Sentenced to death on the NHS
Discussion
In a 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across England to help doctors and medical staff deal with dying patients, they can then have fluid and drugs withdrawn and many are put on continuous sedation until they pass away.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 warn.
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.
“Forecasting 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.
http://www.telegraph.co.uk/health/healthnews/61275...
We can't reform it (e.g. cut back on what it does, see IVF thread), make it more efficient or opt out of it. I'm so glad the NHS exists.
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across England to help doctors and medical staff deal with dying patients, they can then have fluid and drugs withdrawn and many are put on continuous sedation until they pass away.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 warn.
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.
“Forecasting 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.
http://www.telegraph.co.uk/health/healthnews/61275...
We can't reform it (e.g. cut back on what it does, see IVF thread), make it more efficient or opt out of it. I'm so glad the NHS exists.
Fittster said:
In a 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 warn.
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.
“Forecasting 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.
http://www.telegraph.co.uk/health/healthnews/61275...
We can't reform it (e.g. cut back on what it does, see IVF thread), make it more efficient or opt out of it. I'm so glad the NHS exists.
This is one of the main reasons behind public sentiment in the U.S. being against government run healthcare. Starting to sound like Logan's Run.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 warn.
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.
“Forecasting 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.
http://www.telegraph.co.uk/health/healthnews/61275...
We can't reform it (e.g. cut back on what it does, see IVF thread), make it more efficient or opt out of it. I'm so glad the NHS exists.
Jimbeaux said:
Fittster said:
In a 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 warn.
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.
“Forecasting 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.
http://www.telegraph.co.uk/health/healthnews/61275...
We can't reform it (e.g. cut back on what it does, see IVF thread), make it more efficient or opt out of it. I'm so glad the NHS exists.
This is one of the main reasons behind public sentiment in the U.S. being against government run healthcare. Starting to sound like Logan's Run.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 warn.
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.
“Forecasting 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.
http://www.telegraph.co.uk/health/healthnews/61275...
We can't reform it (e.g. cut back on what it does, see IVF thread), make it more efficient or opt out of it. I'm so glad the NHS exists.
http://www.youtube.com/watch?v=9NkoWIH8_wA&eur...
Jimbeaux said:
This is one of the main reasons behind public sentiment in the U.S. being against government run healthcare.
Talking of sentiment, the debate over here isn't exactly objective, with reason being swamped by the inevitable emotive elements who can't get anywhere without their glands on overdrive. They're helped on their way by big government nanny state knows best ideologues. So we had BBC Radio 2 painting a false picture of the 'health gap' in the USA being full of deserving but impoverished little children with wide eyes and sad faces, followed by what looked like selectivity in the calls taken on air - from Brits - swallowing it all. As a few US Forces people pointed out in interviews on non-state radio, there are significant numbers of young professional Americans who are electing not to buy the health insurance they can afford. Maybe USA PHers can add a bit more on this?Sorry to burst your bubble but this is rubbish.
It is often extremely difficult to determine exactly what is happening inside a persons body. This is why mis diagnosis happens. Bodies are as different on the inside as they are on the outside and its all hidden under the skin.
Yes, it is dubious to put "near death" cases on drugs and remove their medication. However it is just as dubious to keep someone alive when they are clearly beyond help or to divert resources to them that could be used on those more likely to recover.
This headline covers two very tricky judgements, firstly how sick is a person really and secondly how to allocate scarce or expensive treatment. Sometimes doctors will get one or both of these calls wrong but untill we get perfect diagnosis and infinite resources (i.e. never) its the best we're going to get.
It is often extremely difficult to determine exactly what is happening inside a persons body. This is why mis diagnosis happens. Bodies are as different on the inside as they are on the outside and its all hidden under the skin.
Yes, it is dubious to put "near death" cases on drugs and remove their medication. However it is just as dubious to keep someone alive when they are clearly beyond help or to divert resources to them that could be used on those more likely to recover.
This headline covers two very tricky judgements, firstly how sick is a person really and secondly how to allocate scarce or expensive treatment. Sometimes doctors will get one or both of these calls wrong but untill we get perfect diagnosis and infinite resources (i.e. never) its the best we're going to get.
Jimbeaux said:
This is one of the main reasons behind public sentiment in the U.S. being against government run healthcare. Starting to sound like Logan's Run.
