UK: NHS “death pathway” kills off 130K elderly patients a year

by NW Spotlight

A top doctor in the UK has warned that NHS hospitals are using end-of-life care, “death pathways”, to help elderly patients die because they are difficult to look after and take up valuable beds; “an equivalent to euthanasia.” The “death pathways” on average bring a patient to death in 33 hours. The National Health Service (NHS) is England’s publicly funded healthcare system.

Professor Patrick Pullicino, a consultant neurologist for East Kent Hospitals and Professor of Clinical Neurosciences at the University of Kent, was speaking to the Royal Society of Medicine in London.

The UK Daily Mail reported that Professor Pullicino “claimed there was often a lack of clear evidence for initiating the Liverpool Care Pathway (LCP), a method of looking after terminally ill patients”. Under the LCP, doctors can withdraw treatment, food and water while patients are heavily sedated.

Because elderly patients who could live longer are put on the LCP to free up beds or because they are difficult to care for, Professor Pullicino said the LCP has become an “assisted death pathway rather than a care pathway”. The Telegraph reported that Professor Pullicino believes the LCP is being used as “an equivalent to euthanasia.” 130,000 patients a year die on the LCP.

Professor Pullicino gave an example where he had personally intervened to take a patient off the LCP. A 71-year-old who was admitted to the hospital suffering from pneumonia and epilepsy was put on the LCP by a doctor on a weekend shift. Professor Pullicino successfully fought to remove the patient from the “death pathway”, and the patient’s seizures came under control and four weeks later he was discharged home to his family. 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.

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Posted by at 05:00 | Posted in Health Care Reform | 99 Comments |Email This Post Email This Post |Print This Post Print This Post
  • DavidAppell

    If you actually read The Telegraph’s story, you’ll see that the 130,000 number, as used in the’s headline, is based on absolutely nothing but one person’s opinion, and his opinion seems to stem from one anecdote.

    • zandeman

      It’s actually based on the number of people who were put into the LCP before they died. The LCP is designed to improve end of life care,so people put into it are expected to die. This is a typical Daily Mail abuse of statistics and bears no resemblance to what Professor Pullicino said.

  • Dan

    Poor sourcing on the article, but I guess why let facts stand in the way of the Republican desire to allow insurance companies to kill people for profit.

    • Raven 6

      Marion County, just signed on to “lets call it something else Health Care”, which includes the very issue. If you happen to live in Marion County, in a state engorged with Leftist policy, ( Democrat ) be prepared to fall on your ideological sword. Janet Carlon, Sam Brentano just put you and every citizen in the County into “you get no choice” managed care. This includes the ability to tax with out consent, and no opt out. This came about because Kits, went into Obamacare in 2009. I guess you were asleep, or on crack.
      Next group in line is the Public Employee Unions. Only the blindingly stupid would think that the lowest common denominator will ignore tham. Get your colon checkup while you still can.

  • Oregon Engineer

    Go do a little research. your favorite search engine key: UK. NHS Liverpool care pathway

    Look up NICE.

    here is one article about the LCP written in 2009.

    Currentlsy the “death Panels” go on in the UK. Also NICE is the sole determination for medical cost controls. No Appeal and no recourse. This is all a warning flag as to the possibilities of Obamacare.

    • zandeman

      I agree that readers should do their own research. If they go to they’ll find links to documents explaining the pathway simply for patients and relatives and in more detail for health professionals.

      And if they do some research on NICE (the National Institute for Health & Clinical Excellence) they’ll find that it was introduced to end what we in the UK called the “postcode lottery”, where the care you could get funded for depended on where you lived and what the local commissioners were prepared to fund. Its role is to mandate funding for evidence based care. Benefit and cost come into it, certainly, because the NHS doesn’t have the funds to do everything for everybody. No healthcare system does. But the evidence gathering process is very thorough and involves the medical royal colleges, professional bodies and patient groups.

      NICE does not mandate care for individual patients, nor can it prevent a doctor providing care which isn’t mandated.

      I think it’s a shame that you started your post so wisely, urging people to do their own research, and finished it with a completely unsupported statement about death panels in the UK. If we do kill off our old people, as you seem to think, it’s hard explain the fact that overall life expectancy in the UK is 82.1 years while that in the USA is 80.8 years.

  • mike

    Nevertheless, Ocare is a joke.

  • 3H

    I haven’t seen anything like this happening under Medicare, so is there much significance in this story other than, possibly, a cautionary tale?

  • oregonnative

    Heck, let us all (3h, Dan, & DA), believe this could never happen, so it is not so. Why do you think they feed “terminal” hospice patients morphine sooner. Too let loose with the beds you fools.

    • Raven 6

      Oregon native
      You are correct. In any groupthink program, you necessarily must have ” The lowest Common Denominator Effect”. Zandeman,
      while ignoring his own admittance, that there is a cost/benefit ratio,
      missed, or is denial of the obvious. In groupthink, it is for example;
      the ability of one to ignore the obvious until they become the obvious. In Germany, my Grandfather mentioned the group mentality, was so strong, that segmentation of groups allowed for
      removal of”a” segment, while everyone else stood about, thanking themselves they were not of that segment.
      Another example or two; “Global Sustainability requires the deliberate quest of poverty, reduced resource consumption and set levels of mortality control ” Professor MAurice King.

