Police and health officials are investigating at least 50 deaths of patients around England amid accusations that the deaths were hastened by denying the patients intravenous fluids.
The inquiries centre on hospitals in Derby, Surrey, Kent, and Sussex. Most of the inquiries are looking into individual cases, but the Derby investigation is probing the deaths of 40 patients with dementia on a psychogeriatric ward at the Kingsway Hospital between 1993 and 1997. In a number of cases patients were allegedly sedated while denied hydration.
A former nurse triggered the investigation in Derby. Three nurses have been suspended since the start of the inquiry in November 1997. No charges have yet been laid, but staff could face charges of manslaughter by criminal neglect. Papers are expected to go to the Crown Prosecution Service (CPS) in the spring. A CPS spokeswoman said: “We have given advice to the police on legal issues.”
Charges could also follow the death of an 81 year old woman in a Surrey hospital. Her relatives claim she was relatively healthy but died as a result of dehydration.
Michael Wilks, chairman of the BMA’s ethics committee, said that responses to the committee’s consultation on withdrawing and withholding treatment suggested that doctors were withdrawing artificial nutrition and hydration from patients who were not terminally ill, particularly patients with dementia and those who had had serious strokes.
The House of Lords has stated that court sanction is needed to withdraw treatment from patients in a persistent vegetative state. But in other cases, doctors must take the decision in what they believe to be the patient’s best interests.
Dr Wilks said: “There may be cases where best interest judgments and full clinical assessments have not been adequate.” He added that the ethics committee regarded the advice it was formulating for doctors on the issue as “absolutely crucial.”
He advised doctors that they should take decisions about withdrawing nutrition and hydration from people who were not in the process of dying “only with great care and with legal advice.” He hoped that the draft advice for doctors would be available for debate at the BMA’s annual representative meeting in July.