Letter to BMJ, "Natural Death - is a pathway needed"
Tuesday, 18 September 2012 04:57 Dr A Cole
The
Editor BMJ
17/9/12
A
conference of the Medical Ethics Alliance entitled “Natural Death - is a
pathway needed”, on the 18th June
at the Royal Society of Medicine, attracted a lot of press attention because
Prof. Pullicino cast doubt
on the scientific possibility of knowing that death is imminent. One
consequence of this has been the number of relatives who have contacted the MEA
with highly distressing accounts of deaths on the Liverpool Care Pathway.
Amongst the most alarming of which, has been the deaths of elderly people deprived
of all fluids for up to fourteen days.
Insufficient attention has been given to a Scottish
critique which states;
“A blanket policy of clinically assisted ( artificial
) nutrition or hydration, or no clinically assisted ( artificial ) hydration,
is ethically indefensible and in the case of patients lacking capacity
prohibited under the Adults with Incapacity ( Scotland ) Act 2000.1
Amongst the symptoms that the LCP lists are - pain,
agitation, nausea, vomiting, and dyspnea - but not thirst, though this is one
of the most distressing of all symptoms. Nor does moistening the mouth relieve
it.
An open letter to NICE calling for central monitoring
of complaints from relatives over the implementation of the LCP was not even
acknowledged. 2 Blanket assurances
that the it conforms with “gold standards” or “quality statements” will no
longer suffice. It clearly does not do so.
Dr
Anthony Cole
JP FRCPE FRCPCH
Chairman Medical Ethics Alliance
References
1 Adopted version 12 - Dec. 2010, NHS Forth
Valley
2 www.medethics-alliance.org 12/8/12
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