Euthanasia British style

A scandal is breaking out in England over revelations that the National Health Service has been implementing a policy of routinely–and apparently without consulting either the patient or the family–cutting off intravenous food and fluids for patients deemed to be close to death, instead just pumping them up with sedative drugs until they die. From the London Telegraph, Sentenced to death on the NHS:

Under NHS guidance introduced across England to help doctors and medical staff deal with dying patients, they can then have fluid and drugs withdrawn and many are put on continuous sedation until they pass away.
 
But this approach can also mask the signs that their condition is improving, the experts warn.
As a result the scheme is causing a “national crisis” in patient care, the letter [from concerned physicians] states. . . .

“Forecasting death is an inexact science,”they say. Patients are being diagnosed as being close to death “without regard to the fact that the diagnosis could be wrong.

“As a result a national wave of discontent is building up, as family and friends witness the denial of fluids and food to patients.”

The issue being raised here is that the diagnoses of being close to death can be wrong, with the sedation preventing doctors from seeing signs of improvement. But I don’t see how denying a patient food and water can ever be right. Even if the plan is to just “let the patient die,” the active step of withdrawing food and water goes beyond that and seems especially cruel. The patient is allowed to die of thirst and starvation. How does that even rise to the questionable standard of “mercy killing”?

About Gene Veith

Professor of Literature at Patrick Henry College, the Director of the Cranach Institute at Concordia Theological Seminary, a columnist for World Magazine and TableTalk, and the author of 18 books on different facets of Christianity & Culture.

  • Matt C.

    It’s just basic utilitarianism at work. Food and water add no value when a person is dying anyway. Sedation is good because it prevents any pain coming from starvation.
    Incorrect diagnoses and masked improvements are relevant, though, because they could impact the amount of value a patient has. If it weren’t for the possibility of mistakes, it would be a no-brainer. The only thing left to do is carry out a statistical study that determines the rate of misdiagnosis and therefore whether the efforts devoted to nourishing the patients are worth it overall.

    Death with dignity.

  • Matt C.

    It’s just basic utilitarianism at work. Food and water add no value when a person is dying anyway. Sedation is good because it prevents any pain coming from starvation.
    Incorrect diagnoses and masked improvements are relevant, though, because they could impact the amount of value a patient has. If it weren’t for the possibility of mistakes, it would be a no-brainer. The only thing left to do is carry out a statistical study that determines the rate of misdiagnosis and therefore whether the efforts devoted to nourishing the patients are worth it overall.

    Death with dignity.

  • Bryan Lindemood

    Thanks for this post, Veith. I worry that this will be our end too here in the states. I have seen things as a pastor that get dangerously close to this, if we’re not already there. Lord, have mercy. Its fun to ask, “Why aren’t we giving grandma any water now?” “Do you mind if I swab her mouth with a wet swab?” Boy, that really pisses some people off!

  • Bryan Lindemood

    Thanks for this post, Veith. I worry that this will be our end too here in the states. I have seen things as a pastor that get dangerously close to this, if we’re not already there. Lord, have mercy. Its fun to ask, “Why aren’t we giving grandma any water now?” “Do you mind if I swab her mouth with a wet swab?” Boy, that really pisses some people off!

  • http://www.utah-lutheran.blogspot.com Bror Erickson

    “The issue being raised here is that the diagnoses of being close to death can be wrong.” That is an issue for pastors too. I mean you hate to give a guy last rites and see him up and walking around the next day. Well you like to see him up and walking around, but you feel kind of foolish.

    The truth is though, if you pull foods and fluid, pump up sedation, likely hood is whatever his/her condition was they are now close to death.

  • http://www.utah-lutheran.blogspot.com Bror Erickson

    “The issue being raised here is that the diagnoses of being close to death can be wrong.” That is an issue for pastors too. I mean you hate to give a guy last rites and see him up and walking around the next day. Well you like to see him up and walking around, but you feel kind of foolish.

    The truth is though, if you pull foods and fluid, pump up sedation, likely hood is whatever his/her condition was they are now close to death.

  • fws

    I hope people speak carefully here to fight the right battles for life effectively. To remove a feeding tube is not to withhold nutrition always. part of the dying process often looks like a lack of hunger. This can be very situational.

    I think the real question is who gets to decide when to do what if the patient is unable to. a written life directive/living will written in full consultation with pastor, family and those likely to be on the decision making hotspot here is a real act of consideration and kindness.

