From The Times:
Daughter saves mother, 80, left by doctors to starve
AN 80-year-old grandmother who doctors identified as terminally ill and left to starve to death has recovered after her outraged daughter intervened.
Hazel Fenton, from East Sussex, is alive nine months after medics ruled she had only days to live, withdrew her antibiotics and denied her artificial feeding. The former school matron had been placed on a controversial care plan ["care plan" having a rather loose meaning here] intended to ease the last days of dying patients.
Doctors say Fenton is an example of patients who have been condemned to death on the Liverpool care pathway plan. They argue that while it is suitable for patients who do have only days to live, it is being used more widely in the NHS, denying treatment to elderly patients who are not dying. [Get that? Read it again.]
Fenton’s daughter, Christine Ball, who had been looking after her mother before she was admitted to the Conquest hospital in Hastings, East Sussex, on January 11, says she had to fight hospital staff for weeks before her mother was taken off the plan and given artificial feeding.
Ball, 42, from Robertsbridge, East Sussex, said: “My mother was going to be left to starve and dehydrate to death. It really is a subterfuge for legalised euthanasia of the elderly on the NHS. ”
Fenton was admitted to hospital suffering from pneumonia. Although Ball acknowledged that her mother was very ill she was astonished when a junior doctor told her she was going to be placed on the plan to “make her more comfortable” in her last days.
Ball insisted that her mother was not dying but her objections were ignored. A nurse even approached her to say: “What do you want done with your mother’s body?”
On January 19, Fenton’s 80th birthday, Ball says her mother was feeling better and chatting to her family, but it took another four days to persuade doctors to give her artificial feeding.
Fenton is now being looked after in a nursing home five minutes from where her daughter lives.
Peter Hargreaves, a consultant in palliative medicine, is concerned that other patients who could recover are left to die. He said: “As they are spreading out across the country, the training is getting probably more and more diluted.”
A spokesman for East Sussex Hospitals NHS Trust, said: “Patients’ needs are assessed before they are placed on the [plan]. Daily reviews are undertaken by clinicians whenever possible.” [Sooo…. daily reviews are not always possible?]
In a separate case, the family of an 87-year-old woman say the plan is being used as a way of giving minimum care to dying patients.
Susan Budden, whose mother, Iris Griffin, from Norwich, died in a nursing home in July 2008 from a brain tumour, said: “When she was started on the [plan] her medication was withdrawn. As a result she became agitated and distressed.
“It would appear that the [plan] is . . . used purely as a protocol which can be ticked off to justify the management of a patient.”
Deborah Murphy, the national lead nurse for the care pathway, said: “If the education and training is not in place, the [plan] should not be used.” She said 3% of patients placed on the plan recovered.
One of the important points to remember is that food and water are not medicine. A person is a vegetative state remains a human being with the need for what is basic to human life. If people see food and water as medicine, as if that person was receiving them as if they were therapy, then you can more easily argue for their denial. Of course there are situations in which adminstering food and water actually harm a person more than they help. Then hard decisions must be made.
But never forget, and keep yourselves attuned to the basic principles. If food and water are seen as therapy for a bad condition, they can be more easily denied. That is the fundamental error being made in many cases. That is why this statement, the response from the CDF, is so important.
Review THIS. An excerpt about people in persistent vegetative state who are given this "treatment":
So, as you lie there, what is going on in your body? When your body’s fluid supply is severely depleted (because you are taking none in) and down by around 15%, hypovolemic shock or "physical collapse" occurs, that is, your blood supply gets lower and lower until you don’t have enough blood volume to function.
Your skin becomes pale and clammy. Your heart starts to race and your breathing becomes rapid and shallow. Unless you get water soon, it will get harder and harder to reverse your condition. You soon desperately need medical care. Your blood pressure drops so low that sometimes it can’t be detected at all. Then your extremities become blotchy and mottled as your body starts to shut down the periphery, shunting an ever-decreasing volume of available blood to the core, the heart and vital organs.
