Friday 2 December 2011

All should check if the Liverpool Care Pathway is operating in their area

The Telegraph has reported this morning that Dr Patrick Pullicino, a consultant neurologist at East Kent University Hospitals, has questioned the current protocol of the Liverpool Care Pathway, a system which thousands of UK NHS patients are placed on each year.

I include below the key elements of their article, which you can read in full on their website.
Dr Patrick Pullicino, a consultant neurologist at East Kent University Hospitals, said it was vital that more information was made available about the use of the Liverpool Care Pathway in the NHS.

He said: "We need to know how frequently it is being used. Data should be released showing the proportion of patients who die in hospital who were on the Liverpool Care Pathway and how many were on it against their will or that of their family."

Tens of thousands of patients with terminal illnesses are being placed on a “death pathway”, almost double the number just two years ago, the Royal College of Physicians has found.

In one hospital trust, doctors had conversations with fewer than half of families about the care of their loved one. In a quarter of hospital trusts, discussions were not held with one in three families.


In addition to the withdrawal of fluid and medication, patients can be placed on sedation until they pass away. This can mean they are not fed and provided with water and has led to accusations that it hastens death.


Kevin Fitzpatrick, spokesman for the campaign group Not Dead Yet, said: “It is very worrying that in any situation less than 100 per cent of families are being consulted before patients are being put on the Liverpool Care Pathway. It is a shock for families to find that out.

“In some situations doctors are prepared to do it without consulting families because they think they know what is best and questions arise as to why they think it is OK to do that. Families have the right to know why a loved one is being put on the LCP.”
Dr Pullicino's comments and the report by the Royal College of Physicians are the latest in a number of high-profile questioning of the controversial scheme. In March this year Dr Clare Walker, the president of the Catholic Medical Association, was quoted saying that euthanasia is being practised widely in the NHS. In September 2009 a group of leading doctors wrote to the Telegraph saying that terminally ill patients were in serious danger of being killed through the pathway. In August 2009 a report by Adam Brimelow, BBC news health correspondent, warned that "there is evidence that some clinicians may already be using continuous deep sedation (CDS), as a form of 'slow euthanasia'". That report echoed the concerns of Dr Adrian Treloar, a senior consultant and lecturer in old age psychiatry, which were published in 2008 in a letter to the British Medical Journal. Dr Treloar stated then that "The Liverpool care pathway (LCP) is the UK’s main clinical pathway of continuous deep sedation and is promoted for roll out across the NHS".

As Alison Davis of No Less Human points out in her paper "The case of Tony Bland", the practice of consigning vulnerable patients to a death pathway stems from the 1992 court ruling against Tony Bland, which resulted in him being dehydrated to death. The government's 2005 Mental Capacity Act extended the possible scope of this practice. The inherent right to life of all patients, whether they are terminally ill or not, must be defended in the face of a war against the weak. As Alison argues:
"What was started in Bland may well end in the direct killing of any sick, disabled or elderly person, on the grounds that such lives have no value. We all have reason to be very afraid."
Dr Pullicino's comments are a reminder for the need to be vigilant in the care of our relatives and loved ones. If you are concerned about the treatment somebody you know may be receiving then contact Patients First Network, SPUC's service which confronts the NHS' practise of silent euthanasia. I urge readers to check whether the Pathway is being operated in hospitals, hospices or care homes where you live. If so, please write to the management there and draw their attention courteously to the concerns which continue to be expressed about the Liverpool Care Pathway by leading medical professionals.

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