Researchers attacked over hospital study

RESEARCHERS monitoring the care of the terminally ill have been accused of unethical behaviour after ignoring the pleas for water of dying hospital patients while their treatment details were being logged.

In one instance, researchers investigating standards of nursing care in four Scottish teaching hospitals watched a woman dying of liver cancer struggle for four hours to reach a glass of water before they intervened. The attempts were logged and the patient described as having a severe thirst. In another case a dying woman who begged for a drink for half-an-hour was monitored but left unaided.

The research, carried out to examine nursing care given to 50 terminally ill patients, was criticised in yesterday's edition of the British Medical Journal by a specialist in care of the dying.

Nicholas Albery, director of the charity The Natural Death Centre, which campaigns for better care for the terminally ill, demanded a rethink on non-interventional research.

Mr Albery, who first read of the monitoring in a previous edition of the BMJ, added: "It is to me a clear case of the scientific approach leading to grossly unethical behaviour."

The report's authors, William Macrae, consultant anaesthetist, and Hew Davies, research fellow at Ninewell Hospital and Medical School, Dundee and Mina Mills, a former nurse tutor, highlighted poor standards of care given to dying patients.

The log on the woman dying from liver cancer included: 5.50pm. Patient tried to reach a drink on her locker without success. At 6.05pm she rolled over and tried to cover herself with her sheet.

6.50pm. Glass of water placed on the locker. There was again no contact.

8.15pm. Nurse asked the patient if she would like tea or coffee. She tried to raise herself to reach the drink on her locker but it was beyond her reach. She struggled but eventually laid back exhausted. She continued the struggle for half-an-hour, moaning as nurses passed.

9.20pm. Patient calls to nurse and indicates she wanted her drink. Nurse gives the patient a drink and leaves. The patient tried to drink but could not keep her head up. She could not put the glass down on the locker.

Observations were halted and the patient helped to drink.

The authors have defended their research. "Our work was aimed at uncovering defects in the care of dying patients which might then be addressed to the benefit of future patients," they wrote in a letter in the BMJ this weekend.