WHAT should death look like when you come to the end of your life? This is the real question behind Derek ‘Del’ Dimmock’s inquest and the issues that the senior coroner at Southwark Coroner’s Court is grappling with. Did Del die with dignity or was he euthanised and robbed of the peaceful death he deserved?
As shocking as this may sound, government and NHS policy points to normalising culling the weak and infirm. This came to light with the introduction of blanket Do Not Resuscitate orders issued in care homes during covid. Then there is abortion to full term, and the Assisted Dying Bill introduced this year, the National Early Warning Score (NEWS) which has a sliding scale of points used by hospitals and hospices that indicate illness severity and frailty after measuring heart rate and oxygen saturation. If you score plus 6 or 7, end-of-life discussions will start. Then there is the ‘Gold Standard’ end-of-life care developed by a palliative care charity, which sounds compassionate but of course will include end-of-life drugs.
End-of-life drugs are important to alleviate pain and agitation, but it is claimed that the system is being misused. This first came to light when the Liverpool Care Pathway (LCP), described as a structured approach to end of life, was exposed. Once on the pathway, treatments, food, fluid and medication were withdrawn and replaced with pain relief and anti-anxiety drugs. The LCP was originally used only in a hospice setting but was quickly adopted into hospitals. In 2012, we woke up to the cull after thousands of families complained their loved ones had been euthanised in hospital without their consent or knowledge.
Doctors can put patients on end-of-life care without informed consent and without informing family, although many write in medical notes that family have been informed when they have not. Palliative care campaigner Denise Charlesworth-Smith, whose 82-year-old father was admitted to hospital in 2012 after a cold left him with low oxygen saturation, said: ‘I was on a train with no phone signal when a junior doctor claimed he’d told me Dad was on the LCP. The first I heard of it was when I was with Dad in hospital and he began hallucinating and talking gibberish. A nurse said, “They always do this when they’re on the LCP”. I had no idea what she was talking about. He died after six days in hospital. I’ll never forget that a consultant, wearing a Ralph Lauren polo shirt, knelt on one knee by his bed and said, “This should never have happened.” I started to investigate after that and that led to me becoming part of the Liverpool Care Pathway team that conducted an independent review.’
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