If you are conscious, your thirst is agony. Your temperature rises and when it hits 107°F (41.7°C), it starts to damage your brain and other organs. Your lips and tongue crack. Your nose bleeds from the dryness of the mucous membranes. You are wracked with pain from the heaving and attempts to vomit. You can’t tell anyone how much you are suffering. Since those around you don’t see your suffering, they think you must not have any pain. This appears to be "merciful."
This is how they purposely kill helpless people. Let dehydration happen to a football player during practice on a hot summer day and everyone goes crazy, pointing fingers and making accusations, filing lawsuits and suing everyone in sight. But this is done daily in the USA and other countries to people who are otherwise healthy, and simply need the love and care that any person with a disability needs. Lock a horse in a stall without food and water and you will go to jail.
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The thing I really don’t understand is how they can justify removal of food, water and meds as “humane.” I suppose this is just a precursor to them trying to legalize lethal injections for the elderly as more reasonable.
Even their euphemisms are euphemisms: “euthanasia” means “a good death” (to a Catholic that should include the presence of a priest, a good confession, anointing, and viaticum maybe with family gathered around), but there’s nothing good about this!
Margaret: Ezekiel Emanuel and other health care advisers for President Obama have advocated similar plans for the elderly. The reason they can do so is they do not view full human dignity as something intrinsic. Rather it is a status to be achieved and a status that can be lost. Therefore, Dr. Emanuel, Tom Dashcle and others who will serve on the Health Care Advisory Benefits council view the elderly, disabled, unborn, etc. as somehow sub-human. They see the level of “humane” care due these vulnerable segments of our population as less than that due the able bodied. Of course we know this is contrary to Catholic moral principles and contrary to Natural Law.
I had to intervene for my mother to be sure her end of life was justly respected. I have friends who have had to intervene for their “adversely diagnosed” infants. A human person, no matter the age, must be treated with respect – given nourishment, treatment, authentic compassion. “Do you not know you are a temple of the Holy Spirit?” NOT a burden to resources, and NOT a bottom line.
I can live without Obama’s version of compassion. A lot of people could.
The Culture of Death is just making it’s logical trajectory…first the unborn, the handicapped, the infirm…and now, the elderly. Maybe BO would like to go to a hospice and just die (as he said recently regarding this issue) but that is not what “health care” should mean, for anyone.
Let’s pray this nation wakes up and “smells the coffee”. Otherwise, it’s gonna be a “bumpy ride”…
…after medics ruled she had only days to live, withdrew her antibiotics and denied her artificial feeding.
Sarah Palin was savaged by the Left and the MSM for her “death panels” comment. While her rhetoric was over the top, she was basically correct as this story indicates. Granted, this story occurred in the UK, but with Obamacare, it is coming to a medical care facility near you.
Denise has it exactly right. When government and its so-called health care systems are run by those who lack spiritual direction and who, day to day, play god in all they do, this is the only outcome to logically expect. It is all about man, all about comfort, all about convenience…for them. None of it is about God or the sanctity of life. Given today’s vote in the Senate as Brian Day said this type of obamination will be here in the USA shortly.
Im not justifying this horrible story, but people seem to forget there are many terrible stories on this side of the pond. There already IS health care rationing going on in the US, and my grandmother was one of those left out because of her means- and she suffered and died prematurely. Perhaps sending the working poor to early deaths seems acceptable to some as long as we don’t get “socialized health care.” Not to me.
I am a physician who cares for a large number of elderly people and who, in the 1980s and early 90s cared for a large number of AIDS patients. For better or for worse, the Lord has put me in the position of having the opportunity to serve a lot of people at the end of their lives.
I am in total agreement with all of the above statements regarding state sponsered euthanasia. And there is no questions that Dr. Emmanuel’s writings can be terrifying.
