Aging population 'is leading to crisis in end-of-life care'

Ageing population 'is leading to crisis in end-of-life care' - Telegraph: Britain faces a growing crisis in its ability to care for people dying of cancer, dementia and other long-term diseases, doctors are warning.

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Patient dying of thirst rang police

Daily Mail: Nurses forgot to give Kane Gorny his medication and he became so delirious he called 999. His mother said she spent hours trying to convince staff he needed attention but was told he was all right. Alarm finally raised an hour before his death when a doctor realised how serious his condition was

Elderly patients 'helped to die to free up beds', warns doctor

Elderly patients 'helped to die to free up beds', warns doctor - Telegraph: Professor Patrick Pullicino has claimed that doctors are using a care pathway designed to help make people's final days more comfortable as an equivalent to euthanasia. The Liverpool Care Pathway (LCP) is used in hospitals for patients who are terminally ill or are expected to die imminently. Under the pathway, doctors can withdraw treatment, food and water while patients are heavily sedated. Almost a third of patients - 130,000 - who die in hospital or under NHS care a year are on the LCP.

Christian Medical Comment: Is the NHS really killing 130,000 patients a year with the Liverpool Care Pathway?

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Texas hospital starving patient against family wishes

Texas hospital starving patient against family wishes | Spero News: Texas Right to Life denounced the decision by physicians to allegedly eliminate hydration and feeding of a patient under their care in a Texas hospital. According to the group, the hospital has refused to allow the patient and his family to take him to a nearby hospice for care.

Update: Patient dies after hospital denies treatment

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Unaccountable healthcare 'experts'

Unaccountable healthcare 'experts' (OneNewsNow.com): buried deep within the healthcare law's 2,801 pages of foggy prose is a provision to create a panel of bureaucrats with final authority on what treatments will and will not be paid for by Medicare, the federal insurance program that serves nearly 48 million seniors and disabled individuals. It's called the Independent Payment Advisory Board (IPAB), a 15-member committee whose cost-cutting edicts are not subject to review by the courts or the people.

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When care is worth it, even when the end is death

You’ve probably heard that we spend a lot of money on patients who die. It’s true: about one-tenth of the money spent on direct care goes to people who die each year. Among Medicare patients, the figure is much higher, about one-quarter.

You may be shocked by those statistics. What health care system would squander so many dollars on patients who don’t benefit? Or maybe you’re saddened. No humane system would subject patients to painful interventions and procedures that serve no purpose.

The idea that we waste money on terminal patients has caught on; the simplicity of the conceit makes it appealing to policy makers. And the data to support it keep coming, because it is easy for researchers to measure how much is spent on patients before they die.

. . . [C]aring for the sick means caring for people who may die. Providing care means reducing the chance they may die — not eliminating it. . . . [T]he policy conceit that spending money on patients who die is a waste overlooks the core purpose of health care — to prevent or forestall illness, disability and death among patients at risk of those outcomes.

It also overlooks a key correlation in health care. When people get sicker, they need more intensive — and expensive — health care services. But when they get sicker, they are also more likely to die. When I met my patient, I took him to the intensive care unit, the second-most-expensive place per minute in any hospital. The other place he went, twice, was the operating room — the most expensive place.

Healthy people, who are unlikely to die, are also very unlikely to find themselves in those settings. Thank goodness. Thus, spending will always be concentrated on people who are the sickest. When one examines spending on patients who die, dollars will be concentrated there, too.

. . . The more nuanced reality is that some aggressive treatment delivers value and is appropriate, even though some patients who receive such care die; other treatment is too aggressive and should be curtailed no matter what the short-term outcome. . . . The important thing is that it’s not all of one and it’s not all of the other.

