Friday, 9 September 2011

Liverpool Care pathway: ‘Diagnosing’ Death

This is from OPCARE9March 2011-

Summary of work packages (WPs):

Signs and symptoms of approaching death. Very little research has been carried out to determine the signs and symptoms routinely seen in patients as they enter the last days of their lives, yet a failure to recognise and respond to the dying phase (diagnosing dying) can lead to sub-optimal care.

Professor Sir Mike Richards
There is a need to identify a consensus (based on current practice and available research evidence) regarding the most useful signs and symptoms of approaching death in order that appropriate care can be initiated and delivered in the final days of life. Where evidence is currently lacking, innovative research studies need to be developed to further clarify the situation.

Notwithstanding that here it is admitted that the signs and symptoms that indicate the onset of the dying process are neither clear nor understood, the LCP, which employs a primitive and basic methodology to thus determine this, is still being rolled out across the NHS and beyond.

Staggering! Beyond belief!

End of life decisions. End of life care often involves making difficult ethical decisions about the use of deep sedation to control symptoms and withholding and/or withdrawing life sustaining treatments such as artificial hydration and feeding, ventilation, dialysis, not attempting resuscitation in the event of cardiac arrest.

Robust research evidence concerning the effects of withdrawing/withholding treatments is relatively scarce and, at best, inconclusive.

Notwithstanding that here it is admitted that there is a lack and a scarcity of evidence with regard to the denial of hydration and feeding to its victims, the LCP protocol is that this shall be done in any case.

Staggering! Beyond belief!

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