Abuse of Liverpool Pathway extends to dehydrating newborns with disabilities

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Liverpool Pathway is a guideline in the UK that doctors follow to ensure that people who are nearing death receive good pain and symptom management. There have been several studies and many articles, over the past few months, concerning the abuse of the Liverpool Pathway. The Liverpool Pathway is abused when doctors decide to place a patient, who is not otherwise dying on the Liverpool Pathway or when a doctor decided to the abuse the Liverpool Pathway to cause death.

An article last June suggested that patients that are difficult to manage were being put on the Liverpool Pathway to die prematurely. An article published in October emphasized how the UK was planning to tighten the guidelines for the Liverpool Pathway to ensure that people are not by euthanasia by dehydration.

An article that was written by Sue Reid and Simon Caldwell and published on November 28 in the Daily  Mail newspaper in the UK under the title: Now Sick Babies go on Death Pathway: Doctor's haunting testimony reveals how children are put on end-of-life plan explains how babies with disabilities were intentionally killed through the abuse of the Liverpool Pathway. The article stated:

Sick children are being discharged from NHS hospitals to die at home or in hospices on controversial ‘death pathways’. 

Until now, end of life regime the Liverpool Care Pathway was thought to have involved only elderly and terminally-ill adults. 

But the Mail can reveal the practice of withdrawing food and fluid by tube is being used on young patients as well as severely disabled newborn babies.

The article then uncovers a report in a medical journal that reports that a physician admitted to withdrawing fluids from at least 10 babies. The article stated:

One doctor has admitted starving and dehydrating ten babies to death in the neonatal unit of one hospital alone. 

Writing in a leading medical journal, the physician revealed the process can take an average of ten days during which a  baby becomes ‘smaller and shrunken’. 

‘Parents and care teams are unprepared for the sometimes severe changes that they will witness in the child’s physical appearance as severe dehydration ensues. 

‘I know, as they cannot, the unique horror of witnessing a child become smaller and shrunken, as the only route out of a life that has become excruciating to the patient or to the parents who love their baby.’ 

According to the BMJ article, the doctor involved had presided over ten such deaths in just one hospital neonatal unit. 

In a response to the article, Dr Laura de Rooy, a consultant neonatologist at St George’s Hospital NHS Trust in London writing on the BMJ website, said: ‘It is a huge supposition to think they do not feel hunger or thirst.’ 

Clearly the report is referring to an abuse of the Pathway that fits the description of euthanasia by dehydration, often referred to as slow euthanasia. Euthanasia by dehydration occurs when a person, who is not otherwise dying, is intentionally dehydrated to death. The abuse of the Liverpool Pathway is very similar to the use of the Groningen Protocol in the Netherlands.

The Liverpool Pathway is undergoing an investigation and a possible revision. The article informs us about the history of the Liverpool Pathway. The article states:

The LCP was devised by the Marie Curie Palliative Care Institute in Liverpool for care of dying adult patients more than a decade ago. It has since been developed, with paediatric staff at Alder Hey Hospital, to cover children. Parents have to agree to their child going on the death pathway, often being told by doctors it is in the child’s ‘best interests’ because their survival is ‘futile’.

The article then informs us that Bernadette Lloyd, hospice paediatric nurse has officially criticised the use of the Liverpool Pathway for children. The article states:

She said: ‘The parents feel coerced, at a very traumatic time, into agreeing that this is correct for their child whom they are told by doctors has only has a few days to live. It is very difficult to predict death. I have seen a “reasonable” number of children recover after being taken off the pathway. 

‘I have also seen children die in terrible thirst because fluids are withdrawn from them until they die. 

‘I witnessed a 14 year-old boy with cancer die with his tongue stuck to the roof of his mouth when doctors refused to give him liquids by tube. His death was agonising for him, and for us nurses to watch. This is euthanasia by the backdoor.’

The article also reports that:

Teresa Lynch, of protest group Medical Ethics Alliance, said: ‘There are big questions to be answered about how our sick children are dying.’

Hopefully the investigations into the Liverpool Pathway in the UK will also effect the care of people, whether they be adults or children, world-wide. The clear abuse of palliative care that is occurring in the UK is also happening throughout the world.

Historically, the T4 German euthanasia program began the same way in 1939. Children with disabilities were first dehydrated to death, and then they were injected, and then they were gassed. 

In case you are wondering, legalizing euthanasia does not stop the abuse.