However, there comes a time in everyone’s life when they are going to die. While that time is God’s decision, it is not unusual for the situation to be reached where continuing to treat with medications (for example, cancer chemotherapy or antibiotics) is clearly futile and when the mechanisms to deliver them (central intravnous catheters, nasogastric tubes etc.) cause more pain and discomfort than benefit. That is the original purpose of hospice – CARE at the end of life.I would agree that nutrition and hydration should not be withdrawn to hasten death. There are times, however, when continuing to try to provide them are more likely to cause pain and suffering than withholding them.
The best decision making occurs when the patient made his/her wishes known while they still could, the family understands the patient’s wishes, the physican has provided accurate prognostic information, and adequate spiritural and physical support is available to the patient and the family.
For me, at least, providing care at the end of life is one of the hardest and most rewarding parts of my practice
Richard,
I too am a physician. I have also completed extensive training in Catholic bioethics and teach classes on end of life care. There are a couple of principles to keep in mind when discussing end of life care. The first is that one must distinguish between ordinary or proportionate care and extraordinary or disproportionate care. This decision is made from the perspective of the patient(or the patient’s surrogate) in consultation with his health care providers. A given therapy can be judged too burdensome in light of the level of benefit it provides. That therapy can then be deemed extraordinary care and discontinued. This is done on a case by case basis. On the other hand, no life can be judged too burdensome. It is erroneous to conclude that someone would be better off dead because their life is a burden. A more detailed discussion is here.
Suffering can be a great means of purification for the soul. Artifically inducing suffering however is a mortification of the body and is never allowed. We should always look to provide for the body’s needs while it is alive. The church teaches that our bodies are temples of the holy spirit. We should always think about taking the best care of it possible. If drugs or procedures will prolong life, but as a side effect MAY produce some suffering, then as Catholics, we should accept that suffering as a grace sent by God. Suffering is our means to attone for our sins and those of others. It is the means through which God gives us the ability to perfect our love for him.
Sometimes it is harder for the healthy to help some one who is suffering. It is easier for us to think that killing them (through removal of the means to keep the body alive) is merciful. However the opposite is true. We will then become the direct cause of the persons death (in essence; murder). We should never force someone to choose suffering versus “being made comfortable”, but to suggest to someone that removal of care of the body is a better option than suffering is to interrupt the grace that God may be giving the person.
How many of the greatest saints endured much suffering to get souls to heaven (including their own). It is better to die a painful death than to commit even a venial sin. As good Catholics we should try to heal the body while also reducing pain if possible. When it is not possible then it is our duty to comfort the sick, to be near them and support them, to pray with them, but never to abandom them.
Denise,
I agree completly.
moon1234,
You said “When it is not possible then it is our duty to comfort the sick, to be near them and support them, to pray with them, but never to abandom[sic] them.” Again, I totally agree.
Few of my patients are Catholic and while I would never euthanize a patient or assist in a suicide, many patients that I attend do not see suffering as redeeming and wish comfort as a primary goal. I work with the patient and/or surrogate to try to fulfill the patient’s wishes and goals. To me, that is the heart of compassion. (Matt. 25:35)
There is a story this week about a man who was diagnosed with a recurrence of stomach cancer in the UK. He was put into the same pathway to death plan. He was denied food and water and died quickly. After his death subsequent test results indicated he did NOT have a recurrence of stomach cancer. B***ards. Sorry. I am to be a lady. Sometimes we are challenged to maintain composure.
Hi Richard,
I understand your reasoning, but we are also called to be a witness to the faith, to spread the faith. I understand that when workinging in a public setting it can be difficult to practice one’s faith. However, sometimes sitting and praying with a person can make even the worst pain bearable. It helps to focus the sufferers attention on God instead of himself.
I sorely wish that many priests would still make rounds at hospitals. They are such a comfort to the sick, even to those who are not Catholic. Just to see a priest in cassok in a hospital is a witness that Christ is present to comfort the dying (If they are truely dying).
