Medical Directors Sentenced

To view original article, click here

Judge Lynn

By Jim Parker

Chief U.S. District Judge Barbara M.G. Lynn has sentenced Novus Health Services Medical Directors Mark E. Gibbs, M.D., and Laila Hirjee, M.D., along with one of the company’s nurses, Tammie Little, to a combined 23 years in prison following their convictions for hospice fraud exceeding $40 million.

Gibbs was sentenced to 13 years as well as paying restitution of nearly $28 million. Hirjee received 10 years in prison and must pay more than $16 million. The judge also sentenced Little to a 33 month incarceration.

The company’s CEO Bradley Harris was also convicted in the case. He agreed to a plea deal, pled guilty and testified against his former employees, according to the U.S. Department of Justice.

Marsha Joiner to Interview Michelle Young Doers

Tomorrow night on the Betrayed by Hospice show, Marsha Joiner interviews Michelle Young Doers, RRT Registered Respiratory Therapist and author of Killing for Profit: The Dark Side of Hospice, available at this link.

Dial 917-388-4520 or listen live on the internet. 5 p.m. Pacific, 6 p.m. Mountain, 7 p.m. Central, 8 p.m. Eastern Time Zones

Michelle writes this heartfelt book from deep within the trenches of what she witnessed first-hand while working for hospice, caring for patients at the end of their life. She saw a business model of cutting corners, making promises that would never be kept and placing the bottom line of the accountants ahead of the care for the patient.

New Office of Inspector General Report: Hospice Deficiencies Pose Risks to Medicare Beneficiaries

WHY WE DID THIS STUDY  

The Office of Inspector General (OIG) has identified significant vulnerabilities in the Medicare hospice benefit and found that hospices did not always provide needed services to beneficiaries and sometimes provided poor quality care.  Click here to view report.

Linda Isner of Murdered by Hospice: Vote "No" on HR 1676, the Palliative Care and Hospice Training and Education Act

My husband Alan Isner was overdosed on Ativan Morphine and Haldol in a hospice and died when all he needed was anxiety medication. He was not suffering from pain or agitation but was given high doses of these drugs and the medical examiner's report revealed enough Morphine to kill several people. 

Why the Site HospiceFraud Exists

An excerpt below from "Hospice Fraud." 

This is not a site that supports hospice haters. This is a site that inspires solutions. You can't totally eliminate care for the elderly, disabled or dying or you will just have euthanasia! You have to have some type of caring whatever you call it and originally hospice was the appropriate way of caring for people using the best of science to relieve suffering without killing.

Today, much greed in the industry and those who have found ways to make a lot of money off of human suffering have changed the landscape. Hospice patients are simply a money crop.

Press Release: "Proposed Federal Hospice Act Must Be Defeated to 'Stop the Waste, Bleeding and Heartache'"

https://www.einnews.com/pr_news/465588180/proposed-federal-hospice-act-must-be-defeated-to-stop-the-waste-bleeding-and-heartache

Washington DC

Dore: "Existing federal hospice programs, such as the Medicare hospice benefit, are plagued by fraud, poor quality care, rampant abuse, arguably murder, and a gross waste of taxpayer dollars. Enacting another federal hospice program, when existing programs are far from being under control, makes no sense and will only cause more of the same."

Memo to the U.S. Senate HELP Committee: Vote No on the Palliative Care and Hospice Education and Training Act

By Margaret Dore, Esq., MBA

For a summary sheet including a similar House bill (H.R. 1676), click here. For a pdf version of this memo, click here.

I.  INTRODUCTION

I am an elder law attorney and president of Choice is an Illusion, a nonprofit corporation opposed to assisted suicide and euthanasia.[1] Formed in 2010, Choice is an Illusion fights against assisted suicide and euthanasia throughout the U.S. and in other countries.[2] We also fight against hospice and palliative care abuse.