      To understand the underlying goal of economic concentration, and thus population control, go to; The and review
      the sourced information. Then as you ponder, review your knowledge of Somolia, run by the U.N. since 1990. You remember, where the starving pirates come from. Hell on Earth.

      Kindest to you all, and remember the butcher, the baker, and the candlestick maker. I’m glad I wasn’t one of that segment.

      • 3H

        You, of course, are immune to group think and are willing to believe that hospitals, doctors, nurses and hospices are all complicit in a plot to open up beds by killing the elderly? Ya know, before I believe that, I’ll need a little more proof. Now, you seem much more prone to group think since you latch on to any ridiculous statement that supports what you already believe to be true.

    • 3H

      You, of course, have evidence to back up this plot that implicates doctors, nurses, hospitals and hospices? It couldn’t be that morphine is administered to make terminal patients comfortable? That would just be too silly to believe?

      Keep in mind, however, that you are not condemning the government, but are condemning private institutions. If what you say is true, however, perhaps we should have more governmental intervention in health care since evidently the free market isn’t doing such a great job.

      • Lou

        “It couldn’t be that morphine is administered to make terminal patients comfortable?”

        Yes a dead patient is certainly more comfortable. The point is those on LCP are GIVEN NO WATER. Who amongst us can LIVE on a diet of NO WATER. The state is deciding who is to die and how and when they die. Does this not seem Orwellian?

        A person dying of THIRST makes a lot of noise unless they are given a lot of morphine. We should perhaps save some bucks by cutting out their vocal cords. They are dead anyway you see; LCP never fails; two days, three days; I imagine the exceedingly strong those who would have lived for years may last for five days without water.

  • zandeman

    The people behind the article are the Daily Mail, a paper that seems to exist to convince its readers that the UK is sinking into a pit of doom. The NHS is a particular Mail target. As a result of its propaganda and of the talking down of the NHS by this government in an attempt to justify its highly damaging reforms, we see a fascinating, if depressing, contradiction between people’s view that the NHS is going to Hell and their experience that their local hospital is wonderful. The apotheosis of this came this month, when the British Social Attitudes Survey showed a fall in satisfaction with “the way the NHS is run” from 70%to 58%, while the annual patient survey of people who actually used the service showed 92% satisfaction.

    People’s view of the NHS is being manipulated by private sector interests, led by the Mail.

    So, this article should be read highly critically. There is no evidence that Professor Pullicino said what the headline conveys. However, he did criticise his colleagues’ decisions to put patients into the Liverpool Care Pathway as often lacking evidence. When someone as close to the patient as this makes such a statement it indicates a need for an urgent review of practice, especially when other senior physicians support his view.

    But the headline about killing off 130,000 elderly patients every year is a disgraceful lie and all too typical of the Daily Mail. It begins by saying that there are “around 450,000 deaths in Britain each year of people who are in hospital or under NHS care”. Well, of course there are. NHS hospitals treat about 1.4 million inpatients a month. People are admitted to hospital because they’re sick. Many are critically ill. We all die and many of us will die in hospital. But the 450,000 figure also includes people who were in NHS care but not in hospital. It therefore includes every death of an elderly person in community care and everyone who died in the care of an ambulance crew.

    The Liverpool Care Pathway is a product of the NHS’s increasing focus on end of life care. It’s designed for people in the last hours or days of their lives, from conditions which can’t be reversed. It doesn’t hasten death, but neither does it postpone it. Medications that serve no purpose are stopped. The patient is given food and fluids for as long as they can take them, but fluid replacement may not be given beyond that point. Priority is given to the comfort of the patient. The pathway was developed over two years of intensive consultation with patients, advocacy groups and professionals. The guidance is very clear that it shouldn’t be implemented without proper training.

    In other words, this approach is designed for people who are dying. The NHS used to be terrible at end of life care, with doctors, nurses and paramedics running round sticking needles in terminally ill people and trying to resuscitate them when they stopped breathing. It was horrible for the patients and their families. It has taken many years and a lot of effort to teach healthcare professionals that death is natural and inevitable, and not an affront to their professional skills.

    It may be that the LCP is being abused in some cases. Sometimes relatives can be very manipulative. Sometimes doctors are careless. The Professor’s concerns need to be looked at urgently to see if the pathway is being misused or abused (two different things, by the way).

    But if anyone reading this travesty thinks they’re uncovered death panels, they need to read it again and do some background research. Stories about health related matters are sensationalised and abused.

  • John Bull

    NHS is a joke. Every Brit who can afford it pays for private care.

  • ShaneYoung

    I believe that if we accept self-ownership, we must also accept an individual’s desire to die, whether it be by his own hand or with the help of someone else.

    That said, if this is being done without consent from those the elderly patients, then it is an extreme infringement of self-ownership. And if its being funded through taxes, then its an extreme infringement on property.

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