Imagine that of a certain age you consult your GP for some minor complaint and s/he wishes to update your medical notes and asks you how you wish to die. For you the timing may be entirely inappropriate but you may not see your doctor that often and he needs this information for the records. Some individuals may be only too pleased to make this decision even though it is often impossible to predict the circumstances of the end of your life and when and how you might feel when you reach that stage or anywhere near it. Not even the medical profession can always make this prediction with certainty.
Not all illnesses, even very serious ones in advanced old age, are terminal but once a patient enters hospital there is the risk that they may be considered as such (and worse still may be considered as a 'bed blocker' and thus costly too the NHS so there is little in the way of treatment and care offered to them). Many seriously ill patients may at that stage be no longer in a position to express their wishes but there are many patients who gain renewed strength and fight or wish to fight for their life.
Withdrawal of a patients medication, nutrition or fluids for whatever reason can lead to weakness and loss of consciousness which can be and is sometimes misinterpreted as end of life which, with appropriate intervention might have been saved.
It appears that the whole concept of this pathway needs careful reconsideration by NICE, the DoH, experienced nurses and physicians and anybody else involved and give back the professionals their autonomy to exercise their professional judgement and skills to look after each individual patient and their families according to clinical, physical, psychological and spiritual demands and needs with respect and dignity.
Liverpool Care Pathway – Does The Pathway Have A Heart?
“Any path is only a path and there is no affront, to oneself or to others, in dropping it if that is what your heart tells you.
“Look at every path closely and deliberately. Try it as many times as you think necessary. Then ask yourself, and yourself alone, one question.
“Does the path have a heart? If it does, the path is good; if it does not, it is of no use.”
- Carlos Castaneda; The Teachings of Don Juan
The heart of this path, if it has a heart, is to provide a merciful release from cruel shackles of pain that otherwise might make our last moments in this life an unbearable torture – for us to bear and for our loved ones to watch.
The Pathway was designed at the Marie Curie Hospice in Liverpool specifically for the terminally diagnosed patient and to recognise when a point had been reached that death was near or imminent so as to provide as peaceful and gentle path from this world as might be provided. These patients were already diagnosed to be dying from cancer; the Pathway was not the tool used to make that diagnosis, but a means - a 'pathway' to follow - to determine that point.
The LCP has become a path without a heart. There is no affront, to oneself or to others, in dropping it if that is what your heart tells you.
I am distraught and I despair that events which have befallen this family continue to befall others. My lovely mum was murdered on the NHS (National-socialist Health Service). Murdered. Is that too strong a word? Her life was taken without her permission. By omission and by commission, actions taken and not taken conspired to end her life. She was kept in ignorance of what was proceeding before her very eyes, as were we. Was she, then, not murdered?
Mum was not even terminally ill. Your article implies that that should be the proviso to qualify someone to be placed on LCP. Why, then, was she chosen to be terminated? She was old, she was frail; that already is good qualification under LCP protocols! We pursued our complaint in the face of lies and subterfuge. Worse, still, it took us three long years and more to discover this truth.
These 'tens of thousands' of patients placed on the Liverpool Care Pathway are not necessarily patients diagnosed with terminal illness. That may be the case within the Hospice setting, but not so outside. There is also good reason that the number placed on this Death Pathway has doubled in just two years.
Recent years have witnessed a deliberate campaign to soften up the British public for the legalisation of ending life. The Liverpool Care Pathway has been a means to bring this to fruition. In the Netherlands healthcare is covered by insurance, but in the UK most people rely on the State. In a cash-strapped NHS, where hospitals are being closed and elder abuse is on the rise, there is growing prejudice against the chronically ill and disabled who are seen as disproportionate consumers of limited resources. Vulnerable lives are at risk. And the Dutch statistics, when properly examined, actually raise great cause for concern.
We should not be placing before health providers in Britain the temptation to consider ending life as a therapeutic option, as some perverse act of kindness and compassion to be used in the patients' "best interests".
With the introduction of LCP, killing has become a ‘legal’ therapy!