S. 693, the Palliative Care and Hospice Education & Training Act," amends the existing Public Health Service Act to require financial support for “Palliative Care and Hospice Education Centers.”[3] This is a new program, which will include direct patient care.[4]

Existing federal palliative care programs, such as the Medicare hospice benefit, are plagued by fraud, poor quality care and a gross waste of taxpayer money.[5] S. 693 must be rejected unless problems with existing programs are resolved; Congress must not throw good money after bad. The bill must also be rejected for the reasons set forth below. 

Fraud, Waste, and Abuse in the Medicare Hospice Program Is ‘Repellent’

Joanne M. Chiedi

https://www.statnews.com/2018/08/28/medicare-hospice-fraud-waste-abuse/

By Joanne M. Chiedi

Like many Americans, I have a story about hospice care for a loved one. When my father was dying from complications of dementia and diabetes, hospice caregivers sat with him, provided pain relief, and helped him be comfortable. They also gave my mother peace of mind that her beloved husband was receiving kind attention in his final weeks. To this day, she refers to those hospice workers as angels.

Sadly, not every family’s story is a positive one.

Two Doctors Convicted of Falsely Certifying Patients as Terminally Ill as Part of $8.8 Million Healthcare Fraud Scheme

https://www.justice.gov/usao-cdca/pr/two-doctors-convicted-falsely-certifying-patients-terminally-ill-part-88-million

FOR IMMEDIATE RELEASE

U.S. Attorney Eileen M. Decker

Thursday, May 5, 2016

LOS ANGELES – Two doctors were found guilty today of federal health care fraud charges for falsely certifying that Medicare patients were terminally ill, and therefore qualified for hospice care, when the vast majority of them were not actually dying.

Following a two-week trial, the doctors were found guilty of participating in a scheme related to the Covina-based California Hospice Care (CHC). Between March 2009 and June 2013, CHC submitted approximately $8.8 million in fraudulent bills to Medicare and Medi-Cal for hospice-related services, and the public health programs paid nearly $7.4 million to CHC.

The two doctors convicted today by a federal jury are:

• Sri Wijegoonaratna, known as Dr. J., 61, of Anaheim, who was found guilty of seven counts of health care fraud; and
• Boyao Huang, 43, of Pasadena, who was found guilty of four counts of health care fraud.

Crime Blog: Hospice owner urged nurses to overdose patients so they would die quicker, FBI says

http://crimeblog.dallasnews.com/2016/03/frisco-hospice-owner-urged-nurses-to-overdose-patients-to-speed-their-deaths-fbi-says.html/

Jamie Knodel Email jknodel@dallasnews.com
Published: March 29, 2016 10:29 pm

BY SCOTT GORDON, KXAS-TV (NBC5)

The owner of a Frisco medical company regularly directed nurses to overdose hospice patients with drugs such as morphine to speed up their deaths and maximize profits and sent text messages like, “You need to make this patient go bye-bye,” an FBI agent wrote in an affidavit for a search warrant obtained by NBC 5.

The executive, Brad Harris, founded the company, Novus Health Care Services Inc., in July 2012, according to state records.

Novus’ office is on Dallas Parkway in Frisco.

No charges have been filed against Novus or Harris. Harris, 34, did not return messages left with a receptionist and at his Frisco home.

Harris, an accountant, told a nurse to overdose three patients and directed another employee to increase a patient’s medication to four times the maximum allowed, the FBI said.

In the first case, the employee refused to follow the alleged instructions, the agent wrote in the affidavit. The document does not say whether the other three patients were actually harmed.

Harris also told other health care executives over a lunch meeting that he wanted to “find patients who would die within 24 hours,” and made comments like, “if this f— would just die,” an FBI agent wrote in the warrant.

An FBI spokeswoman declined to comment on the investigation.

Novus’ website says the company offers hospice and home health care services.

“We have a saying at Novus, be fast and treat people the way we would want to be treated,” the website says. “This encourages us to go the extra mile to make patients feel comfortable and secure about their special needs and requests.”

Kate Kelly: “Doctors are already abusing the power they have."

Dear Assemblymembers:

Please vote "No"on ABX2-15 (assisted suicide/euthanasia). Doctors are already abusing the power they have.  This bill, which will give doctors even more power to medically kill patients, can only make a bad situation worse.

