People think she is stupid, they hope to repeat that until it's accepted as true like they did with Bush maybe... but her "death panel" comment was right on the money, right on the money for real... I never want a panel of bureaucrats overseeing my health care rationing or my death... how anybody can give up their freedoms for some freebie medical care is way beyond my thinking and always will be... and cost containment.. oh really? The Brits tripled their spending on health care in recent years and it's still being rationed, people are killed off and babies are born by the thousands outside the hospitals.. I'm not exaggerating.... those are the stories coming out of Britain... http://www.telegraph.co.uk/health/healthnews/6127514/Sentenced-to-death-on-the-NHS.html Sentenced to death on the NHS Patients with terminal illnesses are being made to die prematurely under an NHS scheme to help end their lives, leading doctors warn today. By Kate Devlin, Medical Correspondent Published: 10:00PM BST 02 Sep 2009 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across England to help doctors and medical staff deal with dying patients, they can then have fluid and drugs withdrawn and many are put on continuous sedation until they pass away.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 ânational crisisâ 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 Lukeâs cancer centre in Guildford, and four others. âForecasting death is an inexact science,âthey say. Patients are being diagnosed as being close to death âwithout regard to the fact that the diagnosis could be wrong. âAs a result a national wave of discontent is building up, as family and friends witness the denial of fluids and food to patients." The warning 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. The scheme, called the Liverpool Care Pathway (LCP), was designed to reduce patient suffering in their final hours. Developed by Marie Curie, the cancer charity, in a Liverpool hospice it was initially developed for cancer patients but now includes other life threatening conditions. It was recommended as a model by the National Institute for Health and Clinical Excellence (Nice), the Governmentâs 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. However, doctors warn that these signs can point to other medical problems. Patients can become semi-conscious and confused as a side effect of pain-killing drugs such as morphine if they are also dehydrated, for instance. When a decision has been made to place a patient on the pathway doctors are then recommended to consider removing medication or invasive procedures, such as intravenous drips, which are no longer of benefit. If a patient is judged to still be able to eat or drink food and water will still be offered to them, as this is considered nursing care rather than medical intervention. Dr Hargreaves said that this depended, however, on constant assessment of a patientâs condition. He added that some patients were being âwronglyâ put on the pathway, which created a âself-fulfilling prophecyâ that they would die. He said: âI have been practising palliative medicine for more than 20 years and I am getting more concerned about this âdeath pathwayâ that is coming in. âIt is supposed to let people die with dignity but it can become a self-fulfilling prophecy. âPatients who are allowed to become dehydrated and then become confused can be wrongly put on this pathway.â He added: âWhat they are trying to do is stop people being overtreated as they are dying. âIt is a very laudable idea. But the concern is that it is tick box medicine that stops people thinking.â He said that he had personally taken patients off the pathway who went on to live for âsignificantâ amounts of time and warned that many doctors were not checking the progress of patients enough to notice improvement in their condition. Prof Millard said that it was âworryingâ that patients were being âterminallyâ sedated, using syringe drivers, which continually empty their contents into a patient over the course of 24 hours. In 2007-08 16.5 per cent of deaths in Britain came about after continuous deep sedation, according to researchers at the Barts and the London School of Medicine and Dentistry, twice as many as in Belgium and the Netherlands. âIf they are sedated it is much harder to see that a patient is getting better,â Prof Millard said. Katherine Murphy, director of the Patients Association, said: âEven the tiniest things that happen towards the end of a patientâs life can have a huge and lasting affect on patients and their families feelings about their care. âGuidelines like the LCP can be very helpful but healthcare professionals always need to keep in mind the individual needs of patients. âThere is no one size fits all approach.â A spokesman for Marie Curie said: âThe letter highlights some complex issues related to care of the dying. âThe Liverpool Care Pathway for the Dying Patient was developed in response to a societal need to transfer best practice of care of the dying from the hospice to other care settings. âThe LCP is not the answer to all the complex elements of this area of health care but we believe it is a step in the right direction.â The pathway also includes advice on the spiritual care of the patient and their family both before and after the death. It has also been used in 800 instances outside care homes, hospices and hospitals, including for people who have died in their own homes. The letter has also been signed by Dr Anthony Cole, the chairman of the Medical Ethics Alliance, Dr David Hill, an anaesthetist, Dowager Lady Salisbury, chairman of the Choose Life campaign and Dr Elizabeth Negus a lecturer in English at Barking University. A spokesman for the Department of Health said: âPeople coming to the end of their lives should have a right to high quality, compassionate and dignified care. "The Liverpool Care Pathway (LCP) is an established and recommended tool that provides clinicians with an evidence-based framework to help delivery of high quality care for people at the end of their lives. "Many people receive excellent care at the end of their lives. We are investing £286 million over the two years to 2011 to support implementation of the End of Life Care Strategy to help improve end of life care for all adults, regardless of where they live.â