Sunday, July 8, 2012
Subject: British Health Service Euthanizes 130,000 Patients a Year
Wednesday, 20 June 2012 18:30
Doctor: British Health Service Euthanizes 130,000 Patients a Year
Written by Michael Tennant
The British National Health Service (NHS) — the epitome of socialized medicine — may be prematurely ending the lives of as many as 130,000 elderly patients annually, a top physician told the Royal Society of Medicine in London. Patrick Pullicino, a consultant neurologist for East Kent Hospitals and professor of clinical neurosciences at the University of Kent, said a controversial end-of-life care method called the Liverpool Care Pathway (LCP) now used in British hospitals has become an “assisted death pathway rather than a care pathway,” according to a report in the Daily Mail.
“If we accept the Liverpool Care Pathway we accept that euthanasia is part of the standard way of dying as it is now associated with 29 per cent of NHS deaths,” Pullicino declared, referring to statistics showing that of the 450,000 annual deaths of patients under NHS care, about 130,000 are of patients who were on the LCP.
The Mail offers a brief history of the LCP:
“If we accept the Liverpool Care Pathway we accept that euthanasia is part of the standard way of dying as it is now associated with 29 per cent of NHS deaths,” Pullicino declared, referring to statistics showing that of the 450,000 annual deaths of patients under NHS care, about 130,000 are of patients who were on the LCP.
The Mail offers a brief history of the LCP:
The Liverpool Care Pathway was first developed at a Marie Curie [Cancer Care] hospice in the city with the intention of making the last days and hours of cancer sufferers as decent and painless as possible.
It rapidly became fashionable: recognized as a model for the NHS in 2001; approved by NICE [the National Institute for Health and Clinical Excellence, which rations care on a cost-benefit basis] as a recommended practice in 2004; and a 2006 health white paper said it should be adopted across the country. Its use spread from cancer sufferers to all patients. Doctors are supposed to identify a patient who is bound to die in the near future.
The plan then can include withdrawal of treatment, including the provision of water and nourishment by tube. Patients are typically heavily sedated.
It rapidly became fashionable: recognized as a model for the NHS in 2001; approved by NICE [the National Institute for Health and Clinical Excellence, which rations care on a cost-benefit basis] as a recommended practice in 2004; and a 2006 health white paper said it should be adopted across the country. Its use spread from cancer sufferers to all patients. Doctors are supposed to identify a patient who is bound to die in the near future.
The plan then can include withdrawal of treatment, including the provision of water and nourishment by tube. Patients are typically heavily sedated.
The LCP’s quick adoption by the NHS and NICE represented “euthanasia by the back door,” in the words of the Telegraph’s Gerald Warner. “In 2007–08,” he wrote, “16.5 percent of deaths in Britain resulted from continuous deep sedation — twice the rate of the Netherlands with its notorious culture of death and legalized euthanasia.”
Since that time the percentage of deaths due to the LCP has increased by 75 percent, with no signs of slowing. Indeed, with the NHS “heading for an iceberg” (as NHS Confederation chief executive Mike Farrar put it) of unsustainable costs, the LCP death percentage is likely to grow even more rapidly. It costs far less, after all, to give a patient morphine for a day or two — death occurs on average within 33 hours of beginning the LCP — than to treat his condition for the remainder of his natural life, which could last for months or even years. Pullicino, according to the Mail, recalled taking a 71-year-old patient off the LCP, after which the man lived another 14 months, mostly at home, “at considerable cost to the NHS and the taxpayer.” (He died after being admitted to the hospital for pneumonia and put back on the LCP.)
Other doctors have recounted similar experiences. Dr. Peter Hargreaves, a consultant in palliative medicine at St. Luke’s Cancer Center in Guildford, told the Telegraph in 2009 that “he had personally taken patients off the pathway who went on to live for ‘significant’ amounts of time.”
Hargreaves worried that the LCP could “become a self-fulfilling prophecy” because doctors would make the determination as to which patients were likely to die and then, by withdrawing lifesaving treatment and heavily sedating them, guarantee that they would die. As Hargreaves and other experts put it in a letter to the Telegraph, “Forecasting death in an inexact science,” and “sometimes, when all but essential drugs are stopped, ‘dying’ patients get better.”
