No Runny Eggs

The repository of one hard-boiled egg from the south suburbs of Milwaukee, Wisconsin (and the occassional guest-blogger). The ramblings within may or may not offend, shock and awe you, but they are what I (or my guest-bloggers) think.

Speaking of rationing – the Mandatory Schaivo edition

by @ 15:40 on September 3, 2009. Filed under Health Care Reform, Politics - National.

(H/T – Ed Morrissey)

It is almost as if our friends across the Atlantic are warning us of what is in store if we follow them into socialized medicine. The Daily Telegraph ran a story of how (Not-So-)Great Britain’s health-care “scrutiny” body, the inappropriately-named National Institute for Health and Clinical Excellence, has adopted a particularily cruel end-of-life program called the Liverpool Care Pathway. I’ll let The Telegraph explain what this “last hours treatment”, now in place in nearly 1,000 British health-care facilities at the insistence of NICE, is:

Under the guidelines the decision to diagnose that a patient is close to death is made by the entire medical team treating them, including a senior doctor.

They look for signs that a patient is approaching their final hours, which can include if patients have lost consciousness or whether they are having difficulty swallowing medication….

When a decision has been made to place a patient on the pathway doctors are then recommended to consider removing medication or invasive procedures, such as intravenous drips, which are no longer of benefit.

If a patient is judged to still be able to eat or drink food and water will still be offered to them, as this is considered nursing care rather than medical intervention.

Unlike the Terri Schiavo situation, where there were conflicting interpretations of the level of care she wanted, what is missing is any decision by either the patient or a patient’s family. Considering the average person spends roughly a third of his or her life asleep, I guess one should not fall asleep in a British hospital with a sore throat.

Seriously, the story goes on to report on a letter signed by several leading British palliative-care experts calling the LCP a “national crisis”. Quoting The Telegraph’s reporting on the letter:

“Forecasting death is an inexact science,” they say. Patients are being diagnosed as being close to death “without regard to the fact that the diagnosis could be wrong.

“As a result a national wave of discontent is building up, as family and friends witness the denial of fluids and food to patients.”

Dr. Peter Hargreaves, a consultant in Palliative Medicine at St Luke’s cancer center in Guildford, told The Telegraph that he personally took patients off that pathway who went on to live for “significant” amounts of time because he did what many doctors don’t – keep monitoring the patient for signs of improvement. Those signs of improvement are harder to spot when a patient is under constant sedatement according to Professor Peter Millard, Emeritus Professor of Geriatrics, University of London.

Another problem with sedation while dehydrating is that a patient can enter a state of semi-consciousness and confusion. I wonder how many of the 16.5% of those who died in Britain in 2007 and 2008 during a state of continuous deep sedation, twice the rate in the Netherlands, which has a policy of physician-assisted suicide, suffered that state.

Of course, not all of those in Not-So-Great Britain are doomed to such a fate. Just ask Abdel Baset ali Megrahi, who got a get-out-of-Britain-free card after serving less than 12 days per person he and his Libyan associates murdered in the bombing of Pan Am Flight 103. Of course, he wasn’t a loyal subject of the British crown; he was a mass-murdering thug.

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