If this were a story about National Socialist death camps, instead of the United Kingdom in the 21st century, people would shake their heads at the horrors of the past. Yet authenticated reports demonstrate that in some admittedly rare cases, patients who were not terminally ill found themselves on the Pathway, without their consent or knowledge. Moreover, in one just such distressing instance reported in the Daily Mail, a sick man was placed on the Pathway in exactly those circumstances. Despite the protests of his family, he was cut off from all medical treatment, food and fluids and unsurprisingly died rather horribly.
The hospital did not deny the circumstances but informed the patient’s utterly traumatized relatives a mistake was made because nurses couldn’t locate the patient’s records, as if that made things any the better. So they argued, they did not know what to do with him. The case illustrates the curse of managerialism which has seized power
over British hospitals, initiated by Thatcher, mesmerized as she was by corporatizing the health system, then magnified by the eager beavers of Blair’s New Labour. The Mail reported
‘Until now, end of life regime the Liverpool Care Pathway was thought to have involved only elderly and terminally-ill adults. But the Mail can reveal the practice of withdrawing food and fluid by tube is being used on young patients as well as severely disabled newborn babies. One doctor has admitted starving and dehydrating ten babies to death in the neonatal unit of one hospital alone. Writing in a leading medical journal, the physician revealed the process can take an average of ten days during which a baby becomes ‘smaller and shrunken.’
The infamous Jozef Mengele, Doctor Death of the Nazi concentration camp regime, would smirk at the chime with his ‘innocent’ medical experiments on those who were unable to protest or help themselves. These stories are breaking at a time when Britain’s much vaunted health service – once upon a time worshiped as a kind of established religion – is coming apart at the seams.
The Pathway originated with a registered charity – the College of Medicine – set up in the 1990’s in North West England (hence ‘Liverpool’.) The adoption of a termination program – and those are the words demanded in the grim circumstances - originating outside the health service caucus was a rather convenient bureaucratic fix to push the responsibility for devising Death Row mechanics away from the NHS, into the hands of ‘experts’ who arms-length devised the programme.
It is thus converted to an optional exercise for doctors to adopt or not, as the case may be. The NHS itself can thus absolve itself from conniving at deaths of children and adults in order to ration scarce resources and save money from tight hospital budgets.
Read this, again from the Mail.
Bernadette Lloyd, a hospice pediatric nurse, has written to the Cabinet Office and the Department of Health to criticize the use of death pathways for children. ‘I have also seen children die in terrible thirst because fluids are withdrawn from them until they die’ She said: ‘The parents feel coerced, at a very traumatic time, into agreeing that this is correct for their child whom they are told by doctors has only has a few days to live. It is very difficult to predict death. I have seen a “reasonable” number of children recover after being taken off the pathway.
Dr Laura de Rooy, a consultant neonatologist at St George’s Hospital NHS Trust in London wrote to the British Medical Journal (which reported the ‘mercy killing’ of the ten babies) stating of the victims: ‘It is a huge supposition to think they do not feel hunger or thirst.’ The Mail cited a document called ‘Liverpool Pathway for the Dying Child’ circulated by the Royal Liverpool Children’s NHS Trust. It specifies includes ghoulish ‘tick boxes’ to be completed by hospital doctors listing the medicines, notably the nutrients and fluids to be stopped.
As a parent, my heart faltered on those words. Is this so very far from the manic attention to detail that marked Nazi eugenics policy? That too aimed at cleansing society of the handicapped, the unfit, the elderly, in short those judged generally useless to society.
Some years ago I was escorted around the hospice run by the Little Sisters of Charity in Chicago, which is dedicated to the care of young, extreme paraplegics. The tender and wonderful care that I witnessed that day remains a powerful embedded memory. There was enough intense radiance on those kids’ faces to run a power station. They were on a pathway all right.
As far as I know, the law has not been changed in the United Kingdom to permit either mercy killing nor effectively, state-licensed elimination of infants and adults who are terminally ill. It is a blatant tautology to claim this is not about husbanding resources and directing them to more deserving cases, particularly the elimination of physically or mentally handicapped infants who will naturally account for a charge on state resources for the term of their lives.