In fact, Hargreaves noted, some patients may exhibit signs of dying when their bodies are merely reacting to sedation combined with dehydration and then “be wrongly put on the pathway.” Once a patient is sedated under the LCP, University of London geriatrics professor P.H. Millard told the Telegraph, “it is much harder to see that a patient is getting better.”
Pullicino echoed many of these sentiments, saying that “patients are frequently put on the pathway without a proper analysis of their condition,” that “predicting death” at a specific time “is not possible scientifically,” and that, as a result, “very likely many patients who could live substantially longer are being killed by the LCP.”
He cited “pressure on beds” — which is to say the inevitable shortage of care under socialized medicine — and “difficulty with nursing confused or difficult-to-manage elderly patients” as reasons that the LCP has become so widely employed by the NHS. In other words, it’s much cheaper and easier to bump old people off than to treat them. Who’s going to know which ones might have recovered and enjoyed a few more years with their children and grandchildren?
No one should be surprised that government-run healthcare kills people. All socialist systems end up rationing whatever goods and services they have to offer; and when you’re rationing healthcare, the most vulnerable patients are going to suffer the most. The only surprising thing is that there are still people who think socialized medicine is a dandy idea — among them President Barack Obama, who said multiple times that he wanted a “single-payer universal healthcare program”; his Secretary of State, who once tried to foist such a system on Americans; and his former Centers for Medicare and Medicaid Services director, Dr. Donald M. Berwick, who declared his undying love for the NHS. Who, then, could doubt that ObamaCare’s purpose is to put the American healthcare system on the LCP — and when the system finally keels over, to convert the United States to a single-payer system and the “death panels” that such a system invariably entails?
Since that time the percentage of deaths due to the LCP has increased by 75 percent, with no signs of slowing. Indeed, with the NHS “heading for an iceberg” (as NHS Confederation chief executive Mike Farrar put it) of unsustainable costs, the LCP death percentage is likely to grow even more rapidly. It costs far less, after all, to give a patient morphine for a day or two — death occurs on average within 33 hours of beginning the LCP — than to treat his condition for the remainder of his natural life, which could last for months or even years. Pullicino, according to the Mail, recalled taking a 71-year-old patient off the LCP, after which the man lived another 14 months, mostly at home, “at considerable cost to the NHS and the taxpayer.” (He died after being admitted to the hospital for pneumonia and put back on the LCP.)
Other doctors have recounted similar experiences. Dr. Peter Hargreaves, a consultant in palliative medicine at St. Luke’s Cancer Center in Guildford, told the Telegraph in 2009 that “he had personally taken patients off the pathway who went on to live for ‘significant’ amounts of time.”
Hargreaves worried that the LCP could “become a self-fulfilling prophecy” because doctors would make the determination as to which patients were likely to die and then, by withdrawing lifesaving treatment and heavily sedating them, guarantee that they would die. As Hargreaves and other experts put it in a letter to the Telegraph, “Forecasting death in an inexact science,” and “sometimes, when all but essential drugs are stopped, ‘dying’ patients get better.”
In fact, Hargreaves noted, some patients may exhibit signs of dying when their bodies are merely reacting to sedation combined with dehydration and then “be wrongly put on the pathway.” Once a patient is sedated under the LCP, University of London geriatrics professor P.H. Millard told the Telegraph, “it is much harder to see that a patient is getting better.”
Pullicino echoed many of these sentiments, saying that “patients are frequently put on the pathway without a proper analysis of their condition,” that “predicting death” at a specific time “is not possible scientifically,” and that, as a result, “very likely many patients who could live substantially longer are being killed by the LCP.”
He cited “pressure on beds” — which is to say the inevitable shortage of care under socialized medicine — and “difficulty with nursing confused or difficult-to-manage elderly patients” as reasons that the LCP has become so widely employed by the NHS. In other words, it’s much cheaper and easier to bump old people off than to treat them. Who’s going to know which ones might have recovered and enjoyed a few more years with their children and grandchildren?
