For those who admire the British single-payer health care system—and that would include President Obama’s outgoing Medicare and Medicaid honcho Donald Berwick, but the doc is not alone in modern Washington—there is an interesting story in today’s U.K. Telegraph.


NHS must come clean over use of “death pathway”

It seems that every year “thousands” of patients in the U.K. are put on the benignly-named “Liverpool Care Pathway,” but neither they nor their families are told. The Liverpool Care Pathway is–in fact–the withdrawal of care:

It aims to give patients a 'good death' by avoiding unnecessary and burdensome medical intervention but there have been accusations it hastens death because it can involve the removal of artificial hydration and nutrition.

Unpack this: “unnecessary and burdensome” = expensive; “artificial hydration and nutrition” = hydration and nutrition delivered to patients who can no longer feed themselves; “good death”=dying of thirst.

But don’t worry, Nurse, your patients won’t be able to bother you by pressing the “help” button to beg for food and water:  

In addition to the withdrawal of fluid and medication, patients can be placed on sedation until they pass away. This can mean they are not fed and provided with water and has led to accusations that it hastens death

One report found that in one unnamed hospital the patients of half the families who were on the “death pathway” had not been consulted. The number of patients put on the “death pathway” has doubled in just two years—but think of the savings!

In fact, the Liverpool Care Pathway works so well that the program has expanded from its original purpose:

The Liverpool Care Pathway was intended for use in hospices but was given approval by the Department of Health in 2006 leading to widespread use in hospitals. Concerns about the pathway were raised first in The Daily Telegraph in 2009 when experts warned that in some cases patients have been put on the pathway only to recover when their families intervened, leading to questions over how people are judged to be in their “last hours and days.”

If Obamacare, which expands the role of government in your healthcare, along British lines, is not repealed or overturned, you may one day find yourself on the way to Liverpool.