In 2009, my mother died after a young doctor encouraged my brother, who held power of attorney, to begin “comfort care.”  My mother, who was NOT DYING, had had a mild stroke.  She had been trying to speak and had indicated that she would like some water.  Instead, on the order of this doctor, she was medically killed  (starved and dehydrated, with massive doses of morphine).

In that same year, I published my mother’s story . Since then, I have been contacted by other adult children in the US and Canada whose parents were  involuntarily killed via starvation, dehydration and overdose..

These involuntary deaths of people who were not dying are not isolated incidents.

If New Jersey's Assisted Suicide Bill Is Enacted, There Will be Pressure to Expand its Reach to Broader Groups of People.

By Margaret Dore, Esq., MBA

Today, the New Jersey Assembly passed a proposed assisted suicide/euthanasia bill, which goes next to the New Jersey Senate. The bill is the "third reprint" of A2270, which has a six months to live eligibility criteria for assisted suicide and euthanasia.

If enacted, there will be pressure to expand “eligibility” to broader groups of people who are not close to death.  I say this due to what’s been happening with hospice and our experience here in Washington State regarding our similar law.  See also this legal/policy analysis of the third reprint.

Hospice

Hospice has a six months to live eligibility criteria.  In August, the Washington Post reported that there “appears to be a surge in hospices enrolling patients who aren’t close to death.”[1]  This practice is resulting in the overdose deaths of non-dying people.[2]

This is consistent with what I've been hearing from people in both the US and Canada regarding the deaths of their family members.[3]

Washington State

In Washington State, our law went into effect in 2009.  Since then, we have had informal “trial balloon” proposals to expand our law to non-terminal people.  For example, there was a column in the Seattle Times, which is our largest paper, containing this suggestion for euthanasia of people who didn't save enough for their old age. The column stated:

A few [readers] suggested that if you couldn't save enough money to see you through your old age, you shouldn't expect society to bail you out.

At least a couple mentioned euthanasia as a solution.[4] 

So, you work hard all your life, pay taxes and then your pension plan goes broke, this is how society would pay you back, with non-voluntary or involuntary euthanasia?

Prior to passing our law, I never heard anyone talk like this.

Don't make Washington's mistake.

Margaret Dore is an attorney in Washington State and President of Choice is an Illusion.  For more information about problems with New Jersey's bill, please see Ms. Dore' legal/policy memo regarding that law, which can be viewed here: https://choiceisanillusion.files.wordpress.com/2014/11/nj-no-on-a2270-no-assisted-suicide-11-12-14.pdf

[1] Peter Whoriskey, “As More Hospices Enroll Patients Who Aren’t Dying, Questions About Lethal Doses Arise,” Washington Post. August 21, 2014, http://www.washingtonpost.com/news/storyline/wp/2014/08/21/as-more-hospices-enroll-patients-who-arent-dying-questions-about-lethal-doses-arise/?
[2] Id.
[3] See e.g. Carol Mungas, "I support House Bill 505, which clearly states that assisted suicide is not legal" (My husband, Dr. James E. Mungas "was effectively euthanized against his will"),  http://www.montanansagainstassistedsuicide.org/2013/03/i-support-house-bill-505-which-clearly.html; Daniela, "Euthanasia without patient consent and over the family's objection," ("Our family . . . is having emotional problems because of what we witnessed.... [N]ow I hear my grandma cry for water every night") http://www.margaretdore.org/2014/11/euthanasia-without-patient-consent-and.html and Kate Kelly, "Mild stroke led to mother's forced starvation,"("I cried much of the time, but softly, so she would not know.  I didn't want to add to her agony.")   http://www.choiceillusion.org/p/mild-stroke-led-to-mothers-forced.html
[4] To view a copy of the newspaper column, please go here: https://choiceisanillusion.files.wordpress.com/2014/10/jerry-large_001.pdf.

Euthanasia without patient consent and over the family's objection

This last August, the Washington Post did a feature article on how non-dying people are being killed in hospices. See http://www.washingtonpost.com/news/storyline/wp/2014/08/21/as-more-hospices-enroll-patients-who-arent-dying-questions-about-lethal-doses-arise/?   

