Monday 11 February 2013

"Has Liverpool Care Pathway become a licence to kill?" asks professor in care of the elderly

Severe criticism of the Liverpool Care Pathway from Professor Brian Livesley, an emeritus professor in the care of the elderly in London, has appeared in the British Journal of Healthcare Management.

Under the headline: "Has care pathway turned into a licence to kill difficult patients", today's Daily Telegraph reports:
The Liverpool Care Pathway appears to have become a "licence to kill” through misuse by doctors and nurses, a leading palliative care expert has said.

Starving and dehydrating someone to death may have become a way of dealing with a “problem patient” because modern health care professionals do not know what else to do, Prof Brian Livesley warned.

The emeritus professor in the care of the elderly at Imperial College School of Medicine, London, warned that limited experience of dying patients because of the lack of life threatening epidemics had created “inadequacy among doctors and nurses".

Writing in the British journal of Healthcare Management, he asked if this had allowed “a pseudo-form of the Liverpool Care Pathway to be used to remove the ‘problem patient’ under a ‘starvation and dehydration quick-fix’”.

He added: “By misuse has the Liverpool Care Pathway become a licence to kill?”

Prof Livesley said the guidelines should mean that symptoms such as thirst, pain and hunger were dealt with while unecessary treatments were avoided. “After all for conscious patients particularly, starvation and dehydration are terrible ways to die,” he wrote.

“Inducing death by neglect when a person has unrelieved symptoms also exposes wilful and/or negligent clinical staff - as well as their administrators - to the certain risk of criminal charges.”

The pathway, a set of guidelines aimed at providing hospice standard care of the dying in hospital, has become controversial after high profile cases of patients being denied food and water in their final days. Some have said that it is akin to euthanasia.

A Department of Health spokesman said: “Experts agree the Liverpool Care Pathway can play a vital role in making sure a person’s final hours are as pain free and digniied as possible.

“However, we have seen that there are too many cases where patients or their families have not been properly involved in decisions.

“This is unacceptable. That is why Baroness Julia Neuberger has been appointed to chair an independent review"
The Department of Health spokesman completely misses the professor's point. Health professionals cannot mitigate the crime of inducing death by starvation and dehydration by seeking to involve patients and/or their families in such neglect. It's no wonder that concern about the Liverpool Care Pathway continues to grow when a department of health spokesman makes such an astonishing comment.

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