Wednesday 2 January 2013

Liverpool Care Pathway - In Whose "Best Interests"?

The Mail Online reports:
"David James, 68, walked into his local hospital last May with suspected constipation but never left after developing hospital acquired pneumonia and blood poisoning."
This unnamed hospital, which cannot be named for "legal reasons" needs to be named and shamed.

This unnamed hospital must not be permitted to hide the truth, nor hide from the truth.

This unnamed hospital insists that Mr.James was not put on the LCP. This unnamed hospital still has much to answer for.

Mr. James walked into hospital seven months ago with a stomach complaint, but later that month became critically ill after contracting hospital acquired pneumonia that led to multiple organ failure.
"This is one of the terrible things. Aside from the pneumonia, we’ve never really had a diagnosis. All we know is that from the moment he went into hospital, he went catastrophically downhill." (May James)
This unnamed hospital must bear some responsibility for this outcome, then. Has the unnamed hospital no apologies, no explanation ready for this family?
“And what gets me is that with this court case, all that’s been discussed, nothing has ever been brought up about why he ended up in that situation. And what led to his deterioration. That’s been pushed under the carpet. 
“We’ve still got questions that need answers and we’re not going to stop.”(Paul James)
Is there more that this unnamed hospital is not telling this brave family? Why was there such a determination to withhold treatment that they went to the court to enable them to do so?

When is enough enough? The decision not to use 'invasive' treatments has to lie with the patient. Or the patient's family. This patient, this family, clearly, had not given up on his life as easily as did his doctors.


The Mental Capacity Act (2005) says that when a patient lacks the capacity to consent to, or refuse, medical treatment, the doctor concerned will have to decide what is in the patient’s best interests. In doing so, the focus should be on what the patient would consider his/her best interests, not what the doctor would consider his/her best interests if he were in the same position.

There should be consultation with relevant others (ie, you must take into account the views of the adult’s nearest relative and primary carer, and of any other person with powers to intervene in the adult’s affairs or personal welfare, or with an interest in the adult, so far as it is reasonable and practicable to do so)


Did the court, did the doctors concerned, take account of what Mr. James considered his 'best interests'?

Did the court, did the doctors concerned, take account of what Mr. James' nearest relative considered his 'best interests'?

How can this be?

This is the Mail Online reporting -


'He was sentenced to death': Grandfather who lost 'right to life' court case dies in the early hours of New Year's Eve

  • David James, 69, died after his 'heart stopped beating', says son
  • He contracted pneumonia in hospital and had been bedridden since
  • Wife May and daughter Julie lost landmark High Court battle last month
  • Local hospital had been allowed to put the retired musician on the Liverpool Care Pathway if his health deteriorated



A grandfather has died just ten days after his family lost a legal battle that allowed his hospital to withhold treatment if his condition deteriorated.

David James, 68, walked into his local hospital last May with suspected constipation but never left after developing hospital acquired pneumonia and blood poisoning.

Within weeks he was in intensive care and was left unable to speak or breathe unaided.

Last summer the hospital trust - which cannot be named for legal reasons - launched a rare legal action seeking permission to withdraw potentially life-saving treatment from Mr James.
His appalled family insisted Mr James, a professional musician, still enjoyed life and was not ready to die leading to a judge rejected the hospital trust's application.

But the trust won an appeal against the decision days before Christmas meaning treatment could be withheld from Mr James if his condition deteriorated.

His daughter Julie, 48, described the ruling as 'legalised murder'.

Little more than a week later Mr James' condition deteriorated and he died in the early hours of New Year's Eve with his family saying they begged staff to do more to help.

Julie said: 'When the nurse told us he was going I just got hold of him and held him tight. I told him we would keep on fighting for him.

'We are all in total shock. It's very hard to take in and my mum is distraught.

'Dad has bounced back so many times that it's hard to accept that it's not going to happen now.

'Even now I feel I should be getting ready to go to hospital to see him. It is hard to believe that this happened to a man who came into hospital for constipation a few months ago.' 

