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Man with Down's Syndrome "accidentally" starved to death in UK hospital

Martin Ryan, age 43, suffered a stroke which left him ostensibly unable to swallow. So he was in the hospital. Where he was starved to death "by accident" over a period of 26 days. According to the article, the doctors thought he was being fed through an NG tube, but he was never even given an NG tube, and by the time they found out he was starving to death, he was "too weak" for the insertion of a PEG tube. He died "in agony" five days after they found out what was going on.

This case is being highlighted as one of horrific neglect. It is at least that.

But does a whiff of fishy smell come to your nose at those references to his death's being a result of "miscommunication" and to its being "too late" to save him (five days before he actually died)?

Let's take the points one at a time. Suppose that the article is accurate when it reports that he never had an NG tube. Then what in the world can it mean to say that the doctors thought he was being fed by one? In my admittedly limited experience, when an NG tube has been dropped, it's left in place. If the doctors were even looking at him, they could see he did not have an NG tube. It's not like the nurses would be feeding him with it and taking it out every time in between.

But things get stranger the more we think about them. What did the nurses think? Since they obviously were not feeding him, why weren't they? Nobody is going to tell me that the doctors thought the nurses were feeding him and the nurses thought the doctors were feeding him. That's not a doctor's job. It seems plausible to me that the nurses thought he was supposed to be left to dehydrate to death since he could not eat naturally. Otherwise, why wasn't he fed? And dehydrating stroke patients to death is hardly unheard-of, in the U.S. or in the UK.

Now what about this business of his being "too weak" for a PEG tube insertion? It's my impression that doctors are very, very quick to say that it's "dangerous" to have the exceedingly minor surgery for PEG tube insertion. I suppose in this case they told his relatives that he might die of the anesthetic. But it took him five more days to die. Could he not have been rehydrated with an IV? And after that fitted with an NG tube after all? Why did he have to "die in agony" even after the "mistake" was discovered?

This whole thing smells to high heaven. The hospital's excuses, lame though they are, sound to me like an attempt to excuse something worse than a mistake. Perhaps the doctors did not especially intend Martin Ryan to be starved to death, but they obviously didn't make the smallest attempt to find out if he was being fed and apparently (if the story is correct) ignored the blatant evidence of the fact that he had no NG tube. In other words, they turned a blind eye. The nurses pretty obviously deliberately didn't feed him. We are talking about a period of 26 days. Even if we allow the nurses to be thought of as mindless automata who had to starve a patient to death if that was the doctor's will, they couldn't even have asked, sometime in 26 days? "Oh, excuse me doctor, but did you intend Mr. Ryan to starve and dehydrate to death, or did you want us to get an NG tube on him?" And when the "mistake" was discovered, it's pretty clear that the hospital made very little effort to rectify its error and save him.

This case points to a deeper and darker problem in the NHS than miscommunication and inefficiency.

HT Secondhand Smoke

Comments (9)

A whiff of a fishy smell? More like the stench of an entire trawler not brought to market in a timely fashion. They're not really bothering to offer much in the way of excuses any longer, only the most transparent, pro forma, "procedural mistakes and oversights may have been made", equivocal rationalizations. The bogosity of the excuses is itself more or less an admission that death was the intended end, cloaked just enough to prevent the casual from grasping that fact.

I know. I've gotten the impression previously that in the UK they may be slightly less inclined to dehydrate tube-dependent people to death than we are in the U.S., but I will have to put this into the evidence basket on the other side of that conclusion!

Ann Abraham, the Parliamentary and Health Service Ombudsman, is expected to deliver a withering verdict in her report.

Will that verdict result in criminal prosecution for, like, you know, killing someone? Or is it just a pro forma display of outrage?

I suppose there is still hope when they bother to offer the flimsy. Weep for the day these things happen to the sound of crickets chirping.

Bill, there certainly won't be any prosecution. In the U.S., they could be sued. Nothing has so much resigned me to our litigious society w.r.t. to medical care as seeing the way it plays out in the UK where medical care is given by the state and medical personnel are, apparently, not subject to malpractice suit.

Scott, believe it or not I had thought something much along those lines. Why are they bothering to make excuses? This raises the hope that perhaps if his family had made a bigger fuss while he was still alive he would have been fed. But I don't know.

This is all just seems like a pantomime - you can sense the big wink the hospital and British officialdom are sending to the public, everyone going through the motions to make it seem like they are going to enforce things they don't believe in, while telegraphing that they in fact don't believe in all those leftover sentiments from the era of Christianity.

Of course no criminal prosecutions will come of this. There won't even be any public outcry - I suspect most Britons are sympathetic to this murder, having long since fully embraced the culture of death. Most probably think he didn't deserve to live in the first place, having Down's Syndrome after all. I suspect most will feel that this is a retroactive abortion.

This is profoundly evil, but is anyone surprised?

As a physician, I can vouch for the obviousness of an NG tube, or lack thereof. One does not accidentally starve another to death over 26 days; rather, one essentially wills the outcome and patiently awaits the desired result.

In "Born toward dying," the late Fr. Neuhaus stated, "I strongly recommend always having with you an aggressive friend or two when you go to a hospital and are really sick." In all sincerity, I hope that I would benefit from aggressive friends and family not only in the emergency room, but in the weeks and months that could follow if I were incapacitated. With the paternalistic model of medical care in shambles, it behooves one not to rely on the beneficence of the professionals to whom he may be entrusted.

My nephew is an 11 year old with DS, and after spending the past week on vacation with him and his family, I can vouch for what a marvelous young man he is and what a blessing he is to his family. The idea that he might be treated so callously by "healing" professionals is nauseating...

Dr. Tillman, I appreciate your insight here and your backup on the fact that the medics here must have known what was going on.

I'm up in the air on whether he was starved to death because he had Down's, because he had had a stroke and couldn't eat naturally, or because of the combination. I have known too many stories of people who are not mentally disabled who have been dehydrated in the U.S. after a stroke. Some have even been capable of writing notes asking for water which have been refused. There is at least in the U.S. a pretty strong bias against tube feeding stroke patients. It's not only wrong but also particularly cruel, because the person is conscious and suffers a great deal from thirst. I had thought perhaps that in the UK they treated tube feeding legally as basic care rather than treatment, though, so I had thought perhaps things were different there. Obviously this story indicates otherwise.

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