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(Daily Mail)   British hospitals prepare to euthanize 60,000 old people. Minister calls this "fantastic step forward"   (dailymail.co.uk) divider line 236
    More: Obvious, Royal College of Physicians  
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21783 clicks; posted to Main » on 31 Dec 2012 at 12:15 AM (1 year ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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2012-12-31 05:26:13 AM  
As an American, I know that whenever I want accurate information regarding current events in the United Kingdom, I can always rely on the Daily Mail.................................................................. .......

to poop on.
 
2012-12-31 05:28:14 AM  
The Daily Mail is as reputable as Fox News and The Sun
 
2012-12-31 05:50:32 AM  

LesserEvil: The bigger problem is: WHY THE FARK ARE HOSPITALS SO DAMN EXPENSIVE?!?!?!??!?


Simple - Multiple insurance company and other regulatory paperwork, plus assorted middlemen all want to take their cut.

Plus all that time trying to shake people down for payment isn't cheap.
 
2012-12-31 05:51:21 AM  
EUthanize
 
2012-12-31 06:00:53 AM  
I only have a problem with this if I am being denied the right to choose when I die at the same freakin time! How can you say "We have the right to choose when you die but you do not"

Both or neither.
 
2012-12-31 06:01:18 AM  

NewportBarGuy: Last time I checked, private health insurance was available for purchase in the UK. If the public system is not enough, sell your assets and buy it. Or die. You have an option.


.
But the government took all of my assets, for the greater good they said.
 
2012-12-31 06:06:06 AM  

RabidJade: The whole end of life argument will never die down until people will drop the right to life belief


No. I have a right to life AND a right to choose the manner of my own death (barring accidents or disease)

fark your false dichotemy.
 
2012-12-31 06:20:36 AM  
Where's Harold Shipman when you need him?
 
2012-12-31 06:44:00 AM  
Something isn't true about this article.
60,000 people put on the "care pathway" in Liverpool in 1 year?
I think those Liverpudlians would notice 12.5% of their population being euthanized.


But seriously 484,367 deaths in England and Wales source (where LCP is presumably practiced) and ~60,000 are unauthorized euthanizations? I think there would be more hysterical reactions in Hospital.
 
2012-12-31 06:54:45 AM  
Hate to break it to you, but this is how it works everywhere, including the US. When my grandmother got really old and stopped working right, they told us that while it was certainly possible to use machines to extend her life if we wanted to waste a hundred thousand dollars, they were just going to give her morphine and that we should let her pig out on ice cream so she would slip into a diabetic coma and die.

Literally told us to kill her.... but I mean... you have to go, and some ways are better than others.
 
2012-12-31 07:12:49 AM  

ZAZ: The pathway involves withdrawal of lifesaving treatment, with the sick sedated and usually denied nutrition and fluids. Death typically takes place within 29 hours.

Happens in America too, and may be standard for certain types of people in hospice care.

As it was explained to me in one case, involving a person with adequate health coverage, attendants monitor breathing rate to decide when the old, sick person is suffering too much. At that point they give morphine, and death usually follows within a couple days. It seemed like euthanasia to me, though the morphine dose is not enough on its own to kill.



As I understand it when you go into hospice you agree that it is a last stop.

The problem here is that many of these people and their families put on the "Care pathway" (BTW what a farked up name) were not informed.
 
2012-12-31 07:19:08 AM  
You know, there's a lot of sense in this article. However, it's buried under the sensationalist leads. The same leads that too many eedjits in here are using as springboards for their bootstrappy nanny state song and dance nonsense.

Being an adult means being able to make tough choices under constraints. Not simply borrowing more money, not hiding from the issue, and not cloaking it in some emotional anecdotal crap.

In the USA, politicians are unable to make decent policy in no small part because everything becomes an emotional argument. First, the system in the USA was like this:

1. one side presents a reasonable argument based on numbers and careful analysis.
2. the other side, having no response but being the other side, throws up some anecdotal BS meant to skew the issues. this side wins.

now, we just cut straight to the chase:

1. one side presents an emotional anecdotal case to press for their policy position
2. the other side retaliates with more of the same.
ad infinitum.