    That said the families should be the ones deciding and not the doctors or government it does seem.

    It would be great to know more details in case the press sensationalized the story… it does happen.

  • fws

    I hope people speak carefully here to fight the right battles for life effectively. To remove a feeding tube is not to withhold nutrition always. part of the dying process often looks like a lack of hunger. This can be very situational.

    I think the real question is who gets to decide when to do what if the patient is unable to. a written life directive/living will written in full consultation with pastor, family and those likely to be on the decision making hotspot here is a real act of consideration and kindness.

    That said the families should be the ones deciding and not the doctors or government it does seem.

    It would be great to know more details in case the press sensationalized the story… it does happen.

  • http://www.newreformationpress.com Patrick Kyle

    To deny food and water is a slightly less uncouth shove into the grave than a bullet or a blow on the head with a club, but the end result is the same.

    Now these decisions in the UK are determined by the government and fiscal “reality.” How long before this trend morphs from ‘death with dignity’ and compassionate ‘care at the end of life’ to an obligation of the aged and sick to die and quit being a burden.

    Not too long ago those who said socialized medicine would have results like this travesty in the UK were mocked as ignorant alarmists, and we were assured by the proponents of socialized medicine that this was extremely unlikely to happen.

    What is really going to anger me further is when we are far down this road and the articles and blog posts appear asking ‘How did it all come to this?’ Our politicians and those who support these policies are building the foundation for it brick by brick, right now.

  • http://www.newreformationpress.com Patrick Kyle

    To deny food and water is a slightly less uncouth shove into the grave than a bullet or a blow on the head with a club, but the end result is the same.

    Now these decisions in the UK are determined by the government and fiscal “reality.” How long before this trend morphs from ‘death with dignity’ and compassionate ‘care at the end of life’ to an obligation of the aged and sick to die and quit being a burden.

    Not too long ago those who said socialized medicine would have results like this travesty in the UK were mocked as ignorant alarmists, and we were assured by the proponents of socialized medicine that this was extremely unlikely to happen.

    What is really going to anger me further is when we are far down this road and the articles and blog posts appear asking ‘How did it all come to this?’ Our politicians and those who support these policies are building the foundation for it brick by brick, right now.

  • http://www.newreformationpress.com Patrick Kyle

    Matt C

    How is what you advocate any different than what the Nazis did to the crippled and mentally handicapped in pre WWII Germany?

  • http://www.newreformationpress.com Patrick Kyle

    Matt C

    How is what you advocate any different than what the Nazis did to the crippled and mentally handicapped in pre WWII Germany?

  • Anonymous

    Mr. Kyle, are your political views merely coincidental with the theology at your New Reformation business or the result of it? I ask sincerely because while I really enjoy and am edified by Lutheran theology, I find the politics of most American Lutherans I know to be much too extreme.

  • Anonymous

    Mr. Kyle, are your political views merely coincidental with the theology at your New Reformation business or the result of it? I ask sincerely because while I really enjoy and am edified by Lutheran theology, I find the politics of most American Lutherans I know to be much too extreme.

  • Matt C.

    Patrick @ 6,

    I was describing utilitarianism, not advocating it. Most westerners (including most Christians, I daresay) unconsiously embrace it without even realizing it or understanding where it leads. And you’re right, it’s not practically different from how Nazis viewed life. Same thing, different day.

    My intent was to juxtapose the idea of being doped up and starved to death because you’re to useless to be fed with the oft-proclaimed idea of “death with dignity” which many actual advocates express. It really doesn’t seem to dignified to me. Guess I need to work on my writing skills; sorry about the confusion.

  • Matt C.

    Patrick @ 6,

    I was describing utilitarianism, not advocating it. Most westerners (including most Christians, I daresay) unconsiously embrace it without even realizing it or understanding where it leads. And you’re right, it’s not practically different from how Nazis viewed life. Same thing, different day.

    My intent was to juxtapose the idea of being doped up and starved to death because you’re to useless to be fed with the oft-proclaimed idea of “death with dignity” which many actual advocates express. It really doesn’t seem to dignified to me. Guess I need to work on my writing skills; sorry about the confusion.

  • Patrick Kyle

    Anonymous,
    I keep my politics out of New Ref Press. Maybe I shouldn’t have the URL linked to my name when I comment on things other than the Gospel and Lutheran doctrine.

    However, as a citizen of two kingdoms I gladly participate in the political process in my vocation as a citizen.