No one should be surprised that government-run healthcare kills people. All socialist systems end up rationing whatever goods and services they have to offer; and when you’re rationing healthcare, the most vulnerable patients are going to suffer the most. The only surprising thing is that there are still people who think socialized medicine is a dandy idea — among them President Barack Obama, who said multiple times that he wanted a “single-payer universal healthcare program”; his Secretary of State, who once tried to foist such a system on Americans; and his former Centers for Medicare and Medicaid Services director, Dr. Donald M. Berwick, who declared his undying love for the NHS. Who, then, could doubt that ObamaCare’s purpose is to put the American healthcare system on the LCP — and when the system finally keels over, to convert the United States to a single-payer system and the “death panels” that such a system invariably entails?
Thursday, July 5, 2012
Tuesday, July 3, 2012
Roberts and Intimidation
Given how many more Americans define themselves as conservative than as liberal, let alone than as left, how does one explain the success of left-wing policies?
One answer is the appeal of entitlements and a desire to be taken care of. It takes a strong-willed citizen to vote against receiving free benefits. But an even greater explanation is the saturation of Western society by left-wing hate directed at the Right. The Left’s demonization, personal vilification, and mockery of its opponents have been the most powerful tools in its arsenal for a century.Since Stalin labeled Leon Trotsky — the man who was the father of Russian Bolshevism! — a “fascist,” the Left has cast its ideological opponents as evil. And when you control nearly all of the news media and the schools, that labeling works.
The liberal media even succeeded in blaming the right wing for the assassination of President John F. Kennedy, even though his assassin, Lee Harvey Oswald, was a pro-Soviet, pro-Castro Communist. Similarly, just one day after a deranged man, Jared Loughner, attempted to kill Congresswoman Gabrielle Giffords and murdered six people in the process, New York Times columnist Paul Krugman wrote that it was right-wing hate that had provoked Loughner: “It’s the saturation of our political discourse — and especially our airwaves — with eliminationist rhetoric that lies behind the rising tide of violence. Where’s that toxic rhetoric coming from? Let’s not make a false pretense of balance: it’s coming, overwhelmingly, from the right.”
Krugman made it all up. But what matters to most of those who speak for the Left is not truth. It is destroying the good name of its opponents. That is the modus operandi of the Left.
It works.
Two examples in the last month bear testimony to its efficacy. One was the overwhelmingly likely motivation of Chief Justice John Roberts to declare the Obamacare individual mandate constitutional despite his ruling that, as passed, the mandate was in fact unconstitutional.
The other was an op-ed column that David Blankenhorn, the prominent conservative advocate for marriage and against same-sex marriage, wrote for the New York Times.
First Blankenhorn.
David Blankenhorn has committed his professional life to fighting for the institution of marriage. As recently as 2010, he testified on behalf of California Proposition 8, which, in 2008, amended the California constitution to define marriage as the union of one man and one woman — and which was immediately challenged in the courts, where liberal judges overturned it.
Blankenhorn was vilified throughout the liberal and gay media (which, in their invective against proponents of retaining the man-woman definition of marriage, are indistinguishable). As Mark Oppenheimer, editor of the “Beliefs” column in the New York Times, wrote: “During the trial [over the constitutionality of Proposition 8] and in the immediate aftermath, Blankenhorn became a national figure; he was . . . the butt of ridicule. . . . And now, he has decided to give up that fight.
“Blankenhorn would be ridiculed in the New York Times, and he would be . . . [ridiculed] in a play by an Oscar-winning screenwriter, starring a bevy of Hollywood stars.”
Blankenhorn told Oppenheimer: “I had an old community organizing buddy who wrote a note to me after the trial and said how does it feel to be America’s most famous bigot? I used to think you were a good person. Now I know you’re a bad person. How does it feel to know that your tombstone will read that you’re just a bigot?”
Two weeks ago, Blankenhorn wrote an op-ed piece for the New York Times in which he announced that he now supports same-sex marriage.
As for Justice Roberts, he and his conservative colleagues on the Supreme Court have been the targets of media and academia vitriol and personal invective for years, and in some cases decades. But while his conservative colleagues don’t care, Justice Roberts does.