I have had many people contact me with similar stories.  Below, please find the latest one by a Romanian immigrant.  I hope that more doctors, nurses and other healthcare professionals can speak out about these cases, before it's too late.

Margaret Dore, Esq., MBA, President

http://horror.kaiserpapers.org/elisabeta-koczur.html

Case in Point: 

My name is Daniela. I am 46 years old and live in Oregon. I believe my grandmother was killed in a hospital on June 24, 2014. She was in the emergency room for three hours and was given morphine after we had refused it and clearly asked for her right to die naturally. The nurse told me that it was time to say goodbye and she died almost immediately upon receiving that shot. I have the medical records, but there is no notation of the morphine she was given, which makes me believe the records were falsified. 

The photograph to the left is of Elisabeth Koczur.

The last wish my grandma had was for a drink of water. I don't think I will ever forget how she looked at me expecting help. Four nurses in the room imprisoned me and I could not move. I was forced to keep looking in her eyes as she pleaded for water. Why was I not allowed to grant her last wish?

Our family is in shock and is having emotional problems because of what we witnessed. My grandma went to the hospital with abdominal pain and shortness of breath. There, according to the medical records, she was diagnosed to have congestive heart failure, but, when she went into cardiac arrest, they did not attempt to resuscitate her. If she had received proper treatment, she might be here with us today. Grana, as I called her, was 99 years old. I think they decided that she had lived too long, but they did not know this beautiful soul.

Washington Post Puts the Spotlight on Hospice/Palliative Care Abuse

By Margaret Dore, Esq., MBA

Choice is an Illusion, President

Below and finally, a comprehensive article in a major paper describing what a lot of us know already, that non-consenting, non-dying people are being killed with morphine and other drugs under the guise of hospice/palliative care.  The article, excerpted below from the Washington Post, describes cases in the US. There are similar cases in Canada and the UK (e.g, the former "Liverpool Pathway").

There are a myriad of reasons why these cases occur, including mistakes and negligence, which is described in the Post article.  The wishes of heirs interested in a speedy inheritance and/or to get dad out of the way before he changes his will, can also be at play.  For a particularly egregious example, see William Dotinga, "Grim Complaint Against Kaiser Hospital," at http://www.courthousenews.com/2012/02/06/43641.htm

With hospice, eligibility is determined by a prediction of less than six months to live.  This is the same eligibility cutoff used for legal assisted suicide in Oregon and Washington State.  This is, however, just a prediction and there are many people deemed eligible who live longer than that and/or who are not dying.  See, e.g., the Washington Post article excerpted below and this article from the Seattle Weekly: "Terminal Uncertainty."  See also this affidavit from Oregon doctor Kenneth Stevens, MD and this affidavit from John Norton.

This hospice/palliative care abuse issue is important for itself, as well, as for its implications in the larger debate over assisted suicide/euthanasia legalization.  Consider, for example, the letter below from Washington State.  The author, the owner of a care facility, describes how since passage of Washington's assisted suicide law, doctors more readily resort to morphine, sometimes without consent.  He states:

Since [Washington's assisted suicide law] passed, we have . . .  noticed that some members of the medical profession are quick to bring out the morphine to begin comfort care without considering treatment. Sometimes they do this on their own without telling the client and/or the family member in charge of the client's care. http://www.choiceillusion.org/2013/12/it-wasnt-father-saying-that-he-wanted.html

He also describes a general devaluation of older people, as follows:

Since our [assisted suicide] law was passed, I have also observed that some medical professionals are quick to write off older people as having no quality of life whereas in years past, most of the professionals we dealt with found joy in caring for them. Our clients reciprocated that joy and respect.  (Id.).

He concludes by asking readers to not make Washington's mistake of legalizing assisted suicide. He states:

Someday, we too will be old. I, personally, want to be cared for and have my choices respected. I, for one, am quite uncomfortable with these developments. Don't make our mistake.  (Id.).