Mr James's condition deteriorated over the weekend and by Sunday his blood pressure was very low and his kidneys had started to fail.

He was given medicine to tackle the low blood pressure but Julie says their calls for him to be given kidney dialysis were rejected.

Julie says the hospital told her dialysis would be 'futile' and would have subjected her father to 'unnecessary distress'.

Family fight: David's wife May with daughter Julie James say they will not give up hope and will keep fighting for their husband and father not to be put on the care pathway
Family fight: David's wife May with daughter Julie James refused to give up hope and 
fought for their husband and father not to be put on the care pathway

Before visiting hospital: David James pictured at home in Easter this year before he contracted pneumonia in hospital
Before visiting hospital: David James pictured at home in Easter this year before he 
contracted pneumonia in hospital

Eventually Mr James went into cardiac arrest on the morning of New Year's Eve and in accordance with the legal judgement hospital staff did not give CPR.

When Mr James's heart failed last August staff did give CPR and he made a good recovery.

Mr James died with his wife of 50 years May, 76, Julie and son Paul, 37, at his bedside.

Julie added: 'This is a direct consequence of the court judgement ten days ago. I think they have effectively been slowly withdrawing treatment ever since.

'As far as the family are concerned my dad has been a victim of neglect from day one - and ever since the court reversed his decision he was effectively sentenced to death.

'We are just all devastated that it happened so quickly.'

Legal battle: May, right, Julie arriving at the High court in London ahead of the ruling which will see David put on the care pathway
Legal battle: May, right, Julie arriving at the High Court in Londonlast month ahead of 
the ruling which saw David put on the care pathway

The case of Mr James further illustrates the furore surrounding the Liverpool Care Pathway (LCP).

Some relatives argue the controversial palliative care system is a way for medical staff to kill off the terminally ill and old.

The courts accepted a claim by the hospital that they were not invoking LCP in Mr James's case but his family are adamant in their belief he was secretly placed in the Pathway.

Julie added: 'After the latest court hearing doctors told us they would negotiate with us when it came to on-going treatment.

'We didn't like that word - this is a human life we are talking about, not buying a new car.

'We knew it was futile too, because ultimately no-one can tell a doctor what to do and what not to do.'

Back in the day: David and May James on their wedding day 29th Sept. 1962 outside Liverpool Registry Office
Happier times: David and May James on their wedding day in Liverpool in 1962

Mr James had played guitar on the 1974 hit who Do you Think you are by Candlewick Green and had also played alongside the likes of Shirley Bassey and the Beatles.

He was diagnosed with bowel cancer 11 years ago and given just six months to live but made a full recovery after chemotherapy, radiotherapy and surgery.

He enjoyed good health until last May when he was admitted to his local hospital with suspected constipation.

The hospital wanted to give him a CT scan which, as it was a Bank Holiday, could not take place for a few days.

When his wife returned the following day she was told he had got hospital acquired pneumonia.

His condition worsened as he also developed a water infection and septicaemia before being admitted to intensive care three weeks later.

He then spent the rest of his life on a ventilator and suffered a stroke and cardiac arrest while his court case was still underway.

But his family have refuted the hospital's claims that he suffered 'multiple organ failure' several times.

Son Paul said: 'He fought and fought until the very end. And we will keep fighting to get justice for him.'

It is understood all treatment given to Mr James was in line with the court ruling, which concluded that CPR was not in Mr James' best interests if his condition deteriorated.

A hospital spokesman said: 'We've had close communication with Mr James' family 

throughout this process and if there are any issues they would like to discuss further we'd welcome that.

'Our thoughts and condolences are with the family at this difficult time.' 'Our thoughts and condolences are with the family at this difficult time.'


GOVERNMENT HEALTH WARNING:
Hospitals can seriously impede your chances of recovery.

In Ray Bradbury's surreal world, the firemen came to set fire to your books.

In our surreal world, the hospitals give you infections and the doctors fight to end your life! And take your life.

This is the 21st century? This is the 21st century!

No comments:

Post a Comment