As reported by CBS News: “Some of the conservatives, such as Justice Clarence Thomas, deliberately avoid news articles on the Court when issues are pending. . . . They’ve explained that they don’t want to be influenced by outside opinion or feel pressure from outlets that are perceived as liberal.
“But Roberts pays attention to media coverage. As Chief Justice, he is keenly aware of his leadership role on the Court, and he also is sensitive to how the Court is perceived by the public. [“The public” means liberal media and academics.]
“There were countless news articles in May warning of damage to the Court — and to Roberts’s reputation — if the Court were to strike down the mandate.
“Some even suggested that if Roberts struck down the mandate, it would prove he had been deceitful during his confirmation hearings, when he explained a philosophy of judicial restraint.”
David Blankenhorn’s change — he has admitted he is tired of fighting the culture wars, and he has gone from being the object of New York Times derision to being a New York Times hero — and Justice Roberts’s change — New York Times columnist Thomas Friedman wrote a column lauding Roberts for his “statesmanship” — reassure progressives that ridicule, demonization, and character assassination work. With the stakes so high in the forthcoming election, expect it to only increase.
The Obama Foreign Policy
The 2012 election will hinge on the economy, not on U.S. foreign policy, unless there is a major overseas crisis — an Israeli attack on Iran, an Iranian detonation of a nuclear weapon, a Middle East war, a North Korean attack, or something of that sort. That said, there is much to lament in the current administration’s foreign policy. But Mitt Romney should be careful in critiquing the status quo, given that it is full of paradoxes and contradictions.
The war on terror? Forget the absurd euphemisms like “overseas contingency operations” and “man-caused disasters,” the hypocrisy of railing against waterboarding three known terrorists while blowing up over 2,000 suspected terrorists (and anyone near them), and the half-hearted efforts of both using and trying to close Guantanamo and envisioning Khalid Sheikh Mohammed in a civilian court. What Obama said he wanted to do and what he actually did do are quite different things. In truth, he embraced or expanded almost all the Bush-Cheney protocols that he demagogued against as a state legislator, a senator, and a presidential candidate. That he gave George W. Bush absolutely no credit for surging in and saving Iraq, or setting up the procedures for operations like those that killed bin Laden, is again a matter of ingratitude, not foreign policy, given that the war on terror is now a successful eleven-year continuum.But there is one caveat. Words ultimately have consequences. The constant naïveté from the administration — the characterization of the Muslim Brotherhood as largely “secular,” the mythography of the Cairo speech, the taboo against using the phrase “radical Islam” — may have been designed to offer a politically correct mask for Obama’s continuance of the Bush-Cheney protocols, but it may also have had the effect of suggesting to our enemies that the U.S. is ambiguous about radical Islam and does not necessarily connect it with anti-American terrorism.
In general, given American exhaustion over Afghanistan and Iraq, combined with the economic crisis, the Obama administration correctly gauged the public desire for no more interventions, but it finessed that isolationist impulse into its own sense of a multipolar world where America was merely one among many nations.
Aside from the war on terror, then, what are the ten legitimate areas of criticism?
1. Securitygate. The Obama administration has leaked the most intimate secrets about U.S. covert operations — the cyber war against Iran, the Predator-drone assassination program, the Yemeni double agent, the bin Laden raid — in a transparent attempt to chest-thump over the once covert anti-terrorism efforts. This was a shameful thing, and we have not yet felt the full consequences of this disaster.
2. The administration initially did not care much about the Arab Spring, but was dragged into it by the looming fall of Hosni Mubarak. Leading from behind in Libya was incoherent, and what followed Qaddafi was more incoherent. Not going into Syria was wise, even if the reasons for not going in were again muddled. Obama remains ashamed of Iraq and ostracizes it (even as it so far remains the most stable of the new Arab consensual governments), and he makes no distinction between the Muslim Brotherhood and secular democratic movements. In other words, rather than encouraging those who thought the Arab Spring might offer a pluralistic society, Obama stood back as Islamists, Khomeini-style, took control, and he then ex post facto labeled them democrats, even though, as in the case of Hamas and the Iranian theocrats, they favor one free election, just one time.
