Ambulance drivers told not to take ‘death list’ patients to hospital

A story published by the Mail on Sunday has suggested that ambulance crews are being told not to take patients to hospital if they have been put on controversial ‘death lists’ drawn up by GPs.

The ‘end-of-life’ care registers, which outline patients who want to be helped to die at home rather than receive hospital treatment, has already raised serious concerns.

Under the scheme, when someone on an ‘end-of-life’ care register calls 999, their names will be flagged up on an electronic database, revealing whether they have expressed a wish to die in their own bed.

The ambulance crew will then decide whether they should take them to A&E or call in other health professionals to treat them at home.

Decision making forms a vital part of a paramedic’s clinical and professional life, and decisions made on a daily basis can vary enormously. The implications of the ‘end-of-life’ care register on decisions required by paramedics are considerable.

Paramedics will be placed in the very difficult position of choosing whether to leave a patient at home or taking them to a hospital for what could be life-saving treatment.

London-based hospital consultant Dr Philip Howard outlined that situations are further complicated when: ‘Patients may have said they want to die at home but at three o’clock in the morning, when they suddenly become breathless, the family panic and they want to go to hospital.’

Neurologist Professor Patrick Pullicino said: ‘I don’t think ambulance crews should be involved in these decisions ethically. If you call an ambulance you expect to be taken to hospital.’

Taken from Journal of Paramedic Practice, published 28 August 2013.