letter to The Daily Telegraph, a group of experts who
care for the terminally ill claim that some patients are being wrongly
judged as close to death.
Under NHS guidance
introduced across England to help doctors and medical staff deal
with dying patients, they can then have fluid and drugs withdrawn
and many are put on continuous sedation until they pass away.
But this approach
can also mask the signs that their condition is improving, the experts
As a result
the scheme is causing a “national crisis” in patient care,
the letter states. It has been signed palliative care experts including
Professor Peter Millard, Emeritus Professor of Geriatrics, University
of London, Dr Peter Hargreaves, a consultant in Palliative Medicine
at St Luke’s cancer centre in Guildford, and four others.
death is an inexact science,” they say. Patients are being
diagnosed as being close to death “without regard to the fact
that the diagnosis could be wrong.
result a national wave of discontent is building up, as family and
friends witness the denial of fluids and food to patients."
comes just a week after a report by the Patients Association estimated
that up to one million patients had received poor or cruel care
on the NHS.
called the Liverpool Care Pathway (LCP), was designed to reduce
patient suffering in their final hours.
Marie Curie, the cancer charity, in a Liverpool hospice it was initially
developed for cancer patients but now includes other life threatening
It was recommended
as a model by the National Institute for Health and Clinical Excellence
(Nice), the Government’s health scrutiny body, in 2004.
It has been
gradually adopted nationwide and more than 300 hospitals, 130 hospices
and 560 care homes in England currently use the system.
Under the guidelines
the decision to diagnose that a patient is close to death is made
by the entire medical team treating them, including a senior doctor.
They look for
signs that a patient is approaching their final hours, which can
include if patients have lost consciousness or whether they are
having difficulty swallowing medication.
warn that these signs can point to other medical problems.