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Archive for the ‘Euthanasia’ Category

The Euthanasia Trojan Horse

Posted by MDViews on September 4, 2009

The Euthanasia Trojan Horse

 

The UK Telegraph reports a euthanasia scheme which now shocks the citizens of the UK. The British, beneficiaries of a one-payor, government system, have to wonder how this came to be. How could the government be killing all these people?

 

To summarize, the UK cancer charity, Marie Currie, developed a protocol called the Liverpool Care Pathway. Designed initially for terminal cancer patients, this pathway received the endorsement of NICE, the National Institute for Health and Clinical Excellence (I’m not making this up) and soon became a standard of care nationwide.

 

This pathway uses the judgment of a medical team including the senior doctor to determine when the end of life is near. (As you might imagine, if a “team” makes a decision, no one person can be held accountable.) At such a time, the doctor withholds food and fluids (starves and dehydrates the patient to death) while administering a sedative to usher the soon-to-be dear departed from this world to the next. (In Minnesota, you can’t starve or dehydrate an pet without risking jail time.)

 

Initially only for terminal cancer, the pathwway now applies to any critical illnes.

 

Some British doctors think the problem is this: How can one accurately determine when is the end near? How does a doctor determine that a patient is about to die? Such a determination is a guess at best, and sometimes just a hunch. So if a patient gets a large amount of sedation and is denied fluids and food, how would one know if the patient might have improved? One would not know and the patient would die a premature death.

 

So a group of experts in geriatrics and palliative care including Professor Peter Millard, Emeritus Professor of Geriatrics, University of London, Dr Peter Hargreaves, a consultant in Palliative Medicine at St Luke’s cancer center in Guildford, and four others have complained.

Dr Hargreaves, Millard and Katherine Murphy, head of the Patients Association, explain in the report,

[Dr. Hargreaves]“It is a very laudable idea. But the concern is that it is tick box medicine that stops people thinking.”

He said that he had personally taken patients off the pathway who went on to live for “significant” amounts of time and warned that many doctors were not checking the progress of patients enough to notice improvement in their condition.

Prof Millard said that it was “worrying” that patients were being “terminally” sedated, using syringe drivers, which continually empty their contents into a patient over the course of 24 hours.

In 2007-08 16.5 per cent of deaths in Britain came about after continuous deep sedation, according to researchers at the Barts and the London School of Medicine and Dentistry, twice as many as in Belgium and the Netherlands.

If they are sedated it is much harder to see that a patient is getting better,” Prof Millard said.

Katherine Murphy, director of the Patients Association, said: “ …There is no one size fits all approach.”

A spokesman for Marie Curie [advocates of the current systerm] said: “The Liverpool Care Pathway (LCP) is an established and recommended tool that provides clinicians with an evidence-based framework to help delivery of high quality care for people at the end of their lives.

So this “tick box” [check box for us] medicine, this “evidence-based framework”, this “Liverpool Care Pathway” embraced by NICE and implemented by the British NHS has resulted in active euthanasia of very ill citizens of the UK. It’s abortion at the other extreme of life, the very old and sick.  Who knows if those people killed by this protocol would have had time to impact their world or family prior to death? Who knows if fractured relationships may have been healed without the starvation, dehydration and sedation? Who knows if someone may have heard the gospel for the first time and responded had not the “evidence-based” death taken them too soon?

I am sickened. Sickened that this occurs in the UK. Sickened that the only problem seems to be killing people too soon. (Why kill them at all? What’s wrong with food and water?) I am sickened that medicine in these United States has embraced every buzzword mentioned above such as evidence-based medicine, best practices, care pathways and protocols. And each of these schemes places a rule-setting committee between the patient and the doctor. By removing the doctor’s judgment from the care of each individual patient, pushing medicine into euthansia, rationing of care and denial of service becomes easy.

Be glad, dear friend, that we in the U.S. are in the infancy of the evidence-based, best practice jugernaut. Be glad we do not have a one payor system (yet) that can foist such atrocities on our sick and dying with the heavy hand of governmental power. But worry, please. Worry and act to stop this from becoming reality.