Do doctors still take an oath to do no harm? Do they truely believe and uphold the oath they take? If they take the oath do many see it just as an old fashioned step that is necessary to get a degree?
Richard and Denise: great posts. I received a very excellent background in bioethics in my seminary training and the issue is really what is ordinary care and what is extraordinary care (which can be painful and useless to a dying patient). Your patients are very blessed to have you as their physicians; I come from a medical family, father a doctor, mother a nurse, and so I am familiar with all of this. My prof, a Msgr, for our Anointing of the Sick and Care of the Dying Class made a very special appeal to us: be present to the dying;only a priest can give what that individual really needs, what the family needs, at that moment. It has made a BIG impression upon me; I’d drive miles to anoint a dying person or to give viaticum. Both medical and priestly care are needed at this time. My prof even eluded to a connection between the physician and the priest (which was very interesting to me as a son of a doctor!)
Thank you Fr. John.
One way I find the right path is to ask “What can I do to this patient and what can I do for this patient?” Given today’s technology, the answers are not always the same. It helps me to get perspective on the right thing to do.
It is important to remember that all we do is channel the healing power of God: “Honor the physician … for the Lord created him, for healing comes from the Most High” (Sirach 38:1).
I hope moon1234 does not think I am not trying to witness to my faith but not all patients share our world/life view (For example, some Jewish patients are uncomfortable with the crucifix on the wall at the local Catholic hospital.) It is my take on the Gospel message that my job is to care for my patient, just as Jesus healed the Samaritan leper without asking him to convert to Judiasm. If I am wrong and Jesus doesn’t want me to meet patients where they are, ease their suffering according to my powers and within their expressed wishes (without violating my oath as a physician or beliefs as a Catholic Christian)then I am (a)confused about Matt. 25:35 and (b)sure I will hear about it when I face Him (Matt 25:41-46)
Oregon, in the States, allows “assisted suicide”
The ultimate reality, end-game, of “assisted suicide” is killing those who are a “nuisance” to society. It’s a slippery-slope which the liberal “intelligencia” are ignorant fools about….
Malta–the state of Washington recently passed an assisted suicide law similar to Oregon’s—just FYI.
Daniel Hannan, a Conservative MEP from South England, has pointed out that the British NHS is the third largest employer in the world.
In. the. world. It is behind only the army of communist China and the government-run rail system in India in its size. It takes up an
enormous percentage of the nation’s GDP, more than the nation’s military expenditures. And this is what the British get for all that?
The best care solution that Leviathan can come up with for Mrs. Fenton is to starve her to death?
We would be wise to look at what is happening with the 60 year old NHS. As MEP Hannan points out, the bloated bureaucracy of the
NHS is an enormously powerful voting bloc, and no one in the UK has the political wherewithal to reform or streamline it. The
people of Britain are, in effect, its prisoners. Can we be sure that our health care “reforms” will preclude that fate from being ours also?
I believe that we must be concerned that that is precisely what is behind this rush to pass health care legislation that no lawmaker
seems to have read or to understand. Rather than a sensible series of incremental reforms, relatively affordable and relatively easy to
scrap if ineffective, we have the impending descent of the bureaucratic Mothership. What has not been addressed in the press has
been the indisputable fact that this new bureaucracy will be the giant lapdog of the party that brought it into the house and feeds it.
It will be an enormously powerful voting bloc, dwarfing Planned Parenthood, the teacher’s unions, and the SIEC.
Am I reasonable here, or do I need to be fitted for my tinfoil hat?
Richard, I understand your point about end of life care and withdrawing medicine but withdrawing pain medication, medication that alleviates symptoms like swelling or in the case of someone who is mentally ill, medicine that gives them relief from anxiety or a disordered mental state “because they no longer need it” is just plain cruel, along with depriving them of food or water.
