"euthanasia is being widely practiced in the NHS in an official way."
Dr. Walker explained that:
"she is regularly contacted by distressed healthcare professionals and managers who describe their experience of witnessing repeated instances of unofficial active euthanasia in their local areas"
The standards of medical ethics and of interpretation of existing legislation appears to vary greatly around the country and from one organization to the next, even in the same local area.
Whether active euthanasia is actually widespread is unknown and anecdotal at best, but the reality is that the Euthanasia Prevention Coalition regularly receives phone calls and emails from family members and friends of people whose medical care-givers appear to be intentionally causing their death. Many of these cases are concerned family members reacting to end of life decisions that are made because the person is actually dying, whereas, sometimes these cases appear to be euthanasia.
Dr. Walker made reference to the application of the Liverpool Care Pathway (LCP) that was developed by the Royal Liverpool Hospital and the Marie Curie hospice in the 1990's.
The LCP is a set of criteria that is used to withdraw Life-Sustaining Treatment and a philosophy for the application of palliative care. There have been reports that indicate people, who were not otherwise dying, being dehydrated to death based on the LCP.
Concerning the LCP, Walker stated:
"If it is used out of context, then it could be used to the detriment of patients e.g. a patient comes into a resuscitation baby and it is not always clear if a condition is acute and can be treated."
Walker reported on a recent survey that was done by a colleague that examined crematorium records. The survey found that 23% of all deaths, in one city, of people who were put on the LCP that there had been no definite diagnosis at any stage.
Walker does not blame the LCP for what appears to be abuses that is causing death, but rather she blames the application of the LCP.
For instance, it is euthanasia to intentionally cause a persons death by dehydration, when that person is not otherwise dying. This is how Terri Schiavo died. It is not euthanasia to withhold hydration and nutrition (H & N) from a person who is actively dying and/or unable to assimilate H & N. That person is actually dying and the provision of H & N provides little to no benefit and may cause suffering.
"The problems come when an idol is made of the protocols. It is the same story with anything if you make an idol of it you lose common sense and critical faculties."
She referred to this problem as
“tick box itus.”
If Walkers assessment is correct, most of these deaths are not euthanasia but rather medical malpractice or deaths related to physician error.
Gordon Macdonald of the Care Not Killing Alliance in the UK questioned that covert euthanasia is widespread in the UK. Macdonald stated that:
"Of course we share concerns over abuses,” he said. “Anecdotally we hear stories of certain care homes with questionable practices but generally we would not accept it’s widespread."
Walker may be understating the problem with LCP. She is correct to state that when protocols are abused, that it can result in the death of a person, who may have recovered with proper treatment. But the LCP does not prevent doctors from intentionally dehydrating people to death who are not otherwise dying.
Many physicians do not share Walker’s ethical principles and may use LCP as a protocol to intentionally and directly cause death (euthanasia) rather than unintentionally causing death out of a lack of proper training.
We must not to overstate the problem of covert euthanasia, as the euthanasia lobby does in order to promote euthanasia, and yet at the same time we must be vigilant to protect vulnerable people from backdoor euthanasia.