I wish the US had the responsible grown ups in government that the UK does.
 
2012-12-31 07:29:14 AM  

Alonjar: Hate to break it to you, but this is how it works everywhere, including the US. When my grandmother got really old and stopped working right, they told us that while it was certainly possible to use machines to extend her life if we wanted to waste a hundred thousand dollars, they were just going to give her morphine and that we should let her pig out on ice cream so she would slip into a diabetic coma and die.

Literally told us to kill her.... but I mean... you have to go, and some ways are better than others.


The reason they are complaining is because that didn't happen.
 
2012-12-31 07:39:22 AM  

LesserEvil: justtray: It can cost upwards of $15,000 or MORE per MONTH to keep old people in assisted living. How much do you think it costs to to keep them alive in hospice care? Less??

The bigger problem is: WHY THE FARK ARE HOSPITALS SO DAMN EXPENSIVE?!?!?!??!?

Why does my Mom's overnight stay cost $3000, for... let's see, an on-call doctor (shared between her and 100 other patients), 3 duty nurses (for each 8 hour shift), shared between 20 patients in 10 rooms, 3 aides (again, 3 shifts) shared between 10 patients. So, approx $120 goes to pay those people... call it another $20 for support people "shared" by all the patients. Forget the meds and stuff, that's billed extra (and exorbitantly, why do a handful of aspirins cost $150?!?). The hospital has been standing for almost 20 years, so beyond maintenance, I can't see anything justifying $3000/night. She had no MRIs or CAT Scans (those are also billed on their own).

Hospitals are a huge rip-off. Most "second world" countries provide similar quality hospital stays at a fraction of the cost.

There is simply no reason why it should cost that much to care for somebody. Until that gets fixed, health care will always be hopelessly broken.


I live in Canada, just paying my taxes and showing my health care card will cover all hospital stays or emergency medical clinic walk ins or doctor's appointments.
Living here rocks.
 
2012-12-31 07:41:01 AM  

Alonjar: Hate to break it to you, but this is how it works everywhere, including the US. When my grandmother got really old and stopped working right, they told us that while it was certainly possible to use machines to extend her life if we wanted to waste a hundred thousand dollars, they were just going to give her morphine and that we should let her pig out on ice cream so she would slip into a diabetic coma and die.

Literally told us to kill her.... but I mean... you have to go, and some ways are better than others.


So, what flavor did you get?
 
2012-12-31 07:46:12 AM  
^ Sorry, that was a farked up thing to say :P
 
2012-12-31 07:48:41 AM  

Benevolent Misanthrope: Jesus Fark.  I'm all for the idea of not prolonging death when folks are suffering - but this... this is absolutely sinister.


Coming soon to America.
 
2012-12-31 08:02:50 AM  
Article is very one sided and it really plays on people's fears. It is obvious that they are describing withholding tube feeds, not regular meals but the article leaves that part out. Many people think that impossibly frail sick elderly patients with terminal illnesses will continue to survive as long as you pump enough tube feed in their peg tubes. The fact is, they continue to lose weight because their bodies can't process the nutrition and they constantly get aspiration pneumonia and urinary infections and their skin breaks down. This is not a a more comfortable way to care for the dying.

They also don't point out they they are talking about withholding IV fluids, not refusing to let people drink water. Giving IV fluids in the final days of life, as the organs start to shut down, is the cruelest thing you can do to someone. The body cannot process the excess fluid, which collects in the lungs and drowns the patient and goes in the spaces between the cells and starts leeching out through the skin.

The real failure of their system is the lack of teaching they are doing with the families of their terminal patients. Since some parts of the article are so skewed, I'm not sure how much to trust the other parts. If the patient and the family understands what is happening with the disease process and the reasons behind why certain treatments have to be withheld, there is much less fear and they maintain a sense of control, which is really important. If the UK system isn't involving the patient and family every step of the way, they need to be horsewhipped.

--a hospice nurse
 
2012-12-31 08:28:27 AM  

liam76: ZAZ: The pathway involves withdrawal of lifesaving treatment, with the sick sedated and usually denied nutrition and fluids. Death typically takes place within 29 hours.

Happens in America too, and may be standard for certain types of people in hospice care.

