Catholic Medical Quarterly Volume 73(4) November 2023

When End of Life Care Goes Wrong

A report from the Lords and Commons Family and Child Protection Group March 2023.
Editor Robert S. Harris. Published by Voice for Justice UK
Reviewed by Dr Pravin Thevasathan

Report coverMany years ago, I was asked to support a plan to place a patient with personality disorder on the Liverpool Care Pathway. Reasons given included the patient's wish to forego treatment. I explained to the relevant staff what the psychiatric condition entailed. The patient was not put on the pathway.

I assumed that such a case was exceptional. Not so, according to this report. More than 600 studies appear to show that patients have been put to death at a time when what was needed was good medical care. Among the cases discussed is that of a man who was diagnosed with lung cancer but was far from being terminally ill. He was killed by means of a lethal cocktail of morphine and mida­zolam. There is also the case of an elderly patient who suffered complications following a minor surgical procedure. She was deprived of hydration and nutrition and died by starvation. Other cases leading to death include hospital admissions for constipation, routine knee replacement surgery, and routine eye surgery.

An emeritus professor of palliative medicine looked at 17 cases documented in the report. He said that he was "shocked to read the extent of how badly patients and their families had been treated at the hands of those who should have known better."

This report needs to be promoted by all those who believe in good clinical care.