    Lutherans in America span the political spectrum. I happen to fall into the pro-lfe libertarian camp, much to the consternation of many of my Lutheran brethren. You can find my polar opposites in both the LCMS and the ELCA. You may find yourself more at ease with the politics of some of these folks.

    Matt C. Sorry, I should have read your post more carefully. Thanks for the clarification.

  • Patrick Kyle

    Anonymous,
    I keep my politics out of New Ref Press. Maybe I shouldn’t have the URL linked to my name when I comment on things other than the Gospel and Lutheran doctrine.

    However, as a citizen of two kingdoms I gladly participate in the political process in my vocation as a citizen.

    Lutherans in America span the political spectrum. I happen to fall into the pro-lfe libertarian camp, much to the consternation of many of my Lutheran brethren. You can find my polar opposites in both the LCMS and the ELCA. You may find yourself more at ease with the politics of some of these folks.

    Matt C. Sorry, I should have read your post more carefully. Thanks for the clarification.

  • Patrick Kyle

    Anonymous,

    I am interested to know what aspect of my politics do you view as extreme? This is an honest question.

    In truth there are a number of areas where my theology does inform my politics to a greater of lesser degree. I would be interested to hear how this comes across to someone not from the US.

  • Patrick Kyle

    Anonymous,

    I am interested to know what aspect of my politics do you view as extreme? This is an honest question.

    In truth there are a number of areas where my theology does inform my politics to a greater of lesser degree. I would be interested to hear how this comes across to someone not from the US.

  • Anonymous

    Mr. Kyle.
    Thank you. I did not agree with you observation about what you call socialized medicine, but I didn’t say your politics in the main were extreme. I don’t know your views well enough to describe them that way.
    But I do not understand what the term “pro-life libertarian” means; I suspect it means a free market anti-abortionist, but I can’t be sure. A classic libertarian, however, is someone who rejects state control precisly at the place where you probably want it most of all – a woman’s mind to make her own pregancy decision. I likely don’t disagree with you on abortion; but I’m not sure I understand how someone like us can be called a libertarian.
    Moreover, it confuses me that pro-life, in the limited American sense, almost never includes anti-war sentiment. Self-described pro-life Americans were Geo. Bush’s most ardent supporters as the US invaded Iraq, Afghanistan, and while so many lives were lost due to the inepitude connected with Hurricaine Katrina. Have you read, by the way, the most recent New York Times Magazine article on the euthanasia that occurred in the flooded hospitals? It was horrid.
    But I digress. My original post should have more pointedly asked whether one could embrace the teachings in the Book of Concord while simulatanously rejecting much of American right wing-ism. I suspect one can, and you assure me that Americans Lutherans in the LCMS (who presumably adhere to the BOC) span the spectrum politically.
    My best to your business. I have listened to Rod Rosenbladt with much enjoyment.

  • Anonymous

    Mr. Kyle.
    Thank you. I did not agree with you observation about what you call socialized medicine, but I didn’t say your politics in the main were extreme. I don’t know your views well enough to describe them that way.
    But I do not understand what the term “pro-life libertarian” means; I suspect it means a free market anti-abortionist, but I can’t be sure. A classic libertarian, however, is someone who rejects state control precisly at the place where you probably want it most of all – a woman’s mind to make her own pregancy decision. I likely don’t disagree with you on abortion; but I’m not sure I understand how someone like us can be called a libertarian.
    Moreover, it confuses me that pro-life, in the limited American sense, almost never includes anti-war sentiment. Self-described pro-life Americans were Geo. Bush’s most ardent supporters as the US invaded Iraq, Afghanistan, and while so many lives were lost due to the inepitude connected with Hurricaine Katrina. Have you read, by the way, the most recent New York Times Magazine article on the euthanasia that occurred in the flooded hospitals? It was horrid.
    But I digress. My original post should have more pointedly asked whether one could embrace the teachings in the Book of Concord while simulatanously rejecting much of American right wing-ism. I suspect one can, and you assure me that Americans Lutherans in the LCMS (who presumably adhere to the BOC) span the spectrum politically.
    My best to your business. I have listened to Rod Rosenbladt with much enjoyment.

  • fws

    #11 Anonymous

    I know Pat pretty well. We attended the same small church (pop 100+/-) for well over a decade together.

    Some in the congregation proposed the 2 beer rule (no heavy discussion of politics or religion without first consuming at least a couple of beers).