* * *
Below, the excerpt from the Washington Post article.

As More Hospices Enroll Patients who Aren't Dying, Questions About Lethal Doses Arise

http://www.washingtonpost.com/news/storyline/wp/2014/08/21/as-more-hospices-enroll-patients-who-arent-dying-questions-about-lethal-doses-arise/?

By Peter Whoriskey at peter.whoriskey@washpost.com

Mother was deprived of choice to live; assisted suicide would lead to more patient abuse

http://ravallirepublic.com/news/opinion/mailbag/article_09c08760-817c-571a-ada1-d42a0e2a3450.html?comment_form=true

August 18, 2014 6:15 am  

The letter by Gail Bell rang true to my own experience (“Mother’s death provided painful, personal example of need to stop assisted suicide,” Aug. 5).

In 2009, my mother died a painful death. It wasn’t from her condition or a disease. You see, my mother was starved and dehydrated to death with massive doses of morphine after she’d had a mild stroke. It had not mattered that she had been trying to speak and had indicated that she wanted water. The family member holding power of attorney, affirmed by a young doctor, had decided that it was time for her to die.

I watched my mother die, day and night for six days. She tried to fight, to wake up, but to no avail, and she suffered. To use the vernacular of assisted suicide proponents, she did not get her choice.

If these terrible deaths happen when aid in dying (assisted suicide and euthanasia) is not legal, what will happen if these practices are made legal? Doctors will have even more power to take away patient choice. If we can’t stop the abuse now, how will we be able to stop the abuse then?

In 2009, I first published my mother’s story, which can be viewed here www.choiceillusion.org/p/mild-stroke-led-to-mothers-forced.html.

I have since been contacted by adult children in both the U.S. and Canada whose parents were involuntarily starved and dehydrated to death. I hope that this practice can be stopped before it is too late. I offer my heartfelt condolences to Gail Bell.

Kate Kelly,
Delta, British Columbia, Canada

Others Dictated For Her

http://missoulian.com/news/opinion/mailbag/mother-s-death-provided-painful-personal-example-of-need-to/article_3c8a1d98-1a9c-11e4-bb8e-001a4bcf887a.html

The July 25 guest column by Sara Myers and Dustin Hankinson begins with a discussion of pain, “great pain,” specifically. The paragraph goes on to use the phrase “great pain” to justify “death with dignity,” meaning assisted suicide and euthanasia.

With their column, I couldn’t help but think of my mother’s last years and the decision of others that it was time for her to die. Pain was used as a justification for increases in her medication – to get the job done. This happened three times before she finally died in the hospital on Sept. 6, 2010. The coroner’s report, case No. 100906, lists the cause of death as congestive heart failure with oxygen deprivation and “fentanyl therapy.” The manner of death is listed as “accident.”

Fentanyl is reported “to be 80 to 200 times as potent as morphine.” It’s also well known that fentanyl patch problems cause overdoses, injuries and deaths. See www.aboutlawsuits.com/fentanyl-patch-problems-continue-overdose-deaths-55136. A 100 mcg/hour fentanyl patch has a range within 24 hours of 1.9-3.8 ng/mL. Mom’s death result was 2.7 ng/mL on/or about 48 hours.

A complaint was filed by me with the Montana Board of Medical Examiners, No. 2012-069-MED. The screening panel dismissed the complaint with prejudice, which means that the board may not consider the complaint in the future.

Since then, I have talked with other people who have had similar experiences involving the death of a family member via a medical overdose. Please see here: http://www.choiceillusionmontana.org/2013/04/dont-give-doctors-more-power-to-abuse.html

The column by Myers and Hankinson states, “I believe one should have control of one’s life including its ending.“

I agree with that statement. However, my mother did not have that control. Others dictated for her. Please rethink legalizing assisted suicide and euthanasia so that we do not give others even more power to kill.

Gail Bell,
Bozeman

Cherelle Samuel: They Drugged My Grandmother and Fed Us Lies

Edited by Margaret Dore, click here to view original

From beginning to end my grandma was a fighter who was battling stage IV stomach cancer and was given 6 months to live back in January she outlived their time table, but the story doesn't end with a closed book.

