Death Pathway Refusal Cards

Topics covered: Ridouts professional advice

Terminally ill patients are being supplied with special cards warning doctors not to place them on a controversial death pathway.

The cards come as a result of a mounting backlash against overuse of the Liverpool Care Pathway which enables medical staff to withhold fluid and drugs from a patient while they are heavily sedated, speeding up their death. Supporters of the technique say that it is the kindest way of allowing people to die without having to endure a painful death.

However, leading doctors have raised concerns that hospitals are misusing the pathway with claims that it has become a substitute to euthanasia and a way to cut costs and free up bed space. The number of patients on the pathway has risen suddenly in recent years and critics estimate that it is associated with almost a third of hospital deaths which amounts to 130,000 people.

Doctors in conjunction with the Medical Ethics Alliance claim that many members of the public have contacted them to complain about the unsuitable use of the pathway, with some doctors failing to seek informed consent.

The anti-euthanasia charity Alert is in the process of distributing cards to patients which will ensure that they can opt not to be put on the pathway if they do not wish to. The cards read “please do not give me the Liverpool Care Pathway treatment without my informed consent or that of a relative”. The initiative is intended to work in a similar way to advance directives which give patients a right to refuse treatment under the Mental Capacity Act 2005.

Leslie Burke who suffers from cerebellar ataxia (a degenerative disease of the central nervous system) has requested a card. He said that “all I want is to live my life from end to end and not have it ended prematurely under any circumstances”. He said that he was terrified that starving and dehydrating patients to death in the NHS was now becoming the norm.

In 2005 Mr Burke was defeated at the Court of Appeal after he had earlier successfully demanded that doctors continued to treat him with artificial nutrition and hydration (ANH) once he lost the ability to communicate. Lord Phillips assured him at the time that, “any doctor who deliberately brings that patient’s life to an end by discontinuing the supply of ANH will not merely be in breach of duty but guilty of murder”.

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