Wednesday 30 July 2008

29,000 reports of serious incidents relating to poor nutrition – the problem is the law

The Telegraph reported yesterday that there were more than 29,000 reports of serious incidents relating to poor nutrition in England during last year. Stephen O’Brien (Conservative), the shadow health minister, is reported as saying:

"This is a further disgraceful statistic from a Government which has failed patients and the public. People go to hospital expecting to get better, yet in 2007, 29,000 people suffered unnecessary and completely avoidable harm from poor nutritional care.”

The range of incidents included badly-fitted feeding tubes, frail patients who cannot reach a glass of water and deaths due to dehydration and choking.

According to The Telegraph, Stephen O’Brien went on to say "Nutrition is central to health and dignity – how many more patients must suffer at the hands of this inept Government?"

Given Mr O’Brien’s concern, which I’m sure is genuine, it’s a pity that he failed to vote on either the second or third readings of the Labour Government’s Mental Capacity Act.

Under the Mental Capacity Act, assisted food and fluids (e.g. tube-delivered) is regarded as medical treatment. Indeed, treatment is defined so broadly in the Mental Capacity Act that other elements of basic care, maybe even spoon-feeding, may be withheld from patients – as SPUC’s lobbyists warned MPs and Peers when the law was introduced into Parliament.

Moreover, the checklist for how to determine a patients' best interests in the Mental Capacity Act is dangerous. The checklist includes many woolly and subjective non-medical factors which serve to undermine protection for the patient’s life or health - clear and objective medical factors which used to be the principle criteria for determining a patient's best interests. A doctor can thus over-ride life and health when considering a patient's best interests.

The legislative environment is thus ripe for euthanasia by starvation and dehydration to flourish.

There is a connection between today’s report of poor conditions in hospitals and nursing homes and euthanasia by neglect. SPUC’s Patients First Network receives calls from distressed relatives saying that their loved ones are not being fed properly. Vulnerable patients are made weaker by lack of food and relatives often feel this is contributing to the premature death of their loved ones. Patients First Network is a support group which promotes good medical care until natural death. Anyone concerned about a friend or relative can call the Patients First Network confidential telephone support service on 0800 1691719.

The Telegraph report tells us that Dr Kevin Cleary, medical director of the National Patient Safety Agency, said:

"We recognise that good nutrition and hydration is essential for the recovery of patients and we support clinicians with guidance to ensure that learning from reported incidents is provided."

Dr Cleary may recognize the importance of good nutrition and hydration to aid the recovery of patients. The problem is the law, however, under which food and fluids can be withdrawn with the intention of ending the patient’s life.