U.K. Docs Worry Patients Dying Prematurely
A group of British doctors who treat the terminally ill said they were worried that some are dying prematurely because of guidelines on dealing with patients in their final hours.
In a letter to The Daily Telegraph newspaper Thursday, six palliative care specialists said the "tick-box approach to the management of death" could become a self-fulfilling prophecy.
The guidelines, which are not mandatory, were designed by a hospice in Liverpool and recommended as a model in 2004 by the body that sets national health care standards.
They lay out signs that a patient is close to death - including loss of consciousness and difficulty swallowing - and say that once an assessment has been made doctors may remove medication or intravenous drips that are no longer effective.
The letter-writers said the problem with the guidance was that "forecasting death is an inexact science" and that some patients might be denied food or fluids, or put under sedation with the result that signs of improvement might be missed.
"It is supposed to let people die with dignity, but it can become a self-fulfilling prophecy," said Dr. Peter Hargreaves, one of the signatories. "Patients who are allowed to become dehydrated and then become confused can be wrongly put on this pathway."
"Patients who are allowed to become dehydrated and then become confused can be wrongly put on this pathway," he told the Telegraph, adding that, "What they are trying to do is stop people being over-treated as they are dying.
"It is a very laudable idea. But the concern is that it is tick box medicine that stops people thinking."
Marie Curie Cancer Care, the charity that drew up the guidelines, said the procedures had "improved the end of life experience for thousands of people" and claimed the doctors' letter would cause unnecessary fear.
CBSNews.com's complete coverage of the U.S. health care reform debate
Also Thursday, a report by management consultants McKinsey&Co. advised the health service to cut a tenth of its 1.5 million-strong work force over the next five years to make up a budget shortfall. It also suggested the NHS sell off hospitals and cut back on some services.
The government said it had rejected the proposals, which were among many submitted by consulting firms after the government asked for suggestions on how to make up a 20 billion pound ($33 billion) shortfall expected by 2014.
"The government does not believe the right answer to improving the NHS now or in the future is to cut the NHS work force," Health Minister Mike O'Brien said.
Details of the study were published Thursday by the Health Service Journal. McKinsey&Co. refused to comment.
CBS/ AP In a letter to The Daily Telegraph newspaper Thursday, six palliative care specialists said the "tick-box approach to the management of death" could become a self-fulfilling prophecy.
The guidelines, which are not mandatory, were designed by a hospice in Liverpool and recommended as a model in 2004 by the body that sets national health care standards.
They lay out signs that a patient is close to death - including loss of consciousness and difficulty swallowing - and say that once an assessment has been made doctors may remove medication or intravenous drips that are no longer effective.
The letter-writers said the problem with the guidance was that "forecasting death is an inexact science" and that some patients might be denied food or fluids, or put under sedation with the result that signs of improvement might be missed.
"It is supposed to let people die with dignity, but it can become a self-fulfilling prophecy," said Dr. Peter Hargreaves, one of the signatories. "Patients who are allowed to become dehydrated and then become confused can be wrongly put on this pathway."
"Patients who are allowed to become dehydrated and then become confused can be wrongly put on this pathway," he told the Telegraph, adding that, "What they are trying to do is stop people being over-treated as they are dying.
"It is a very laudable idea. But the concern is that it is tick box medicine that stops people thinking."
Marie Curie Cancer Care, the charity that drew up the guidelines, said the procedures had "improved the end of life experience for thousands of people" and claimed the doctors' letter would cause unnecessary fear.
CBSNews.com's complete coverage of the U.S. health care reform debate
Also Thursday, a report by management consultants McKinsey&Co. advised the health service to cut a tenth of its 1.5 million-strong work force over the next five years to make up a budget shortfall. It also suggested the NHS sell off hospitals and cut back on some services.
The government said it had rejected the proposals, which were among many submitted by consulting firms after the government asked for suggestions on how to make up a 20 billion pound ($33 billion) shortfall expected by 2014.
"The government does not believe the right answer to improving the NHS now or in the future is to cut the NHS work force," Health Minister Mike O'Brien said.
Details of the study were published Thursday by the Health Service Journal. McKinsey&Co. refused to comment.
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Further, it is stated the problem is 'forecasting death is an inexact science'!
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The above being the facts of the matter, the solution is really simple:
treat each patient as an individual allowing for individual care instead of trying to 'pigeonhole' the patient to a category in the guidelines manual!
Pretty simple, huh? It should be common sense, since everyone's metabolism, ailments, and needs are mostly unique to them and some measure of adjustment needs to be made to accommodate each person!
It doesn't require any further, never-ending, budget-busting study to figure out! Just do it!
As for the report on a '' budget shortfall'' in the Health Service this is absolute garbage and the person who wrote this article should check their facts more carefully.
The government has ring fenced health spending for the next years and hence it will not be cut.It will be increased in real terms so there will be no budget shortfall.
The report is an attempt to find savings in this department(the department of health) which can then be used in other areas of the system i.e education or defence.
These cuts have been rejected out of hand and would always be so.
It's a shame a country with a health system in the 30's does not value the health system of another country which has been shown in all independant comparisons to be far superior.
You should be ashamed of yourselves that a civilised nation allows it's citizens to scream at each in halls because they don't wish to pay extra money to stop those people not insured from dying because they can't afford health care.
You mock other countries but it is your country which you hold up as the pillar of virtue which has been discraged and mocked this summer.
I think the patients should be more worried than the Doctors.
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So, after they denied the patients food & water & then drugged them so nobody could tell if they were improving or not they died. I suppose the statement that the procedure had "improved the end of life experience for thousands of people" was the result of interviews of the patients after they had died. Yes, it is expensive as all hell to keep somebody alive as they near the end of their life. BUT, if money is going to be the determining factor as to when the "plug is pulled" & as people age treatment becomes longer, more generalized, and more expansive. So, if saving money is the criteria then by all means, let us save money at the most expensive time of treatments. A. Don't treat anybody for anything who is retired or over the age of 70. B. Using arcturial tables in existence to establish the "value" (earnings potential) of a persons' remaining life expectancy when they are presented for diagnosis & treatment. If the cost of the treatment for whatever their condition is exceeds their "value" then do not treat them. Drug them, give them no food or water, & you will free up the hospital bed immediately as they will be sent to a "hospice" (warehouse) to live out the remainder of their life. As you may have guessed by now I find the concept of saving money while someone dies or lives in suffering to save that money to be a barbaric concept. Now, if you want to talk about the quality of life & when to "pull the plug" that's an individul decision and the subject for a whole other debate. But don't you DARE tell me that you want to let somebody die who might live or let someone suffer in pain or with a correctible medical condition so that you can save some money on insurance premiums so that you can buy that plasma screen TV you want.
Please do not decide for me.
We won't be fooled again.................
Yes my troll friend. We were fooled by the republicans one time and we won't be fooled again! I agree with you there.
And as one poster noted, this is a conservative, politically generated article. Pure bunk.
But it does'nt matter. We WILL have reform. The majority (a clear majority) of Americans WANT reform.
government controlled health care. No need to lie. ]
do the polls show that these same people don't know what 'goverment controlled healthcare' means ... or that it means something completely different to all of them?
what does the poll mean if they don't know what 'govt controlled' means?
http://www.commondreams.org/headlines05/0322-03.htm