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Medical Ethics


Cleopatra
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How times have changed eh? I have been living long enough to remember when doctors would do everything in their power to keep a terminally ill patient alive as long as they could, even though they knew that the patient was suffering and would die in the end no matter how much they tried to keep him/her alive.

Despite pleas form patient and/or relative to cease trying and end the patient's suffering by allowing him/her to die, the hard headed doctors doggedly refused to stop trying to keep the patient alive, asserting that they could not play God, often quoting the Hypocritical Oath and insisting it was their duty to do everything to keep the patient alive.

Today it has been revealed that 60,000 patients die on the Liverpool Care Pathway each year. The only thing is it isn't the patients or their relatives who are making the decisions, it's the same medical profession who in years gone by insisted they could not play God and asserted that it was their duty to keep the patient alive to the bitter end that is making the decisions and in fact neither patient or relatives are informed of the decision.

Seem economics have taken over from the Hypocritical Oath - let them die then get rid of them and save the on expense of treating them to keep them alive.

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"Keep them alive" for what purpose or point? Fair enough if they were strutting around, but most arn't; and all you are doing is extending is the indignity of a drawn out death, with additional costs to the tax-payer. Ironic that those who tend to believe in an after-life are the most reluctant to leave this one!

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But there should be a choice by patient and/or relatives to be put on the program or not. No doubt the program is a good idea but the choice is not being afforded to patient/relatives. The doctors are making the decision without telling the patient/relatives. In other words they are playing God, which they had previously refused to do.

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But there should be a choice by patient and/or relatives to be put on the program or not..

There is a choice. " “The decision to begin the care pathway is made in partnership with the patient and their carers.

“Such decisions would never be based on financial constraints, but always on recognition that a patient is dying and that further investigation and treatment would be futile, undignified and intrusive.”  The care pathway can be discontinued at any time.

However, like every system there are failings. Those failings should be investigated, but the programme itself is a model of best practice.

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There is a choice. " “The decision to begin the care pathway is made in partnership with the patient and their carers.

“Such decisions would never be based on financial constraints, but always on recognition that a patient is dying and that further investigation and treatment would be futile, undignified and intrusive.”  the care pathway can be discontinued at any time.

However, like every system there are failings. Those failings should be investigated, but the programme itself is a model of best practice.

 

Dear Wolfie, the decision to begin the care pathway is not being made in partnership with patient and carers according to a report published today. I will repeat. Doctors are making the decision to put patients on the program and patient/relatives are unaware that they have done so because there has been no discussion between doctor/patient/relatives.

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Dear Cleo, perhaps you need to stop reading the Daily Mail.

If the Liverpool Pathway was as bad as you make it out then I would suggest putting every scouser on it, but it isn't and I know because my own Mother is on it.

At no time has my Mother's wishes been over-ruled by anyone. Even the report suggests that only 6% of cases caused concern. It is supported by the Marie Curie Cancer Care and it is they who have asked for an investigation as 6% is 6% too many.

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The report actually said that 60,000 people had been put on the Pathway without their own consent or knowledge.

 

Many, if not most, patients who go on to the Pathway are too ill by that time to give any kind of informed consent - hence the emphasis on partnering with family members. So the 60,000 includes all of these.

 

The report is quite vague on the actual numbers where no consent at all is sought, and obviously this is something to be investigated and avoided, but there are significant numbers of elderly patients who die in hospitals every year with no capacity to make their own decisions and no known family members. Should they be subjected to a long, drawn out death just because of this?

 

It's perfectly possible that many of the numbers the report has identified as being placed on the Pathway without patient or family consent have no family at all, but have been supported and represented by friends, long term carers, care home staff etc.

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 Dear Wolfie, you are flogging a dead horse cos your foreign friend has a God given right to be right all the time. How do I know this? I read in in the Daily Mail.

 

 <word removed> ! I'm not foreign. I'm as british as you are. Born and bred in Warrington <removed> !

Edited by Dizzy
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Charles Futcher Jr said his parents, war veteran Charles Snr and Hilda, were put on the controversial Liverpool Care Pathway without consent. The husband and wife died within ten days of each other at the same care home in Petersfield and their son said they were treated like 'animals' and doctors 'seemed to take it upon themselves to get rid of them'.

 

Oh well the doctors do discuss it with patients/carers before putting patients on the pathway. But maybe the patients/carers were just not present at the time, eh?

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