Friday 17 May 2013

Liverpool Care Pathway - The Sum Of All Fears

The living will that includes an EoL decision to agree to organ donation may become a death wish. It is a clear and present danger, the sum of all fears...


You have made a Living Will or Advance Directive.

The term advance directive (increasingly being replaced by the term advance decision) means a statement explaining what medical treatment the individual would not want in the future, should that individual 'lack capacity' as defined by the Mental Capacity Act 2005. The term 'living will', whilst helping people to understand the concept, is somewhat misleading in that, unlike a will, it does not deal with money or property. Moreover, it can relate to all future treatment, not just that which may be immediately life-saving. An advance directive is legally binding in England and Wales. Except in the case where the individual decides to refuse life-saving treatment, it does not have to be written down, although most are and a written document is less likely to be challenged.- Patient.co.uk

You have included all the parameters for treatment or non-treatment and you are sure you have pretty much covered your bases...

I, (name) of (address) wish the following to be considered in the event of my incapacity to give or withhold consent for medical intervention.

If ever I am unable to communicate and have an irreversible condition and I am expected to die in a matter of days or weeks, or if I am in a coma and not expected to regain consciousness or if I have brain damage of disease that makes me unlikely ever to recognise or relate to people then I want treatment only to provide comfort and relieve distress, even if this may shorten my life. I do not want treatment that can only prolong dying.

I consent to any acts or omissions undertaken in accordance with my wishes and I am grateful to those who respect my free choice. I reserve the right to revoke or vary these conditions but otherwise they remain in force.

If I am certified brain dead, should any of my organs be of value to others, I give consent to their removal for the purpose of transplantation.
Patient.co.uk

Hmmm...

"Even if this may shorten my life..."

Well, that forgoes the LCP option. On The Big Questions, Dr. Richard Hain says the LCP is about "not prolonging or hastening it."

Still, this proviso does expand the options for the LCP team...


The organ harvest, the temptation of the Advance Directive and the dangers of euthanasia.

A difficult choice presents itself.

There is another patient who would benefit from organ donation. This patient is on a higher trajectory on the Complete Lives Treatment Curve. 

"Expected to die..."

A decision has to be made. It is very tempting to weigh one life off against the other and make a quick 'quality of life' assessment...

It can't happen.

It won't happen.

It does happen -

- Mail Online

It will happen...

Ethical choices will be stretched and acted upon.

Already, this is happening...

They Can Diagnose Dying... Can't they?

Mail Online reported on the girl who woke up when doctors were preparing to harvest her organs -
She is now making a good recovery at a rehabilitation centre and is able to walk, talk and even ride her horse Mathilde.
Her family is now suing the hospital for damages, claiming that doctors had been desperate to harvest her body parts.
'Those bandits in white coats gave up too quickly because they wanted an organ donor,' her father Kim told the Danish newspaper Ekstra Bladet.
The family’s lawyer Nils Fjeldberg said that Ms Melchior keeps asking if doctors were trying to kill her.

Liverpool Care Pathway - Nazifying The NHS

People killed by euthanasia in Belgium are having their organs harvested for transplant surgery, a new report has revealed.
Eurotransplant, a co-ordination group for transplants in Austria, Belgium, Croatia, Germany, Luxembourg, the Netherlands and Slovenia, is now devising elaborate protocols for ‘organ donation and transplantation after euthanasia’. Dr Peter Saunders, of Care Not Killing, an umbrella group of more than 50 British medical, disability and religious charities opposed to euthanasia, said he was shocked by the report.
‘I was amazed at how nonchalantly the issue was dealt with as if killing patients and then harvesting their organs was the most natural thing in the world,’ he said.

Criminal activity seizes opportunity for profitability and gain. Expanding the possibilites of ease for organ theft is foolhardy.

It opens up avenues for organ theft to order.

It is the sum of all fears.

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