That may well be what is driving sentiment in the US, but it really is daft. The problem of when to withdraw care or continue care is an unavoidable part of treating anyone in any healthcare system. To pretend that exactly the same decisions aren't made every day in the US would be to bury one's head in the sand.ATG said:
Jimbeaux said:
This is one of the main reasons behind public sentiment in the U.S. being against government run healthcare. Starting to sound like Logan's Run.
That may well be what is driving sentiment in the US, but it really is daft. The problem of when to withdraw care or continue care is an unavoidable part of treating anyone in any healthcare system. To pretend that exactly the same decisions aren't made every day in the US would be to bury one's head in the sand.turbobloke said:
900T-R said:
So it comes down to what you trust more - governments or private health insurance companies. Talk about a rock and a hard place... 
Or, an individual's ability to choose a provider (of whatever) and the freedom to exercise that choice.900T-R said:
turbobloke said:
900T-R said:
So it comes down to what you trust more - governments or private health insurance companies. Talk about a rock and a hard place...
Or, an individual's ability to choose a provider (of whatever) and the freedom to exercise that choice.
turbobloke said:
ATG said:
Jimbeaux said:
This is one of the main reasons behind public sentiment in the U.S. being against government run healthcare. Starting to sound like Logan's Run.
That may well be what is driving sentiment in the US, but it really is daft. The problem of when to withdraw care or continue care is an unavoidable part of treating anyone in any healthcare system. To pretend that exactly the same decisions aren't made every day in the US would be to bury one's head in the sand.ATG said:
turbobloke said:
ATG said:
Jimbeaux said:
This is one of the main reasons behind public sentiment in the U.S. being against government run healthcare. Starting to sound like Logan's Run.
That may well be what is driving sentiment in the US, but it really is daft. The problem of when to withdraw care or continue care is an unavoidable part of treating anyone in any healthcare system. To pretend that exactly the same decisions aren't made every day in the US would be to bury one's head in the sand.Grandfather of my American g/f has been 'close to death' with congestive heart failure and multiple other health issues for over a year now, according to those who have been treating him. He was worst around 2 months ago, and my g/f had been told by one of the nurses that they were giving him very high quantities of morphine.
2 months on, his health has improved, although he is still on similar quantities of medication.
Its pretty hard for me to understand quite how g/f feels as she's been through the whole cycle to accepting that her grandfather's death was imminent, back to being told he is improving.
This is all in California, so I've got to suggest it isn't just a UK issue, more to do with how people are living much longer with diseases and ailments that years back would not have been treated and would have lead to a swift death.
2 months on, his health has improved, although he is still on similar quantities of medication.
Its pretty hard for me to understand quite how g/f feels as she's been through the whole cycle to accepting that her grandfather's death was imminent, back to being told he is improving.
This is all in California, so I've got to suggest it isn't just a UK issue, more to do with how people are living much longer with diseases and ailments that years back would not have been treated and would have lead to a swift death.
If you believe any of this you are a complete idiot.
The consultants who posted this have a vested interest in feathering the nest of their own profession, and know that a few shock horror headlines are capable of swaying a gulible public. The same rubbish thats happening with opthalmology, dermatology etc in order to protect them from dwindling referrals, in a polyclinc primary care futured NHS.
Similar things are happening all over the NHS as doctors are asked to be managers and not doctors. We'll have adverts on TV next. Unfortunately this type of headline is specifically aimed at an american mentality, and unfortunately. when once upon a time we'd have laughed at the Americans for such rubbish, we are now starting to resemble them. We don't have any opinions formed which aren't given to us in playschool fashion by the telly. I bet American doctors are quaking in their boots that they will no longer be some of the highest earners in the US, and yelling that the NHS abuses, and neglects patients. The truth is the very opposite is likely to be true.
End of life decisions are very complex, and do not involve the 'prolong life at any cost is the only sensible route option'.
The decision for end of life should be made by the patient, their family and the medical staff that have actually taken the time to counsel them with regards to their wishes. Macmillan, ellenor, the local GP and family all have monthly meetings with regard to patients wishes at the end of life, and are in contact with the patient to the extent of the patients wishes. A lot of these patients could say, 'nope I want to have everything done and survive no matter what', and we do just that. Undeniably some patients will say no, I don't want treatment despite the fact you explain to them that medical treatment would be capable of prolonging their length and quality of life. You them have a difficult problem of deciding whether the patient is making an informed choice or under duress of depression or financial/family/culture.