    There is no political litmus test for being a Lutheran. I dont´think abortion is EVER the right choice unless the physical life of the mother hangs in the balance, but I am also against criminalizing it since I don´t think that is the best way to reduce the number of abortions to as close to zero as possible. Where I live in brasil abortions are criminalized and are also very very common.

    Pat is a very passionate man about just about anything I can think of that he is involved in and isn´t shy about voicing his opínions. I wish more men and women were as serious and passionate about things and were able to mix that, as Pat manages to, with a tolerance of differing opinions.

    If you REALLY want to put Pat on a roll, open a discussion with him on practical and radical application of the holy gospel. You will not be able to get him to shut up. :)) Compared to the Gospel, it seems that politics are truly a minor side interest to him.

  • fws

    #11 Anonymous

    I know Pat pretty well. We attended the same small church (pop 100+/-) for well over a decade together.

    Some in the congregation proposed the 2 beer rule (no heavy discussion of politics or religion without first consuming at least a couple of beers).

    There is no political litmus test for being a Lutheran. I dont´think abortion is EVER the right choice unless the physical life of the mother hangs in the balance, but I am also against criminalizing it since I don´t think that is the best way to reduce the number of abortions to as close to zero as possible. Where I live in brasil abortions are criminalized and are also very very common.

    Pat is a very passionate man about just about anything I can think of that he is involved in and isn´t shy about voicing his opínions. I wish more men and women were as serious and passionate about things and were able to mix that, as Pat manages to, with a tolerance of differing opinions.

    If you REALLY want to put Pat on a roll, open a discussion with him on practical and radical application of the holy gospel. You will not be able to get him to shut up. :)) Compared to the Gospel, it seems that politics are truly a minor side interest to him.

  • Booklover

    I’m not sure about the withdrawal of food and water, but the pumping up with sedatives is common here in the USA in our hospitals and hospices. I have seen it with some of my dying relatives. The hospice nurse says, “If he moves, that means he’s in pain. Give him more morphine.” So they sedate the patient even when there has been no moaning or visible distress. The doses of morphine get closer and closer in timing until the patient eventually dies. I hope I don’t sound critical because some of the hospice nurses seem loving, but it is what I have observed and it makes me nervous. Of course we want our loved ones to be comfortable, but sometimes I think the over-sedation is for our own comfort.

  • Booklover

    I’m not sure about the withdrawal of food and water, but the pumping up with sedatives is common here in the USA in our hospitals and hospices. I have seen it with some of my dying relatives. The hospice nurse says, “If he moves, that means he’s in pain. Give him more morphine.” So they sedate the patient even when there has been no moaning or visible distress. The doses of morphine get closer and closer in timing until the patient eventually dies. I hope I don’t sound critical because some of the hospice nurses seem loving, but it is what I have observed and it makes me nervous. Of course we want our loved ones to be comfortable, but sometimes I think the over-sedation is for our own comfort.

  • Patrick Kyle

    Frank,
    Thanks, man.

    Anonymous,

    Thanks for the reply.
    A couple observations. Classical libertarianism views the limited role of government as providing for the national defense and protecting citizens from physical violence and theft or fraud. We view abortion as depriving our smallest and weakest citizens of life. Therefore the debate does not center on the women’s “right to do what she wishes ” with her body, but the life of the human she is carrying.

    Hadn’t heard much about the euthanasia carried out post Katrina, but find it sickening.

    Glad you have enjoyed Dr. Rosenbladt’s lectures. If there is anything we can help you with in that regard feel free to email me at New Ref Press.

  • Patrick Kyle

    Frank,
    Thanks, man.

    Anonymous,

    Thanks for the reply.
    A couple observations. Classical libertarianism views the limited role of government as providing for the national defense and protecting citizens from physical violence and theft or fraud. We view abortion as depriving our smallest and weakest citizens of life. Therefore the debate does not center on the women’s “right to do what she wishes ” with her body, but the life of the human she is carrying.

    Hadn’t heard much about the euthanasia carried out post Katrina, but find it sickening.

    Glad you have enjoyed Dr. Rosenbladt’s lectures. If there is anything we can help you with in that regard feel free to email me at New Ref Press.

  • Cincinnatus

    Anonymous has apparently never read the Wikipedia article on libertarianism. Too many misconceptions to count.

  • Cincinnatus

    Anonymous has apparently never read the Wikipedia article on libertarianism. Too many misconceptions to count.


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