As it was explained to me in one case, involving a person with adequate health coverage, attendants monitor breathing rate to decide when the old, sick person is suffering too much. At that point they give morphine, and death usually follows within a couple days. It seemed like euthanasia to me, though the morphine dose is not enough on its own to kill.


As I understand it when you go into hospice you agree that it is a last stop.

The problem here is that many of these people and their families put on the "Care pathway" (BTW what a farked up name) were not informed.


HindiDiscoMonster: kinkkerbelle: Article is very one sided and it really plays on people's fears. It is obvious that they are describing withholding tube feeds, not regular meals but the article leaves that part out. Many people think that impossibly frail sick elderly patients with terminal illnesses will continue to survive as long as you pump enough tube feed in their peg tubes. The fact is, they continue to lose weight because their bodies can't process the nutrition and they constantly get aspiration pneumonia and urinary infections and their skin breaks down. This is not a a more comfortable way to care for the dying.

They also don't point out they they are talking about withholding IV fluids, not refusing to let people drink water. Giving IV fluids in the final days of life, as the organs start to shut down, is the cruelest thing you can do to someone. The body cannot process the excess fluid, which collects in the lungs and drowns the patient and goes in the spaces between the cells and starts leeching out through the skin.

The real failure of their system is the lack of teaching they are doing with the families of their terminal patients. Since some parts of the article are so skewed, I'm not sure how much to trust the other parts. If the patient and the family understands what is happening with the disease process and the reasons behind why certain treatments have to be withheld, there is much less fear and they maintain a sense of control, which is really important. If the UK system isn't involving the patient and family every step of the way, they need to be horsewhipped.

--a hospice nurse

[media.tumblr.com image 400x400]


I'm okay with that. There is so much false information out there about how end of life care decisions are made by health professionals, I took a chance.
 
2012-12-31 08:30:00 AM  
They ought to be called "Death Committees" instead of "panels."

"Committee" just sounds more like there's some thoughtful discussion occurring.

And in Great England where they talk funny, they can call them "Expiry Councils."
 
2012-12-31 08:35:05 AM  

kinkkerbelle: I'm okay with that. There is so much false information out there about how end of life care decisions are made by health professionals, I took a chance


Ok with missing the point (and just wanting to educate peopel), or ok with families not being informed?

If it is the first, I get it.

If it is the second, go fark yourself.
 
2012-12-31 08:38:45 AM  
This story is in a British tabloid. I don't believe a word of it.
 
2012-12-31 08:43:31 AM  
Very well said kinkkerbelle
 
2012-12-31 08:46:47 AM  

Bucky Katt: The Daily Fail is making shiat up again.


Actually they're NOT making shiat up in this case. A Google search for Liverpool Care Pathway yields all kinds of other (more reliable) sources.

Don't get me wrong. I'm all for quality palliative care. I just believe that patients and families have a right to be involved in the decision making process.

As for people who trust physicians to make wise decisions: What do they call the person who graduated at the bottom of their class in medical school: Doctor.
 
2012-12-31 08:47:31 AM  
Kinda surprised no one's offered the link to the Behind the News article:

What is the Liverpool Care Pathway

The NHS is quite open about practices and reviews, and 'wtf happened here' panels.

In the US I never knew as much about my local services as I do in the UK.
 
2012-12-31 08:49:38 AM  

duffblue: Now if we could only get the Baby Boomers to off themselves we'd be in business.


Sorry, bud...we're not yet done spending the rest of your money.
 
2012-12-31 09:04:45 AM  
i45.photobucket.com

That makes me moist.
 
2012-12-31 09:09:12 AM  

GAT_00: This is the Daily Fail.  At least one key piece of information is missing here, assuming this wasn't totally distorted.


It always saddens me when people seriously debate something from a rag that wishes it were as respectable as the National Enquirer.
 
2012-12-31 09:13:07 AM  

nursedude: Bucky Katt: The Daily Fail is making shiat up again.

Actually they're NOT making shiat up in this case. A Google search for Liverpool Care Pathway yields all kinds of other (more reliable) sources.

Don't get me wrong. I'm all for quality palliative care. I just believe that patients and families have a right to be involved in the decision making process.