3. Russian reset is mostly a failure. Embarrassing the Czechs and the Poles over missile defense got us little. Putin has been no help with Iran. An occasional peep about Russian human rights was unceremoniously swatted down. Putin now assumes Eastern Europe and the former Soviet republics fall under his own Russian Monroe Doctrine. A new loose axis of Russia, China, Iran, and North Korea threatens to create a nuclear buffer to U.S. interests.
4. Obama has snubbed our closest allies, so much so that should the U.S. ever find itself again in need of a coalition, it is hard to imagine who would join it. Canada got mostly ingratitude for its presence in Afghanistan, and it is still furious over the Keystone Pipeline debacle. Our once closest ally, Great Britain, recognizes that the United States is now neutral on the Falklands (a.k.a. the Maldives), and that if Argentina were to invade again, the U.S. would probably withhold help. Israel knows that the U.S., at best neutral, votes present on the Middle East and does not much worry that Israel may soon be surrounded by Islamist frontline states. Whether we would fully supply Israel in its next war is legitimately in doubt. In contrast, Turkey, Hamas, and the Muslim Brotherhood, for the first time in history, believe that America is more sympathetic to their causes than to Israel’s. Anti-democratic Venezuela and Cuba, and their Latin American kindred Communist states, also sense that the U.S. is a friend of such totalitarian movements — a suspicion shared by the vanishing number of regional democrats.
5. President Obama was quiet when nearly 1 million Iranian protesters hit the streets in the spring of 2009, almost as if he felt his own multicultural bona fides should be given a chance to finesse the Khomeinist theocracy — or as if the pro-democracy protesters were some sort of inauthentic neocons. It was a shameful decision at a rare time when the Iranian people were looking for pro-democracy affirmation — offering the last chance to stop the Iranian bomb without some sort of military intervention.
6. The new emphasis on Asia is so far in utter confusion. Japan, Taiwan, and South Korea are less, not more, assured that a diffident U.S. would come to their defense in case of an existential crisis. Are they still under the U.S. nuclear umbrella, or is the umbrella itself shrinking fast? Simultaneously borrowing from and lecturing China leads to the image of U.S. impotence. The timing of looking eastward was terrible, as NATO sinks into irrelevance at precisely the moment when an insolvent southern Europe is waging a propaganda war against an ascendant Germany. As the euro zone unravels, a strong U.S. presence in Europe is needed more than ever.
7. Despite the growing anti-democratic tendencies of the Erdogan government in Turkey, Obama has structured his Middle East policy around that government, unconcerned that its policy of insidious Islamization is a model for slowly subverting what follows from elections.
8. The apologies, contextualizations, and bowing were trivial gestures, but in aggregate they added to the sense of U.S. diffidence and decline. As they became right-wing talking points, they also became rarer — a reflection that Obama’s own advisers understood that the optics of his one-worldism were becoming harmful to U.S. interests.
9. The addition of $5 trillion in national debt was disastrous in terms of U.S. foreign policy. It lost us what leverage we had over China. It destroyed any credibility in advising the European Union about its own financial meltdown. It curtailed options in the Middle East. Massive defense cuts loom. In this regard, the associated decisions not to open federal lands to new oil and gas leasing, and to cancel Keystone, were also strategically dense, given that an additional 2 to 3 million barrels of North American production would have given us greater leeway in the Persian Gulf and lessened our exposure to foreign creditors.
10. With a little deft diplomacy, Obama could have salvaged a vestigial American presence to monitor the security of Iraqi democracy and blunt Iranian subversion. The failure to attempt this was an especially ironic lapse, given that the administration now wants to radically increase U.S. troop levels in nearby monarchical Kuwait.
The key for the Romney campaign is not, in the manner of the anti-Bush unthinking Left, to offer blanket condemnations, given that on many aspects of the war on terror, Obama, to his credit, continued the successful policies that he inherited. In contrast, there are plenty of policies that are Obama’s own — and therefore quite dangerous.
Monday, July 2, 2012
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