LCP means withdrawal of treatment. Liverpool care has become a viable, cost-effective alternative option to cost-intensive, real palliative care!
The Liverpool Care Pathway is a legal document established as a legal "therapy". Through the Department of Health CQUIN incentives, it has been made the subject of cost/benefit assessment by health managers and economists. In a cost conscious health service, a short sharp end will be a tempting therapeutic option to £500 per week and more for ‘continuing care’.
CQUIN is the DOH funding policy. CQUIN has set targets for 2011/2012 with regard to the End of Life LCP program. The forward plan is to increase the number of patients identified to be on the end of life care pathway from a baseline of 0% to 20%; it is further planned to have 30% of all patients who die in hospital dying on the Liverpool Care Pathway.
To ensure they receive their provider income in full, Trusts have to comply with or exceed these goals.
The protocol of the LCP is to look for signs of ‘dying’ in order that life might be placed on that downward cycle toward a controlled, predictable and predicted final termination. While the protocol of the Hippocratic Oath is to look for signs of life in order that life might be saved and secured and preserved. Is, then, the LCP counter to the Hippocratic Oath?
The LCP is actually the 'tool' used by which to 'diagnose' death. Not only are ongoing treatments withdrawn along with food and fluids, however; the LCP protocols recommend pre-emptive prescribing of treatments which assume that diagnosis to be correct.
Medical errors are far from rare, according to several comprehensive studies of the issue.
But diagnostic errors - a subset of the overall problem - haven't received nearly as much attention as other medical errors.
"Diagnostic error is barely on anybody's radar screen," according to Dr. Mark Graber, 62, a nephrologist in Long Island, N.Y., and an expert on diagnostic errors.
That is alarming. Even so, misdiagnosis may result in any of many outcomes. Misdiagnosing death that results in being placed on the LCP will have only one outcome. Clearly, LCP is a one-way ticket on the NHS (National-socialist Health Service) into the next world.
This is frightening. Baroness Warnock has said that elderly people suffering from dementia are “wasting people’s lives” and “wasting the resources of the National Health Service” and should be allowed to die. These are the words of a respected commentator on medical ethics. Lady Warnock’s comments were published in an interview with the magazine of the Church of Scotland, Life and Work, and have been condemned by dementia charities. Are these further candidates for the LCP?
Are we being 'groomed' to accept death as a final solution for our social and economic ills? Is that an outrageous suggestion?
Jacques Attali, is a leading French intellectual and former President of the European Bank for reconstruction and development.
He has said: "As soon as he goes beyond 60-65 years of age man lives beyond his capacity to produce, and he costs society a lot of money...euthanasia will be one of the essential instruments of our future societies."
Surely, these are lines from the screenplays of Soylent Green 0r Logan's Run? Again, do we tread this path, take these careless steps and stumble blindly into the abyss?
With the introduction of LCP, killing has become a ‘legal’ therapy!
My mum was given 2 days to drink and eat by herself before they removed the fluid drip and ceased the antiobiotics she was having. The nurses did not try to help her eat and unknown to us she could not have eatern or drunk byherself because her teeth were stuck together for over 48 hours by a smooth food mix that she had previously been fed. I turned up at the hospital one day and the drip had been disconnected and I watched over the next two days in the heat of the summer as she died a slow painful death. The caring NHS hospital did not take any notice of me when I protested they said it was there decision. Have I missed something have doctors and nurses been turned into gods? I was with my mum at the end at 87 she was past her shelf life as far as the society of today was concerned, she had given all she had during the war and never claimed a benefit in her life. I will always remember the pain she was in with raging head and limb pains if you say anything they just pump people full of morphine to hasten death. It has not helped that the hospital she was in the JPH has just had scathing reports for its care of the elderly. Reading this you might think she was old but remember it could be you or someone you care for. My mum had people who loved and tried to care for her what of those that have no one. The Liverpool pathway is little more than a sure death sentence for the old and vulnerable in society. Intervention by outside bodies is needed to regulate it. We are heading fast down a slippery slope.