As for people who trust physicians to make wise decisions: What do they call the person who graduated at the bottom of their class in medical school: Doctor.


Families are supposed to be informed and involved in the decision. Look at the bottom paragraph for the sum total of the information the daily fail is basing the entire article on. According to a (legitimate) study, one third of people weren't given a pamphlet about the Liverpool Care Pathway, the daily mail decided that meant that one third of people weren't informed at all about it, which is a blatant misrepresentation. There might be some cases where the family/patient isn't fully informed, and that's what the official inquiry is about, but the Daily Mail's take on it is patently rediculous and designed to give you the impression that health professionals are just saying 'we'll kill that one off today, hahahaha' and murdering 60000 patients.

The Daily Mail can go fark itself.
 
2012-12-31 09:19:22 AM  

ZAZ: ...though the morphine dose is not enough on its own to kill.


The morphine IS the killer, it suppresses breathing and other autonomous function until you die... saying the morphine doesn't kill you is like saying the pillow over your head didn't kill you.

When you have a patient in hospice there is no limit to the morphine dose and no one questions the dosages given. If you have a conscious patient you simply up the dosages slowly... that continues while they're unconscious and then they die.

It's a quiet form of euthanasia administered by the families of people suffering from cancer. One school of thought is that this is just preventing needless suffering of both family and patient by bringing a faster end to something that is inevitable... another is that you should die when you die, not when you're drugged to death.

I'm in favor of latter, many are in favor of the former... when you have two in the same family who are close to the decision making process it can lead to some serious disagreements, some of which will never heal.

When someone is in bad shape it's easy to say they're suffering and that it should end... but having watched someone go from deaths door to being happy, walking, laughing, etc... I say let it happen when it will happen on its own, do not accelerate it by removing treatment or introducing escalating levels of morphine.
 
2012-12-31 09:21:57 AM  
i.dailymail.co.uk

Why yeth, my boy friend'th cock ith thith long! Oh Rudy!
 
2012-12-31 09:27:52 AM  

sithon: He does look like a self satisfied git though,doesn't he?


You sayin' he's a wanker?
 
2012-12-31 09:32:05 AM  
That guy FTFA face looks really punchable.

/really
 
2012-12-31 09:40:40 AM  

L.D. Ablo: [blogs.amctv.com image 560x330]


This. Why wait 'til they're oldsters? Off them when they're soon-to-be-no-longer-cute-and-capable-of-working-on-that-report-overni ght.
 
2012-12-31 09:44:26 AM  
this is the future of healthcare in the USA.
 
2012-12-31 09:47:30 AM  
I'll Hazzard a guess and say that the British government Linda hand to the US's own Pathway program.
 
2012-12-31 09:48:25 AM  
On the other hand, sometimes death is not as inevitable as the doctors think.
My brother's wife had an aneurysm several years ago & was in coma for months. The doctors told him her brain was so severely damaged she would never really recover & would likely never awaken. Taking her off life-support was presented as a serious option.

Happy to report the doctors were quite wrong. She is now pretty much fully recovered and enjoying her grandchildren.

/csb
 
2012-12-31 10:13:30 AM  

maglite: ZAZ: ...though the morphine dose is not enough on its own to kill.

The morphine IS the killer, it suppresses breathing and other autonomous function until you die... saying the morphine doesn't kill you is like saying the pillow over your head didn't kill you.

When you have a patient in hospice there is no limit to the morphine dose and no one questions the dosages given. If you have a conscious patient you simply up the dosages slowly... that continues while they're unconscious and then they die.

It's a quiet form of euthanasia administered by the families of people suffering from cancer. One school of thought is that this is just preventing needless suffering of both family and patient by bringing a faster end to something that is inevitable... another is that you should die when you die, not when you're drugged to death.

I'm in favor of latter, many are in favor of the former... when you have two in the same family who are close to the decision making process it can lead to some serious disagreements, some of which will never heal.

When someone is in bad shape it's easy to say they're suffering and that it should end... but having watched someone go from deaths door to being happy, walking, laughing, etc... I say let it happen when it will happen on its own, do not accelerate it by removing treatment or introducing escalating levels of morphine.