You then do everything you can to protect the patients wishes within the legal framework in this country.
Alternatively we, as GP's could make the decision when someones near to the end of life, and automatically refer them to a consultant they've never met before for him to decide whats proper for the patient in a hospital clinic. Madness to think thats gonna improve granny time.
The consultants who posted this have a vested interest in feathering the nest of their own profession, and know that a few shock horror headlines are capable of swaying a gulible public. The same rubbish thats happening with opthalmology, dermatology etc in order to protect them from dwindling referrals, in a polyclinc primary care futured NHS.
Similar things are happening all over the NHS as doctors are asked to be managers and not doctors. We'll have adverts on TV next. Unfortunately this type of headline is specifically aimed at an american mentality, and unfortunately. when once upon a time we'd have laughed at the Americans for such rubbish, we are now starting to resemble them. We don't have any opinions formed which aren't given to us in playschool fashion by the telly. I bet American doctors are quaking in their boots that they will no longer be some of the highest earners in the US, and yelling that the NHS abuses, and neglects patients. The truth is the very opposite is likely to be true.
End of life decisions are very complex, and do not involve the 'prolong life at any cost is the only sensible route option'.
The decision for end of life should be made by the patient, their family and the medical staff that have actually taken the time to counsel them with regards to their wishes. Macmillan, ellenor, the local GP and family all have monthly meetings with regard to patients wishes at the end of life, and are in contact with the patient to the extent of the patients wishes. A lot of these patients could say, 'nope I want to have everything done and survive no matter what', and we do just that. Undeniably some patients will say no, I don't want treatment despite the fact you explain to them that medical treatment would be capable of prolonging their length and quality of life. You them have a difficult problem of deciding whether the patient is making an informed choice or under duress of depression or financial/family/culture.
You then do everything you can to protect the patients wishes within the legal framework in this country.
Alternatively we, as GP's could make the decision when someones near to the end of life, and automatically refer them to a consultant they've never met before for him to decide whats proper for the patient in a hospital clinic. Madness to think thats gonna improve granny time.
In the States they will bring you back from death as often as they can so they can charge you for it.
It's like breaking your leg while on holiday in Spain. They'll keep you in bed for two weeks, MRI your whole body, put in a femoral nail AND a stick on a Ilizarov external fixator, then bill your insurance company £150k.
In the UK you would get just the treatment you need and maybe a bit of MRSA thrown in for good measure. There's nothing like repeat business after all.
It's like breaking your leg while on holiday in Spain. They'll keep you in bed for two weeks, MRI your whole body, put in a femoral nail AND a stick on a Ilizarov external fixator, then bill your insurance company £150k.
In the UK you would get just the treatment you need and maybe a bit of MRSA thrown in for good measure. There's nothing like repeat business after all.
Fittster said:
900T-R said:
So it comes down to what you trust more - governments or private health insurance companies. Talk about a rock and a hard place...
Private health care makes money from live people, the government save money once you die.turbobloke said:
ATG said:
Jimbeaux said:
This is one of the main reasons behind public sentiment in the U.S. being against government run healthcare. Starting to sound like Logan's Run.
That may well be what is driving sentiment in the US, but it really is daft. The problem of when to withdraw care or continue care is an unavoidable part of treating anyone in any healthcare system. To pretend that exactly the same decisions aren't made every day in the US would be to bury one's head in the sand.This isn't some government plot to off the elderly.
mechsympathy said:
This isn't some government plot to off the elderly.
Quite.But. These independent quangos and committees are of course truly independent with no thought or concern for the wishes of those in government responsible for appointing the individuals leading them (and from there, on to the rest of the nodding dogs) while the largesse sometimes involved is immaterial to decisions taken even to the extent of those being appointed rarely having vastly different political and ideological beliefs, which unanimity is purely a coincidence. Also the guidelines are truly guidelines not recommendations or orders or anything like that. Fancy thinking otherwise, how absurd.
Gassing Station | News, Politics & Economics | Top of Page | What's New | My Stuff