MargaretMN, I’ve reread Richard’s posts and I don’t see where he wrote that doctors should cease palliative care for the dying.
Did I miss something?
US readers would do well to study what has happened to the NHS here in the UK. Nowadays there is considerable political involvement in health planning (to cite one example, vast expenditure on questionably valuable antiviral drugs to combat the Great Plague i.e. H1N1). Equally noticeable is the contemporary reliance on managerially drafted codes of practice and quasi-judicial review procedures to replace old-fashioned reliance on professional judgment and conscience. Currently the service is beset by legalism and fundamentalism. This is a reflection on developments in wider society.
Clinton
You did not miss anything in my posts. Thanks.
Please consider reading this link for the terrible story that gave rise to the following law in the UK:
“The Mental Capacity Act (2005) for England and Wales, has enshrined in statute law the idea that assisted food and fluids should be considered as medical treatment that could be withdrawn.”
This time of harassment is not new. In 1991, I was with friends in a hospital in Portsmouth, when feeding tubes were removed from the brother of a friend of mine. I tried to argue with the doctors, as my friend was too upset and emotional to make any decisions about her brother. Another friend of hers was agreeing with the doctors that food and water were excessive. The man was starved to death and he was only in his 50s. He had been in an accident and was breathing on his own, but in a coma.
Being in a coma was considered a death sentence for this other wise very healthy man.
Here is the point in the post that I was responding to: “Susan Budden, whose mother, Iris Griffin, from Norwich, died in a nursing home in July 2008 from a brain tumour, said: “When she was started on the [plan] her medication was withdrawn. As a result she became agitated and distressed.”
Here is what Richard said: “However, there comes a time in everyone’s life when they are going to die. While that time is God’s decision, it is not unusual for the situation to be reached where continuing to treat with medications (for example, cancer chemotherapy or antibiotics) is clearly futile and when the mechanisms to deliver them (central intravnous catheters, nasogastric tubes etc.) cause more pain and discomfort than benefit.”
I can accept that at some point treating a condition may be futile or even cause more discomfort than leaving the condition untreated. And that may be morally the right choice at the end of life. But what if it’s not? I’d rather that the decision be made about the individual’s particular case rather than instituting some DNR, withdraw all meds protocol. “Palliative” is a much broader category than pain meds, although it does include that.
Childermass,
I’d be very interested to hear more details about your grandmother, God rest her soul. I was under the impression that medical treatment necessary to sustain life could not be withheld (by law) on the basis of a patient’s ability to pay..
As this apparently did not happen, perhaps this should be the first thing addressed by any proposed “health care reform”. Either enfoce, strengthen, or legislate laws to prevent what you describe.
We have to get on top of the culture of death; contraception, abortion, sterilization and euthanasia. This is a spiritual battle. Pray for the Holy Souls in Purgatory and then ask their intercession to bring an end to the culture of death. You won’t wake up the next morning and see the culture of death ended. There will be a gradual process until things are greatly improved.
Help the Holy Souls in Purgatory and gain their help as well in fighting the culture of death.
http://missionbell.homestead.com/Afavourgrantedbytheholysouls.html
http://www.dailymail.co.uk/news/article-1219853/My-husband-beaten-cancer-doctors-wrongly-told-returned-let-die.html This is another example of the ‘Culture of Death’ in my country. The widow was paid £18,000 compensation when her husband died, but the hospice deny any responsibility! this stuff cannot be hidden behind smokescreens of so called care. It’s outright murder. My own mother had cancer and a stroke over 20 years ago in England. She assured me she was in no pain but they gave her morphine. When I argued with them I was asked ‘how long can your father go on with this?’ (My father was quite frail at that time) I told them my father wasn’t their patient, my mother was! The drip feed they had her on ‘accidentally’ came out. It was never replaced and she died a few days later. I know she was dying but there was no need to hurry her along. She was terrified this would happen to her and I couldn’t stop them. Please pray for the medical staff that did this to her.