I moved in with her in March this year and was with her every step of the way so my final decision came from what I thought was from the heart.  We had a few good months where we would go out and she would go to gamble. She always kept a smile on her face up until the last few days we had with her.

Judge upholds count of assisted suicide

http://www.philly.com/philly/health/20130802_Judge_upholds_count_of_assisted_suicide.html#hLRSrC4PBjvmaCti.99

POTTSVILLE, Pa. - A judge on Thursday upheld charges against a Philadelphia woman accused of helping her 93-year-old father commit suicide through a morphine overdose at his home here, where he was in hospice.

Prosecutors in Schuylkill County charged Barbara Mancini, 57, with aiding suicide. The judge refused to drop the charges after a preliminary hearing.

Pottsville police say Mancini handed Joseph Yourshaw a bottle of liquid morphine at his home in February, leading to his death four days later. The death certificate, which listed the immediate cause as "morphine toxicity" that complicated high blood pressure and heart disease, was issued in June.

Mancini, who was trained as a nurse, remains free on bail. Her lawyer could not be reached for comment Thursday evening. The local district attorney's office asked the state to prosecute the case due to a conflict of interest.

An end-of-life advocacy group called for the charges to be dropped, saying the U.S. Supreme Court allows dying patients to receive adequate pain relief, even if it hastens their death. "Attorney General [Kathleen] Kane should leave Barbara and her family alone so they can grieve over their loss," Barbara Coombs Lee, president of Denver-based Compassion and Choices, said in a statement.*

*Compassion & Choices is the former Hemlock Society.  To learn more about C & C, read:  and Theresa Schrempp, Esq.,  "Compassion & Choices is a Successor to the Hemlock Society" and Senator Jennifer Fielder on Compassion & Choices: "Beware of Vultures." 

Or, go to these links:  http://www.montanansagainstassistedsuicide.org/2012/12/compassion-choices-is-successor.html and http://www.montanansagainstassistedsuicide.org/2013/06/beware-of-vultures-senator-jennifer.html 

The "Liverpool Care Pathway," Hospice and Palliative Care Abuse

The "Liverpool Care Pathway" (LCP)  is a system of hospice/palliative care in the UK.  In the last few years, the system has come under fire as "stealth euthanasia" in which patients are put on the LCP "without consent" and without "being allowed, food, fluids and medication."  See the BBC article set forth below: “Liverpool Care Pathway: Your experiences.”

I periodically receive similar complaints from people in the US and Canada.  Consider, for example, this letter by an elder care facility owner in Washington State where assisted suicide is legal:

"Since the [assisted suicide] act passed, we have . . . noticed that some members of the medical profession are quick to bring out the morphine to begin comfort care without considering treatment.  Sometimes they do this on their own without telling the client and/or the family member in charge of the client's care." 

http://www.montanansagainstassistedsuicide.org/2012/07/dear-montana-board-of-medical-examiners.html

Consider also, this letter published in a Montana newspaper:

“If these terrible deaths happen when aid in dying (assisted suicide and euthanasia) is not legal, what will happen if these practices are made legal? Doctors will have even more power to take away patient choice."

http://www.montanansagainstassistedsuicide.org/2013/04/dont-give-doctors-more-power-to-abuse.html

Margaret Dore, Attorney at Law
President, Choice is an Illusion, a nonprofit corporation

___


"Liverpool Care Pathway: Your Experiences"

http://www.bbc.co.uk/news/health-23301360

The LCP was developed to support dying patients

 

The Liverpool Care Pathway (LCP) should be phased out, an independent review is expected to say.

The system was designed to allow terminally-ill patients to die peacefully and with dignity.

However, the LCP has come under criticism with some believe it is being used to speed up the process of dying. There have been some reports of patients being put on it without consent and not being allowed, food, fluids and medication.

Here, [three] family members of those who have been on the Liverpool Care Pathway, share their experiences of the programme. [There are two unfavorable views and one favorable view of the LCP]

Kayleigh Hollobone

Two years ago, when I was 22, I lost my 56-year-old mother to cancer.

