This is the title of a feature article in this week's Catholic Herald. The writer, Felicity Smart, relates how she and her husband were left very concerned at the application of the Liverpool Care Pathway to their elderly friend.
I ask about intravenous hydration and almost hope to be told that there would be no benefit, because then withholding it would be justified and I could stop asking questions. But the nurse says that in a case such as this, hydration is only given if the relatives request it because it just prolongs a life that would otherwise end sooner rather than later. So Vera could benefit from it."It just prolongs life!" So denying it shortens life!
Dehydration also causes distress, so:
A tube is inserted in her arm, which must be for pain relief - not only for the inflammation, but probably to allay the pain of dehydration. Pain relief is also a sedative. Dehydration, and the additional painkillers for it, could shorten her life.
During the course of discussions, Felicity Smart was told that her elderly friend, who was conscious at the time of admission, was informed by a doctor that
no further treatment (my emphasis) was possible, surgery being too risky for someone so frail.
Quite rightly, Felicity asks
if Vera know that "treatment" now includes nutrition and hydration. Did she really want to be dehydrated to death?
To which there was no answer.
The conversation with the palliative care specialist is also worrying:
She tries to tell me that very ill people don't want fluids anyway, so withholding them is not unkind. But did Vera know that dehydration is painful? Ah, but pain relief can make her "comfortable" (a word used several times as a euphemism for this kind of death).
This patient was treated according to the Liverpool Care Pathway, described as "the gold standard of care for the dying" and which "is being rolled out across the NHS.
Now I understand that care in these situations is an immensely complicated matter. If the patient's body is rejecting or not processing food and hydration, I daresay its administration can be ceased. But if the patient can use liquid, its administration is no more extraordinary than the pain relieving substances that are administered intraveniously.
I think we all need to ensure that we are registered with the Patients First Network that advised Felicity about the questions to raise with the medical professional.