Liverpool Care Pathway – A Point In Question

The NHS (National-socialist Health Service) has always had to juggle available resources. Financial constraints have determined the decision to favour best outcomes and so it was hardly a matter of surprise to read the following in The Scotsman:

BMA: Let patients die 'to save cash'

Published on Saturday 25 June 2011 13:55

THE leader of Scotland's doctors has questioned whether society can afford to pay thousands of pounds to keep terminally-ill people alive for weeks or months when health service budgets are under unprecedented strain.

Dr Brian Keighley, chairman of the British Medical Association Scotland, said in some cases tens of thousands of pounds were spent on drugs to extend cancer patients' lives for relatively short periods.

‘Quality of life' assessments are considered in tandem with the financial cost to maintain such a life and the appropriate executive decision is taken.

The Calgary Herald  has reported a doctor's comments upon what is recorded as the cause of death and what was the actual cause of death. Thus:

His death certificate, filled out by this doctor, listed the cause of death as melanoma.

The public record is not accurate.

My patient did not die from his cancer, but at the hands of a once-trusted colleague.

The doctor is an internal medicine doctor, practising in Oregon, where assisted suicide is legal.

The question arises, consequent upon these comments: What is recorded as the cause of death and what was the actual cause of death in regard to patients who die on such end of life protocols as the Liverpool Care Pathway?

According to the Daily Mail,

Figures released by the Office for National Statistics revealed that in 2009, 816 hospital patients were listed on death certificates as having died suffering from dehydration.

Elsewhere, the Mail reported,

Rhonda Smith, of malnutrition charity Bapen, said the death ­certificates massively underestimated the true extent of the problem – and that the real figure ran into thousands a year.

Question: LCP protocols include withdrawal of fluids. Do these statistics include patients who had their lives terminated on the LCP?

Question: What do doctors record as the cause of death on the death certificate in the case of patients who have their lives terminated on the LCP?