Matt Anderson

Posted in Doctoring, Euthanasia, Faith and the Glory of God, Medical Issues, Politics | 5 Comments »

The Cookbooking of Medicine

Posted by MDViews on September 1, 2009

  I’ve been in practice (out of residency) for more than 27 years, a doctor for 31 years and doing clinical medicine (since a 3rd year medical student) for 33 years. (Goodness, I’m old!) I’ve dealt with cranky ward clerks, primadonna nurses, obtuse administrators, incompetent MD peers, powerful insurance companies, government bureaucracy, employee conflicts, good financial times and bad financial times. I’ve even survived two lawsuits. But the cookbooking of medicine is the most fraudulent, intrusive, problematic and dangerous paradigm to come down the pike yet. I’ve written about it and submitted it hoping to get it published. It wasn’t. So I’ll contribute it here, my blog. If you are a young doctor, you may think I’m nuts, because it may be all you have known. If you are an older MD, you’ll probably understand. If you are not in medicine, you may be appalled. Most people to whom I tell this story–can’t believe it. But true it is. Hope you enjoy the read.

 

 

 

The Cookbooking of Medicine

 

Standards. Protocols. Evidence-based medicine (EBM). Pay for performance. Best practices. Buzzwords all—these terms describe the new direction of medicine in the 21st century.

 

As you read this, groups of doctors along with administrators, bureaucrats, nurses and lawyers gather at corporate headquarters, medical schools, insurance companies and government buildings to set standards of care every doctor should follow. Such groups base these standards on “best practices” or “evidence-based medicine”, a consensus of opinion on what the best care should be for any and all illnesses. Such a system sounds so good, so wonderful—what could possibly be wrong with encouraging all doctors to practice the best medicine possible?

 

Well, plenty, it seems to me, as one who deals with it everyday.

 

For example, 26 year old Mrs. Johnson (name changed), a missionary home on furlough, presents for her annual exam. She and her husband were virginal until married and have remained faithful to each other. As the doctor does her pap smear, a test for cervix cancer, she also swabs her cervix for Chlamydia and gonorrhea, two STD’s.

 

The doctor knows her chances of having Chlamydia and gonorrhea are exactly zero, but has to meet a quota of screening 80% of all women up to age 27 for Chlamydia and gonorrhea or she will not get her bonus, or “pay for performance”. So, knowing the test will be negative, she does it anyway. Why does this rule exist? Because most research done on STD’s occurs in inner city hospitals where the rates are very high, not on missionaries home on furlough. The doctor, wanting her “pay for performance” performs an unnecessary test.

 

For diabetics, doctors may order unnecessary tests or prescribe unnecessary medicines to capture pay-for-performance. Worse, early diabetes does not qualify for treatment, even if the doctor, looking at the big picture, deems treatment appropriate. So, the doctor may deny care he or she may judge necessary, since the protocol won’t allow it.

 

Welcome to the world of cookbook medicine, where one-size-fits-all. A world in which your doctor receives money, “pay for performance,” for following “guidelines” or “best practices.” Such a system removes the doctor’s judgment about what is best for you and substitutes corporate or government guidelines regarding what is best for a group.

 

Doctors, me included, always want the best for our patients. But how does one determine what is best? Even the best studies can be in error. Two of the largest and best studies of regarding postmenopausal hormone therapy came to opposite conclusions regarding the risk of heart disease. Does a study on an inner-city population translate to a well-to-do suburban population? Do studies on one race translate to all races? Does a study based on thousands of people necessarily translate to the individual patient in the exam room? Individuals vary by sex, physical characteristics, mental capacity, emotional make-up, cultural differences, values, ethnicity and side effects to medicines just to name a few variations a doctor sees. Is what may be good for a majority the best for you in your situation? Are you really unique? Could politics influence these protocols, say, to save money? Or further a politically correct “treatment”, such as euthanasia?

 

For me every encounter, every crisis, every illness, every life-threatening emergency is unique to my one patient at that particular time in her life. I collate all the information I have about…everything—her needs, her social situation, her illness, how it affects her life as she lives it, her fears, her exam and her history; then decide what the best treatment would be for her. Such a process is antithetical to the cookbook.