Today the medical profession lacks a shared understanding of which patients are which. That gap must be addressed. It will be an excruciating task, and it will be politically noxious. Someone will again accuse officials of forming death panels. But leaving the distinctions to individual doctors leads to inequities, harm to patients, distrust in medical care and lawsuits; ignoring the problem should not be an option, either. NY Times

Older UK cancer patients more likely to die due to NHS 'age bias'

Older cancer patients more likely to die due to NHS 'age bias' | World news | The Guardian: Older people in the UK are more likely to die of cancer because they receive less investigation of and treatment for their disease due to 'age bias' by the National Health Service, a major new report warns. They suffer delays in having their case referred to a specialist, are less likely to undergo radical surgery and have worse outcomes than younger patients.

Triumphs of nationalized health care: 'No patient will wait longer than 18 weeks'

'No patient will wait longer than 18 weeks' - The Scotsman: Patients in Scotland will not wait longer than 18 weeks for treatment after being referred by their GP, pledged the health secretary. 85 per cent of patients are already being seen within this target. But the battle to bring down waiting times still lags behind the NHS in England, where the 18-week target was introduced much earlier and where almost 90 per cent of patients are treated within that time. Commentary

Feeding tube restored to immigrant woman

A Rwandan immigrant woman and survivor of the horrors of the 1994 genocide who had her feeding tube removed because a U.S. Catholic-affiliated hospital deemed her care too expensive, apparently will not die of starvation and dehydration thanks to a court order and the efforts of her children. LifeSiteNews

Who wants to decide the price of life?

Jamie was born just over the cusp of viability, on the day he turned 26 weeks. He spent the first year of his life attached to a ventilator in a west London hospital, and when he was discharged he was still attached to the ventilator via a tracheotomy – a hole in his neck with a tube connected to his oxygen supply. Until the tracheotomy was removed 16 months later he had nursing care for 21 hours a day. He has mild cerebral palsy, which manifests itself in his running on his tiptoes – though he scoots and walks flatfooted. He has cost the NHS hundreds of thousands of pounds. He is priceless. Guardian

NRLC resources on rationing

This past November, Obama Administration official Donald M. Berwick, administrator of the Centers for Medicare and Medicaid Services, quietly issued a regulation that would have been used to nudge elderly patients to reject lifesaving treatments. NRLC has strongly opposed this controversial provision, known as Section 1223, and the provision did not end up in the final version of Obamacare. When the Obama Administration was unsuccessful in enacting this dangerous provision Donald Berwick, whom NRLC has called a "one-man death panel," used a regulation to do what Congress would not.

But late last night, an abrupt reversal by the Obama administration came when they decided to drop this dangerous "end-of-life care" provision which would have been used to nudge or pressure older people to agree to less and less expensive treatments. The sudden change shows that pro-life opposition can and will make a difference! Stay informed!

The return of the death panels

Paul Greenberg: As every polemicist knows, the way a question is asked can determine the answer. To quote one of those experts -- a thanatopsist? -- at the University of Michigan, someone with heart disease might be asked: 'If you have another heart attack and your heart stops beating, would you want us to try to restart it?' Or someone with emphysema could be asked, 'Do you want to go on a breathing machine for the rest of your life?' Or the cancer patient would be asked, 'When the time comes, do you want us to use technology to try and delay your death?' As if anyone could know when the time will come, and how the patient will feel about it then. And please note the phraseology: It's not save your life, but delay your death. Never underestimate the power of negative thinking.

Concerns about 'death panels' overhyped

Not everyone in the pro-life movement is on board with the concerns about the “death panels” the Obama administration recently instituted, as one professor says they are overhyped.

Warren Throckmorton is an associate professor of psychology at Grove City College in Pennsylvania and fellow for psychology and public policy with the Center for Vision & Values. He believes the idea has some merit as it, for example, could have helped prevent the painful euthanasia death of Terri Schiavo at her former husband’s hands. But pro-life groups say they worry doctors would be incentivized to pressure patients into making treatment decisions that would ultimately ration their health care.

