Liverpool care Pathway – A Wrong That Goes Unrecognised

Terminal Sedation -

What is it? It is what it says it is. It is a decision with purposeful intent to terminate a life. It is death by induction. This process, known as the Liverpool Care Pathway, recommends prescribing of medications not merely in response to presenting symptoms but as a precautionary measure in expectance that they will present.(End of Life Care - Symptom Control document)  

Measures taken therefore, being predictive, are predetermined to comply with the protocol program. The Pathway becomes a conveyer belt to the certain destination the protocol foresees.

The Medicalisation of Death –

If drugs are pumped into the patient to prevent death’s rigours, it is not to protect the patient from the discomfiting processes of dying; it is a cosmetic action solely, taken to protect those at the bedside from the discomfort of witnessing such offending sights and those overseeing the death that it follows the protocol stipulated. It is the depersonalising and medicalisation of death such as, in similar manner, mushy peas are dyed green and spread is dyed yellow to make them pleasing and acceptable to the eye.

If this choice of words should cause offence that is regrettable, but a terrible wrong has been done. It is a wrong that continues to go unrecognised as a wrong and remains unaddressed despite the protests of its victims.

The LCP was a protocol devised for the already diagnosed terminally ill to determine when that moment of death is nigh and to make that departure from this life an easier one for patient and loved ones.

The LCP is a protocol used to diagnose the terminally ill and to embark them on that course to depart from this world, into the next!

A decision was taken at some point to put my dear mum on this Pathway and to embark her on her journey of assisted passage. Did those nurses at Caterham Dene take this decision alone or were doctors complicit in its making? Were decisions actually reached prior to her consignment to the Dene? Were the ‘three named nurses’ also a party to the deception?

Nurse practitioners were deemed to have acted 'illegally' at Keighley, West Yorkshire – 

NNPs took verbal orders for medicines from doctors over the phone to save them coming to the ward. They also administered morphine and other opiates intravenously. Neither was allowed under hospital or professional regulations. Grigg-Booth, and at times other NNPs, also prescribed opiates such as pethidine and diamorphine for patients. This was risky and unlawful as they can hasten or cause death. 

Diamorphine use is ‘risky and unlawful’ as it can hasten death.

Morphine and other opiates were administered intravenously –

But not without verbal authority from doctors.

Nurses were brought to task, but doctors who made themselves complicit ‘over the phone’ escaped beneath a cloak of anonymity. Why do they not out of their dark closets step and own up? The BMA will give them full diplomatic immunity. They may rest assured of this for they are above the law. It is only in extreme cases, such as that of Shipman, that the full weight of the law must be permitted to step in and take its unswerving course.

A parallel may be drawn to the cover up of the guilty in the priesthood. Even so, why do they not out of their dark closets step and own up? They may do so now with impunity, for they have a cover story. They may now without risk to self and reputation own up - there is a legal document in place that permits the intentional act of killing, be that by act of commission or by act of omission.

That legal document is the Liverpool Care Pathway.