When someone is dying they often become acidotic from rising C02 levels in the blood. They have an increased respiratory rate because they body tries to return to homeostasis by "blowing off" the extra C02. A normal respiratory rate is 10-20 breaths per minute. When people reach this state in the dying process, we see respiratory rates of up to 40 breaths per minute. The patient has to use extra muscles to breathe because of "air hunger." I've seen people move their entire bed with each breath due to this process. The morphine does slow down the respiratory rate but the goal is to slow it to near normal so that the patient is more comfortable and doesn't simply die from the exhaustion of breathing in that manner over several days. Morphine hides the "air hunger" from the patient and they don't feel the effects of not getting enough air. It's like being forced to run in a marathon and you can't stop running until you die. Morphine isn't used to kill people, it is given because letting that process go on for days or even weeks is torture to the patient. The morphine isn't killing the patient, the terminal disease process is killing the patient.
 
2012-12-31 10:15:35 AM  
Next up, suicide education for grade schoolers. Can kids teach their parents to off themselves like they can teach their parents to recycle?
 
2012-12-31 10:20:02 AM  

Babwa Wawa: The mentality that death is unnatural is very difficult for doctors overcome.


It should be. That mentality is the entire reason they exist at all.
 
2012-12-31 10:30:45 AM  
cf.drafthouse.com
 
2012-12-31 10:40:45 AM  
Benevolent Misanthrope:

Jesus Fark.  I'm all for the idea of not prolonging death when folks are suffering - but this... this is absolutely sinister.

The problem I have is that is not really euthanasia: they're still being left to die slowly, instead of being finished off with a nice injection like I'd choose for myself if it's available.

And they ought to get the full 17 minutes.
 
2012-12-31 10:48:31 AM  
Old people are going to bankrupt the US
 
2012-12-31 10:50:10 AM  
kinkkerbelle:

The morphine isn't killing the patient, the terminal disease process is killing the patient.

That is the problem I have with it. Why not give a big dose of morphine (or some sedative) all at once and get it over with quickly and humanely? If it took a cancerous ferret that long to be "euthanized" I'd just decapitate the poor bugger myself with one good whack from a machete or a .22 to the back of the head like I'd do when a cat brought in a mouse and tried to torture it slowly.
 
2012-12-31 10:52:40 AM  
maudibjr:

Old people are going to bankrupt the US

And obese people. And stupid people who vote.

And the rich avoiding taxes. Killing all the old & fat people won't put the USA in the black: the rich will still not pay their fair share.
 
2012-12-31 11:04:35 AM  
kinkkerbelle:
When someone is dying they often become acidotic from rising C02 levels in the blood. They have an increased respiratory rate because they body tries to return to homeostasis by "blowing off" the extra C02. A normal respiratory rate is 10-20 breaths per minute. When people reach this state in the dying process, we see respiratory rates of up to 40 breaths per minute. The patient has to use extra muscles to breathe because of "air hunger." I've seen people move their entire bed with each breath due to this process. The morphine does slow down the respiratory rate but the goal is to slow it to near norma ...

My point was that often that level of diagnosis is not being made correctly, or at all.

I can give several anecdotes where a family member was effectively told "you are going to die, give up" and proceeded to choose to live rather than take the easy way out.

In one case it was many happy months spent at home with relatives visiting... in another it was for seven years of independent living and enjoying life. In third case I'm happy to say it is TEN YEARS and counting.

Morphine takes away pain AND the ability to fight. When it's inevitable, it's inevitable, so in a situation as you say it's just prolonging suffering... but my point is not to jump to a conclusion when things look bleak, you only get one shot at staying alive and my personally decision is to endure end of life pain if there is a chance I can rally for a few days, weeks or months
 
2012-12-31 11:23:48 AM  

glennizen: ou make some good points. In multiple threads I see you hold forth from on high.

But you're 27 yo. You don't know anything like what you think you know. Could you please focus on being a little less of an asshole?


I started working in a nursing home at 16. I first worked as an EMT at 18 on a Basic unit doing primarily nursing home transports as my paid gig.