Throckmorton says the regulations don’t constitute a “death panel” because the meetings with physicians are voluntary, the patient makes his or her own treatment decisions, and helping patients with advanced directives — which could ultimately ensure they do receive lifesaving medical treatment and are not denied care — is generally a good thing. “No death panel there, just the patient, perhaps family, and the physician,” he says. “Since the conversation is voluntary, a patient can avoid the whole thing.” LifeNews

Cutting human beings

Articles & Commentary: Arizona attempted to save money by curtailing expensive procedures that were believed to be relatively ineffective. From the standpoint of hard choices and cold calculation, this principle is defensible. But there is little reason to believe that Arizona undertook the time-consuming and painstaking data collection and cost-benefit analyses that should inform such policy change. Instead, it clumsily targeted a discrete group of people with names and faces who will die without a standard procedure that is proven to be successful in so many cases.

Krugman: Death Panels Will Fix Debt Crisis

Krugman: Death Panels, VAT Will Fix Debt Crisis: Paul Krugman, NY Times columnist, apparently thinks death panels could be one way the federal government will be able to keep soaring medical costs under control as baby boomers enter retirement. Video

Editor: I thought there was no such thing as death panels in Obamacare.

The real meaning of rationing

Rationing already takes place in many ways in health care. Managed care is exactly a form of rationing in which a private insurer determines whether patients should or should not receive services. In addition, private sector rationing injects profit motives into the calculations. The recent debate over health care has centered around who should do the rationing: private enterprises, often driven by profit or other private objectives, or government officials who are easily characterized as motivated by the immediate political returns of lower taxes or hiding the true shortcomings of services they administer. JAMA

The Cost of Dying: End-of-Life Care

The Cost of Dying: End-of-Life Care - 60 Minutes - CBS News: 'Often the best care is saying 'Let's see how you do on this particular treatment for a couple of days. And see if you respond.' Not necessarily doing a lot of tests,' Dr. Elliott Fisher, a researcher at the Dartmouth Institute for Health Policy, said. 'The best care may well be staying home with a trial of a new medication, rather than being admitted to a hospital where you can be exposed to a hospital-acquired infection. We have a system that rewards much, much more care.'

In almost every business, cost-conscious customers and consumers help keep prices down. But not with health care. That's because the customers and consumers who are receiving the care aren't the ones paying the bill.

By law, Medicare cannot reject any treatment based upon cost. It will pay $55,000 for patients with advanced breast cancer to receive the chemotherapy drug Avastin, even though it extends life only an average of a month and a half; it will pay $40,000 for a 93-year-old man with terminal cancer to get a surgically implanted defibrillator if he happens to have heart problems too.

After analyzing Medicare records for end-of-life treatment, Fisher is convinced that there is so much waste in the present system that if it were eliminated there would be no need to ration beneficial care to anyone. Multiple studies have concluded that most patients and their families are not even familiar with end-of-life options and things like living wills, home hospice and pain management.

Rationed Healthcare and Assisted Suicide

FRC Blog � Rationed Healthcare and Assisted Suicide: The Oregon Health Plan (Medicaid) refused to pay for a drug that would prolong Randy Stroup's life and ease his pain, but would pay for his suicide.

Recess Appointment Attacked as 'Expert on Rationing'

With Congress officially on recess, President Obama will on Wednesday use his ability to make recess appointments to name one of his more controversial nominees: Donald Berwick, nominee to be Administrator of the Centers for Medicare & Medicaid Services (CMS).

The April nomination of Berwick was in trouble and might not have been able to meet Senate confirmation due to comments Berwick made in the past about rationing health care. Even if Berwick could have been confirmed by the Senate, Democrats have little appetite for another round of fighting about changes to the health care system, Democrats said.

In an interview last year with Biotechnology Healthcare, Berwick said society makes decisions about rationing all the time, and that the "decision is not whether or not we will ration care -- the decision is whether we will ration with our eyes open. And right now, we are doing it blindly." ABC News

Law affects end-of-life care

A new law goes into effect July 1 giving Idaho health care workers the right to refuse to provide end-of-life care they find morally objectionable. Some fear the legislation places the conscience of a caregiver ahead of a dying person's rights. CDA Press