 

When I speak with those in charge of the protocols, they always say the doctor must still use his or her best judgment even if such judgment conflicts with the guidelines, but that really isn’t true, in my experience. The leap from a guideline to a protocol to a rule is short. When I’ve gone against protocols, administration demands explanations, threatens discipline and docks my pay if I don’t measure up. Soon the heavy hand of the protocol dictates what you can and can’t do regardless of your judgment.

 

As we go down the path of more central control of medicine where doctors are told what constitutes disease, illness, and appropriate treatment, your doctor will become more and more a technician, doling out care, tests and medicines based on the whim of government bureaucrats or corporate panels. I fear the protocol, the best practice prescripts, the machinations and rules which stand between you and your doctor will plow the furrow for the seeds of health care rationing and denial of care.

 

 

 

 

Posted in Doctoring, Euthanasia, Medical Issues, Politics | 5 Comments »

Separating Life and Death

Posted by MDViews on June 5, 2009

Here is an article I submitted to WORLD magazine regarding OB/GYN physicians, rights of conscience and the Hippocratic Registry of Physicians on which I’ve posted before. They graciously decided to publish it.

So, here I am on a Friday night, pizza night at our house, surrounded by life; children and their spouses, numerous grandchildren, nieces, sister-in-law; enjoying the glory and warmth of love and life and family. All the while the culture of death marches on. 4,000 unborn lost their lives today in the US. 4,000 women now carry the wounds of the tearing of that life from her womb. Many aged passed across the river to eternity today, some, unfortunately helped by misguided physicians who judged their sick life to be no longer worth living. Somewhere tonight, a woman in an ER hemorrhages from an abortion done earlier while her “hero of woman’s rights” who performed her abortion deposits the money she paid into his bank account and goes out on the town, unavailable to help her now.

Life is always bitter-sweet, eternally significant, joyfully sorrowful; and today is no exception.

In the joy of the weekend, the relaxation of time off, the refreshment of vacation, the rejuvenation of renewed relationships; remember, always remember, the weak, the helpless, the lost and the battle we face, with God as our help, to save them.

Thanks for reading.

Matt Anderson

Posted in Abortion, Euthanasia, Faith and the Glory of God, Family | 8 Comments »

The Oath of Hippocrates and the newly-formed Hippocratic Registry of Physicians

Posted by MDViews on March 20, 2009

I thought I would update you on an exciting concept being championed by John Patrick, MD. In response to laws and rules designed to remove the rights of conscience from physicians, John Patrick has started a Hippocratic Registry of Physicians. It is only in Canada for now, but AAPLOG board discussed this concept at its meeting in January. It’s a concept that has feet and hands.

Basically, the death lobby (abortion and euthanasia folks) is not content with permission to practice the killing trade. They want acceptance and approval. They do not want people (me and others) accusing them of an immoral act. They want everyone to know and accept that they are right and moral and ethical and justified in all their killing.

So, that is the motivation behind the American College of OBGYN (ACOG) issuing an ethics opinion stating an OBGYN doctor is ethically obligated to perform or refer for abortion. And it’s the motivation behind the American Board of OBGYN (ABOG) to require adherence to the ACOG ethics code as a requirement for board certification.

The death lobby has prolife pharmacists in the crosshairs as well. They want them to be required to dispense abortifacients. There are rumblings from Oregon, Washington (recently passed laws legalizing euthanasia) and countries across the pond of moves to require doctors to “provide euthanasia service” if requested.

All this has motivated physicians who hold to the Oath of Hippocrates to establish a Hippocratic Registry of physicians who would pledge to support life, as the Hippocratic Oath does. One can see an entire parellel health system developing which would include life-affirming hospitals, doctors, pharmacists and nurses. It would be a system which would have competing accreditation agencies.

Whether the death lobby would even allow such a system to exist is questionable in my mind. But it is the right thing to do. If the killers intend to force us to participate in abortion and euthanasia, we must quit, withdraw or start our own health system which honors life.

So there you have it. Stay tuned for more updates.

Posted in Abortion, Doctoring, Euthanasia, Medical Issues, Politics | 3 Comments »