The British Medical Journal cited as defense that the parents of the ten babes apparently approved the Pathway exit. This is a spurious, intellectually wretched argument. The parents are thus dragged into morally indefensible and compromising complicity on the grounds that accelerating death by withdrawal of life supports will ease the suffering of their offspring. Of course the real purpose is to endorse by-consent eugenics practiced by the medical profession, which then become the accepted norm.
If those same doctors had sought permission to kill the babies with a lethal injection, like putting down an old dog, I’ll hazard the response of the parents would have been markedly different. Shutting down life support systems one by one equates eugenics with natural causes. It is subtle, but wrong and thoroughly indefensible.
This is a eulogizing clip from the Pathway website:
The LCP is an integrated care pathway that is used at the bedside to drive up sustained quality of the dying in the last hours and days of life .It is a means to transfer the best quality for care of the dying from the hospice movement into other clinical areas, so that wherever the person is dying there can be an equitable model of care.Do you see anything concealed in this convoluted PR jargon about stopping medication and starving victims to death? But notice that interesting subliminal text, doing down the old cozy goodnight hospices, where people died in dignity, in favor of the cold ‘clinical arena’.
Let me share with you what I know directly about ‘best quality care’ based on close personal experience. Just over two years ago an old gentleman with whom I had enjoyed a respected relationship was diagnosed with terminal grade four cancer tumors. He had been bothering doctors for months about stomach pains but always received the all clear. Suddenly he had weeks to live. Disturbing in itself, that the danger periods of incipient cancer in a near eighty-year-old man went ‘unnoticed’ by the professionals. The cynical mind suspects he was picked out for the conveyor belt early on.
He ended up in the Pathway to eternity, where he was excruciatingly mistreated. His wife, daughter and grand-daughter had difficulty even gaining admission to see him in the ‘clinical area’ where he was confined. The grand-daughter rang me to say they were starving her grand-father, withdrawing medication and not even changing the sheets regularly. He got the full Pathway Monty, shriveled away to parchment and died. The family were frustrated from proper access to prevent them seeing this appalling degradation of an elderly and good citizen ending his life on Death Row, clearly because the sight of him would have been so highly distressing.
The aggrieved young grand-child wrote in great distress to the responsible local health trust. She received the blunt response that the administration were sorry that she found the treatment of her grand-father unacceptable. Full stop.
I heard a similar story from one of my professional contacts, who told me how he and his wife turned up unexpectedly at a hospital where her uncle was being treated for a terminal illness. They found the elderly man practically naked, slumped half in and half out of bed. When the nurse was summoned, she explained she had been ordered by her supervisors not to touch him.
This is the real picture of the Pathway, once you get past the egregious soapy stuff about ‘peaceful, pain-free deaths.’ One doesn’t need to be a professional philosopher to work out that something is intensely wrong with a ‘health’ system that proffers death as one of its cures. Everyone knows that engineered termination has been going on in hospitals everywhere, probably forever, but to effectively legitimize ‘mercy killing’ – of infants and the equally helpless elderly – is another matter altogether. We are very close here to ‘men like gods’ syndrome, when the cold approach of the man in the white coat starts to look sinister.
It is definitely a step towards the moral and ethical brink when parents are advised that the life of a new born infant should be terminated, suffering as they undoubtedly would the agonies of doubt as to whether this is professional advice or part of a cleansing process to clear the hospitals and the health services of burdensome lives.
Media reports suggest that a majority of patients not expected to survive would be placed more or less automatically in the Pathway programme. Practitioners are advised by the protocol to make grisly lists of candidates marked down for the Pathway exit. Next the scratch of pen on clip boards, the de-listing of the various items of support to be struck off in little boxes, one by one. There is no point in skipping niceties here. These are the rituals of death sentences. Does someone lean over the doomed figure and explain what and why they are going to do? I fancy not.
The medical profession hacking away at the coalface of the British health service sees nothing wrong with this shocking morbidity. Nine out of ten doctors who were asked the question if they would proscribe the same treatment for themselves come their own end of term affirmed they would. This of course is a nonsensical and absurd hypothetical question posed solely for political motives. It simply exposes the ethical bankruptcy of killing people in a medical environment. Yet the apparent endorsement of the Pathway by the doctors’ trade union, the British Medical Association, is a sure sign that what has been done is not easily undone.
