients placed on the LCP without clear evidence,
according to the the
Daily Mail.


The senior consultant at East Kent Hospitals told the Royal Society of
Medicine he had personally intervened to have a 71-year-old man taken off
the LCP and be treated successfully, despite claims he was expected to die
within hours or days. He had arrived in hospital with pneumonia and
epilepsy.



"I removed the patient from the LCP despite significant resistance,"
he said. "His seizures came under control and four weeks later he was
discharged home to his family.


"The lack of evidence for initiating the Liverpool Care Pathway makes it
an assisted death pathway rather than a care pathway."


Professor Pullicino said the 71-year-old man lived for another 14 months
before he suffered pneumonia again and was admitted to a different hospital.
He was put on the LCP and died five hours later.


"Very likely many elderly patients who could live substantially longer
are being killed by the LCP. Patients are frequently put on the pathway
without a proper analysis of their condition," he added.


"Predicting death in a time frame of three to four days, or even at any
other specific time, is not possible scientifically. This determination in
the LCP leads to a self-fulfilling prophecy.


"The personal views of the physician or other medical team members of
perceived quality of life or low likelihood of a good outcome are probably
central in putting a patient on the LCP."


He said those who went on to come off the LCP and live longer than expected
were costly to the taxpayer because of the extra health care and support
needed.


The LCP was developed as a template for health workers to make the last days
of terminally ill patients comfortable.


The guidance recommends patients' on the pathway are regularly assessed, and
they can be taken off the LCP if they are no longer close to death.


A Department of Health spokesman said: "The Liverpool Care Pathway is not
euthanasia and we do not recognise these figures. The pathway is recommended
by NICE and has overwhelming support from clinicians - at home and abroad -
including the Royal College of Physicians.


"A patient's condition is monitored at least every four hours and if a
patient improves, they are taken off the Liverpool Care Pathway and given
whatever treatments best suit their new needs."