Samizdata

Remember the mockery that Sarah Palin got for her prediction that state health care might result in “Death panels”?

She was wrong about a few things. There is no need for a panel of bureaucrats to decide when it is time to stop treating old people and those with Downs syndrome. That can be done more conveniently by the doctors and nurses. And while we’re at it, why confine ourselves to stopping treatment? Would it not also reduce the burden on the NHS and its employees to become a bit more proactive and actively shorten these useless lives?

This article by Dominic Lawson about the Gosport War Memorial Hospital scandal is one of the most powerful I have ever read.

Last week’s monstrously belated report on the Hampshire hospital’s treatment of its patients in the 1990s revealed that at least 450, and probably more than 650, had been killed — sorry, had had their lives shortened — as a result of a policy of attaching them to syringe drivers pumping diamorphine. Diamorphine is medically indicated only when the patient is either in the severest pain or terminally ill, because its notable side effect, when large doses are consistently administered, is respiratory failure. Injections of diamorphine — in 30mg doses — were Dr Harold Shipman’s chosen method of dispatching his patients. But the numbers at Gosport exceed the tally of Britain’s most prolific mass murderer.

You may be thinking, no need for that sort overblown rhetoric. Surely this is a case of misplaced mercy, of overdoing the pain relief? That is what I thought too. It is why I had not paid much attention to this story until now. More fool me. Read on:

The report, led by James Jones, the former Bishop of Liverpool, reveals that only 45% of those administered terminal quantities of diamorphine were said to be in pain. And in 29% of cases their medical notes give either no reason, or no comprehensible justification, for the lethal dose (most died within a couple of days of being attached to the pump).

(Emphasis added by me, as it is in all the excerpts I quote in this post.)

Even that is not the worst. Read on further:

The ones most likely to get the treatment appeared to be not the sickest, but the most “difficult”. As the stepson of one of the victims remarked: “If a nurse didn’t like you, you were a goner.” This was clear from the testimony of Pauline Spilka, an auxiliary nurse. After the local newspaper in 2001 reported the complaints by relatives of Gladys Richards, (whose life had been “shortened”), Spilka went to the police. In an interview with Detective Chief Inspector Ray Burt of the Hampshire constabulary, Spilka said: “It appeared to me then and more so now that euthanasia was practised by the nursing staff. I cannot offer an explanation as to why I did not challenge what I saw at that time . . . I feel incredibly guilty.”

Spilka was especially troubled by the fate of an 80-year-old patient (his name is redacted) whom she described as “mentally alert and capable of long conversations . . . able to walk . . . and to wash himself”. He was, however, “difficult”. She told the policeman that this patient was “always making demands” and that “I remember having a conversation with one of the other auxiliaries [Marion] . . . we agreed that if he wasn’t careful he would ‘talk himself onto a syringe driver’.”

So it came to pass: “One day I left work after my shift and he was his normal self. Upon returning to work the following day, I was shocked to find him on a syringe driver and unconscious. I was so shocked and angered by this that Marion and I went to confront the ward manager.” They were told to put a sock in it. Nursing auxiliaries are at the bottom of the chain, without any medical qualifications. What was their word worth, against that of the formidable (and formidably well connected) Dr Jane Barton

Whereas a word from Dr Jane Barton was literally enough to sentence a woman to death. Lawson continues:

Perhaps the most upsetting case — at least, as the father of an adult with Down’s syndrome, I found it so — was that of 78-year-old Ethel Thurston, admitted with a fractured femur. She was described in the report as having “learning difficulties [and] the mental capacity of a 10-year-old”, though she “once held down a job in a bank . . . and had been able to travel across London independently”. The nurses’ notes took a different tack: “Willing to feed herself only if she feels like it . . . her behaviour can be aggressive.”

On July 26, 1999, Dr Barton made her recommendation: “Please keep comfortable. I am happy for nursing staff to confirm death.” Happy? The following then appears in the nursing notes: “Syringe driver started diamorphine 90mg. Midazolam 20mg.” These huge doses were administered at 11.15am. At 7pm a nurse confirmed Miss Thurston’s death.