Wednesday, September 9, 2009

UK Death Panels



Drudge links to two examples of the effects of the UK bureaucracy on a premature infant and an elderly man. In both cases, care is withheld. 
As a retired nurse, both scenarios make my blood boil. I cannot understand not trying to save life. I believe that there was a possibility to save the infant boy had he been given a chance by utilizing the technologies we have developed. It is costly to offer a newborn care in an intensive care unit and there was certainly a slim chance the baby would survive. Even minimal care of placing the baby in an incubator for warmth, monitoring the oxygenation levels and cardiac function would indicate that a thorough evaluation of prognosis could be made. Instead, the mother was told that due to the gestational age guidelines they would not attempt to save the baby's life.

http://www.dailymail.co.uk/news/article-1211950/Premature-baby-left-die-doctors-mother-gives-birth-just-days-22-week-care-limit.html

The second article describes a daughter's efforts to obtain care for her father after he suffered a stroke. Instead of continuing supportive care
and attempting rehabilitation, the father has had fluids discontinued. It appears the father is also getting sedation/pain killers that in the elderly cause confusion. The confusion appears to be a criteria of the bureaucracy that indicate a terminal state. The so called named terminal state may be induced by medication and then the "death panel dictates" are invoked. The man is fortunate that he has a daughter speaking for him but it sounds that he is written off as far as any meaningful intervention to return the man to a state compatible with life.

http://www.telegraph.co.uk/health/healthnews/6156076/Daughter-claims-father-wrongly-placed-on-controversial-NHS-end-of-life-scheme.htm

Will our health care system in the future use cost as the deciding factor in determining if an individual human is to be given a chance to live or simply allowed to die? Will "best effective care" deny fluids and have death hastened through the use of drugs such as Morphine which depress respiration, are not eliminated from the body because in dehydration the kidneys cannot eliminate the drugs and thus enhance the 
process of dying? Are all of us seniors looking at compassionate care or will we be deprived of life saving technologies that give a few more months or years with those we love and by whom we are loved and cherished.

In the early 90s,  I had a knee replacement and became confused by heavy duty pain medication. In 2001, I again was confused after being overmedicated following surgery.
I cannot help but wonder if I would have been determined to be terminal because my mind was not functioning clearly.

There truly does come a time, after we have exhausted our best efforts, that decisions do need to be made regarding discontinuing aggressive treatments. Basic human rights and common sense would indicate that decisions would be made by the patient (if able, or based on previous decisions made by the patient), family and attending physician.  I have no desire to be on a ventilator if I am unable to regain the ability to breathe on my own. I have a living will. My family and friends know that when I am unable to make decisions and have no reasonable hope of regaining a sentient state or being able to return to a stable physical state that I do not want treatments to prolong life. I do however want fluids and comfort measures used until God calls me home. 

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