The Pathway affair has arisen at a time when British health service certainly shows every sign of itself being eaten by cancers destroying the noble aims for which it was established in 1948. According to whistleblowers, some thousands of patients have died needlessly or prematurely in hospitals all around the country because of bureaucracy, incompetence and the craze to fulfill set targets, like Soviet quotas for boots and ladies underwear.
Patients at the Mid Staffordshire Hospital were virtually abandoned by the staff, left to fend for themselves which included desperately drinking water from flower vases. This same hospital was found to be routinely falsifying patient reports to meet the sacred performance ‘targets’ while concealing an unnaturally high level of mortalities. There was a recent report which received much publicity concerning a man who died from the consequences of an unnecessary operation conducted solely to meet performance targets.
Patients complain of being left for hours untended in hospital corridors, even as the health service pleads lack of resources are responsible for the closure of the once world renowned Accident and Emergency (A & E) centers.
It is revealed that health service directors at the summit authorized payments of £15 million to silence whistleblowers threatening to expose hundreds if not even thousands of scandals wracking the country’s hospitals. Many were compelled to sign permanent gagging orders. When the Mid Staffordshire dam broke, a flood of hitherto unknown horror stories appeared seemingly from nowhere, as the whistleblowers broke ranks.
Is the Pathway, then, the symbolism of a deeper syndrome?. Only this week Dame Sally Davies, the government’s Chief Medical Officer, warned that deaths in hospitals attributable to drug resistant superbugs might escalate to levels of a pandemic. True, British health officials are inclined to cry wolf every time Big Pharm needs another cash injection. But to be quite fair to Lady Davies, 2,500 deaths were recorded in 2011 from antimicrobial infections resistant to a large cocktail of antibiotics currently prescribed and the number is unquestionably increasing.
The unfortunate truth is that British hospitals are sinking in standards to those of far less developed countries. Lady Davies wants more money to fight the projected pandemic, which brings us to the point that the cost of healthcare is increasing, but the resources to pay for it, shrinking. But is this entirely correct? The main line of defense against insidious superbugs is rigorous and basic standards of cleanliness, such as the simple expedient of constant attention to basic hygiene in the hospital environment. Yet surveys in British hospitals (and incidentally, also in the United States) demonstrate that doctors, of all people, are routinely ignoring such elemental procedures as scrupulous hand-washing after examining each and every patient.
This article has been concerned with changing societal attitudes to healthcare in the UK which point to survival of the fittest, the introduction of Social Darwinism if you will. Blair once mused if it were possible to deduce from genes of the unborn still in the womb that they might grow up as criminals. You were left wondering if some future autocracy might regard this as a justifiable cause for intervention.
The Pathway that we have just explored is an extraneous means of Man playing God in determining the course of life and death. I reject the argument that it has anything to do with dignity of life and death and is far more to do with societal management, as populations grow, we all live longer and become a potentially increasing charge on the state.
In this context an interesting statistic reveals that Alzheimer’s Disease has now shot from 24th to tenth position in the death league table in the United Kingdom, in just twenty years. Even allowing for the average increase in life expectancy of four years (below, incidentally, advances in other leading European states), then such a huge multiplication is hard to explain wholly by natural factors. In general the new table suggests that Britons are anyway increasingly less healthy than their Continental counterparts.
We should inquire why that is. What is apparent about the UK is its rapid descent into a total surveillance, top-down managed society, in which an individual is now ‘supervised’ so to speak more or less at the moment of stepping outdoors (and of course, within). Population control used to be the stuff of science fiction, and those who dared raise it written off as fantasizers. Are we entirely sure of that, now that one per cent of the population has control of practically everything?
Scientists ponder what causes Alzheimer’s. It seems to be associated with maladjusted proteins which become toxic when accumulated in sufficient quantities, so they virtually scramble nerve cells in the brain. This in turn induces neuro-fibrillary paralysis or brain rot, and then death, put rather drastically. I have seen it said that aluminum getting into food and water may be a causal factor. I do not pretend to fully understand the medical mechanics but I do consider the sudden dramatic increase in what used to be a rather rare malady little short of alarming.
Mass dementia to turn populations into zombies? Obamacare, anyone?
This article has not been edited due to time constraints. If you find any errors please contact me immediately.
Richard Cottrell is a writer, journalist and former European MP (Conservative).
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