Come see what life at any cost gets you, and you'll understand completely why I'm an asshole about this topic. Moralistic, life-at-any-cost busybodies who are content to let their loved one die a slow, horrific and painful death from infection in a nursing home while Alzheimer takes their minds, or families unwilling to follow the wishes of their sons and daughters while they lay there in a vegetative state dependent on a trach and a g-tube to survive with no quality of life anger me.

I've seen what happens when you get a Cardiac Arrest back after 50 minutes, and they don't survive neuro intact. I've seen what happens when a massive stroke is ignored and goes beyond the treatment window. I've seen what dementia and Parkinsons does to a human body.

That is NOT life to me. It's pointless, endless suffering that will only get worse.

10 years ago I thought I could never uphold a DNR. Now I think anyone who doesn't do so is a complete monster.
 
2012-12-31 11:27:26 AM  
Obummer is wringing his hands in anticipation, cause you know...if England does something, we should do the same thing.
 
2012-12-31 11:32:00 AM  

kinkkerbelle: When someone is dying they often become acidotic from rising C02 levels in the blood. They have an increased respiratory rate because they body tries to return to homeostasis by "blowing off" the extra C02. A normal respiratory rate is 10-20 breaths per minute. When people reach this state in the dying process, we see respiratory rates of up to 40 breaths per minute. The patient has to use extra muscles to breathe because of "air hunger." I've seen people move their entire bed with each breath due to this process. The morphine does slow down the respiratory rate but the goal is to slow it to near normal so that the patient is more comfortable and doesn't simply die from the exhaustion of breathing in that manner over several days. Morphine hides the "air hunger" from the patient and they don't feel the effects of not getting enough air. It's like being forced to run in a marathon and you can't stop running until you die. Morphine isn't used to kill people, it is given because letting that process go on for days or even weeks is torture to the patient. The morphine isn't killing the patient, the terminal disease process is killing the patient.


THIS.

We have to do a yearly pain control update class in our system for all nursing and AH providers (EMT/Ps, Nurses, Therapists), and this was one of the main talking points about end of life care and poor pain control, in that everyone is afraid to give the "last dose" because of the massive amounts of Morphine these patients are prescribed for comfort. One of the best points I've ever seen made about it was that even if a person dies after getting their morphine dose, the provider isn't the one that killed them in end-of-life care settings, the disease is. The provider only made them comfortable.

maglite: I say let it happen when it will happen on its own, do not accelerate it by removing treatment or introducing escalating levels of morphine.


And this attitude right here is the reason so many people with terminal illnesses die in pain and suffering. The whole point of introducing escalating levels of morphine is not to hasten death. It's to treat pain in a patient which is rapidly becoming unable to process opiate pain killers into their effective pro-drug due to the physiologic process of dying. I've taken terminal cancer patients home to die on long-distance transports who are literally on Morphine 30mg IVP max every HOUR. In-patient hospice settings may have them where there is no max dose per hour.

maglite: Morphine takes away pain AND the ability to fight. When it's inevitable, it's inevitable, so in a situation as you say it's just prolonging suffering... but my point is not to jump to a conclusion when things look bleak, you only get one shot at staying alive and my personally decision is to endure end of life pain if there is a chance I can rally for a few days, weeks or months


That's nice. Don't force your opinions or life philosophy about dying on others. Especially those who have to endure pain far beyond what you could ever understand just by breathing.
 
2012-12-31 11:50:33 AM  
Part of a formal description of the LCP from an article linked earlier:

"...while legal consent is not required to place a patient on the LCP, the fact that the plan is being considered should always be discussed with a relative or carer and, if possible, the patient themselves."

How can EVERYONE not have a problem with this? The hospital literally does not HAVE to tell anyone, nor have any form of consent. Depending on how this decision is made it really is either death panels or Dr. Death. Either way, it is not the proper way to handle this kind of thing.

The LCP is a set of standards of care and notification. It is a fantastically good idea to have such standards and I am glad they do. But as long as the decision requires NO form of consent and even notification is not required under penalty of legal or financial punishment they will continue to have non-notification issues. You can't make that kind of think voluntary for the doctor or nursing staff because human nature will result in many instances of people not being notified when they "should".
 
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