In what some are saying is an effort to save money and available beds in the UK’s state-run health care system, a doctor has revealed that sick children are being placed on controversial “death pathways” previously used only for the elderly and terminally-ill adults.

The Daily Mail is reporting that until recently, it was believed that an end-of-life protocol known as the Liverpool Care Pathway (LCP), a kind of hospice program, was used only on elderly patients and terminally ill adults. However, an anonymous physician writing in the prestigious British Medical Journal, has revealed that the process is also being used on babies and admits that he has personally overseen the death of 10 severely disabled newborns who were starved and dehydrated to death.

In one case, which involved a baby born with a long list of congenital anomalies, the child’s parents opted for the death pathway.

“They wish for their child to die quickly once the feeding and fluids are stopped. They wish for pneumonia. They wish for no suffering. They wish for no visible changes to their precious baby,” the doctor wrote.

“Their wishes, however, are not consistent with my experience. Survival is often much longer than most physicians think; reflecting on my previous patients, the median time from withdrawal of hydration to death was ten days. 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.”

He goes on to describe 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.”

The physician admits that as the days go by, and the scene becomes more and more gruesome, the parents can no longer bear the sight. Even he struggles to watch the process unfold to its final horrific end and describes his feelings when examining these children to be “an indescribable mixture of compassion, revulsion, and pain.”

As a result of these revelations, UK authorities have launched an independent inquiry. The investigation will look at whether or not cash payments made to hospitals to hit “death pathway” targets may be influencing doctors to use the protocol.

A child’s version of the LCP was developed with pediatric staff at Britain’s premier children’s hospital, Alder Hey Hospital, and requires the parents agreement to put the child on the pathway after doctors proclaim all hopes for survival are futile. The babies are then discharged from the hospital and sent home to die, but only “after all possible reversible causes for the patient’s condition are considered.”

Such precautions usually look much better on paper than they do in real life, however.

Bernadette Lloyd, a hospice pediatric nurse who has complained to the Cabinet Office and the Department of Health about the protocol, describes the use of death pathways for children to be cruel and unusual punishment for everyone involved.

“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,” she wrote. “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.”

She went on to describe the case of a 14 year-old boy with cancer who died with his tongue stuck to the roof of his mouth after doctors refused to give him liquids by tube.

“His death was agonizing for him, and for us nurses to watch,” Lloyd said. “This is euthanasia by the backdoor.”

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