During the six months from her diagnosis in January 2012 until her death, she was unknowingly to us put on the LCP. She was deprived of fluids and any source of nutritional supplement without even the slightest consent or conversation with me or my family.

It was only after my absolute insistence and persistence that my mother received fluids and that was after over 36 hours without any.

It scares me that people who do not have bossy and demanding families, like me and mine, to fight for them will be left or even encouraged to die via the LCP.

My mother survived another three months. We got to hear her laugh and joke again and importantly my mother got to say her goodbyes. Had the enforced LCP been allowed to continue, those few important months of time with my mother would have without a doubt been taken away from me and my family.


I can't stress how important me and my family feel about the process of the LCP. It needs to be readdressed - the memories it could have deprived me of are invaluable. She wrote me a letter that I will have forever and it will always be the most treasured item I possess.

Helen Redshaw

"The Liverpool Care Pathway aided her in a gentle and thoughtful way”

My mother passed away from cancer just three months ago. The Liverpool Care Pathway was used and I have nothing but praise for it. We had help from night nurses through the NHS Beacon program, Marie Curie and Macmillan, all of which gave exemplary care. Leaflets on the LCP were given to us and time was taken by all to fully explain why and how it would work. 

Towards the end, my mother couldn't swallow and didn't want food - this was her body getting ready to die. It was slow and peaceful, and she was my mother until about the day before when we all knew she was leaving.

There was no prolonging of life. She was ready to go and the Liverpool Care Pathway aided her in a gentle and thoughtful way. It wasn't the refusal to give her food and drink; she no longer wanted it.

She had as natural an early death as can be and I am thankful as it helped me and my family cope as we saw her slip away. This is something that should be offered and explained to patients and family and I have nothing but support for it.

William Hughes

My father Professor Robert Hughes was subjected to this technique without my or his consent. When it became clear that his cancer of the prostrate became untreatable I was asked what I wanted to do and I told them clearly that I wanted him to die with dignity.

I was assured by the staff at the hospital that would happen, that he would have died a dignified death. He didn't. He was sedated, unconscious and died within three days looking like something from Belsen concentration camp.

He was not given water or food but instead put on a driver syringe containing diamorphine, midazolam and cyclizine. The first two of those drugs would down a horse. . .

Sadly there is no going back. I didn't know that once started, it's irreversible.

No one makes this clear. This is the main part, if not for some the final part, of the LCP.

In the new scheme when that comes out, if they allow these two drugs to be continued to be used, it is euthanasia, plain and simple.

Death by Dehydration and Starvation

Click here to view original letter.

My mother, Sharon Moe, was diagnosed with colon cancer in February of this year. After her surgery, I was told that she may be able to live for 6 months to 2 years. My mother was against assisted suicide and euthanasia and wanted to live as long as possible. She was placed back in the care of the nursing facility where hospice started to care for her. She was placed on a continual feed through a feeding tube because she was unable to take in anything orally due to her medical condition.

From the beginning, hospice wanted to stop the continual feed. My mother was adamant that she wanted to live and told the hospice nurse that she wanted to stay on the continual feed. My mother was able to converse and sit upright within a day or so after being taken back to the nursing facility. Her health was improving and she was doing really well after surgery despite the fact that she was underweight from not being able to eat.

The hospice nurse was still wanting to remove the continual feeding, even though my mother was doing well. My mother was able to tolerate the food and was not aspirating from it. The nurse placed a pain patch on my mother even though she wasn't in pain. They didnt ask her if she was in pain--they just administered the pain patch because she had a 'furrowed brow'. This pain patch caused my mother to hallucinate and be in a semi-comatose state. She was talkative and looking better before the patch was administered. After the patch had been in her system overnight, she started seeing things and was very scared.

My mother did not get the chance to live on longer as she had willed, but her death was hastened by dehydration and starvation after removing the continual feeding. My mother was not experiencing any pain and would tell someone if she had it....

Mike Moe, Great Falls Montana