In a pastoral letter last Friday, Bishop Philip Egan of Portsmouth challenged Catholics to review England’s end-of-life care after a report tied negligent drug prescriptions to hundreds of elderly deaths.  

An independent panel reported June 20 that at least 450 patients at Gosport War Memorial Hospital died amid “an institutionalised regime of prescribing and administering 'dangerous doses' of a hazardous combination of medication not clinically indicated or justified, with patients and relatives powerless in their relationship with professional staff” between 1989 and 2000.

The report added that there had been a “disregard for human life” at the hospital.

Bishop Egan wrote June 29 that “Whilst the lessons to be learnt in this case will be many, it seems clear that as a society we need urgently to review our geriatric care and our end of life care, specifically in relation to fundamental moral principles.”

He urged prayers “for the repose of those who have died, for their families, and for justice and reconciliation” and extended “love, sympathy and prayers” to the bereaved families.

The bishop cited the failed campaign for assisted suicide in Guernsey, and the case of Alfie Evans, as evidence that “we cannot leave awkward decisions to the courts alone. We need to reprise our basic human values.”

He expressed disease with the concept “quality of life”, saying it “seems to invest experts and judges with power over the life and death of an individual.”

Better, he said, is the term “‘dignity of life,’ which reminds us of the absolute good of the person and their infinite worth.”

While the National Health Service is a “huge blessing,” he added that “we must ever be vigilant to the policies, values, priorities and procedures that operate within it.”

He noted the Liverpool Care Pathway for the Dying Patient, guidelines for palliative care developed in the 1990s and widely used until an independent review led to its abandonment in 2013.

Bishop Egan commended the “noble intentions” of the LCP, but added that in England's busy hospitals, “the pressure to save money and to utilise beds, together with an emotive empathy for those suffering, might suggest the need to hasten death.”

“We need to go back to basics,” he urged. “As Catholics, we believe that life from conception to natural death is a gift of God. It is sacred, and so every person on earth has an inviolable dignity as God’s creation. Frailty, pain and sufferings are always a difficult trial.”

We must both unite these sufferings with those of Christ, and “turn to doctures and nurses in the hope that … they can alleviate and heal our condition.”

“Indeed, in today's world, we can thank God for amazing advances in modern health-care, and not least in palliative care and pain-management at the end of life.”

The bishop made three concluding points, beginning with an exhortation to pray daily “for our doctors, nurses and health-care professionals, asking God to bless and guide the wonderful and generous work they do. Pray too for the sick, the dying, those in hospital, and anyone suffering pain mental, emotional or physical. If a Catholic is seriously ill … please call the priest so that s/he can be offered the sacraments.”

Bishop Egan then recommended that “if you or a loved one is terminally ill, consider whether it might be praticable to die at home. Ask whether it is possible for drugs to be used that do not totally withdraw consciousness and a chance to pray and commune with family and friends. As next of kin, gently insist on being involved in decisions. It might be appropriate to ask staff for a second opinion or a re-evaluation of treatment.”

While life “cannot be prolonged indefinitely … it is not morally permissible until the very last to withdraw feeding and hydration. If the medical team suggests there is little more they can do, that is the moment, if not done already, to call the priest to offer the sacraments.”

Finally, he urged that everyone pray daily “for a happy death, that is, to die in a state of grace, aided by the sacramental care of Mother Church and supported … by family and friends.”

“Let us accept whatever death the Lord has prepared for us … let us prepare ourselves by persevering in the practice of our Faith, by attending Mass and making a regular confession, by daily prayer and faith-formation, and by living a good life in justice and charity.”

“Indeed, as a child, I was taught every night to pray the following prayer, which I also commend to you: Jesus, Mary and Joseph, I give you my heart and my soul. Jesus, Mary and Joseph, assist me in my last agony. Jesus, Mary and Joseph, may I breathe forth my soul in peace with you.”