Monday, 25 June 2012

Liverpool Care Pathway – The Road To Perdition

The NHS promised universal care. Today, this care is cost-driven. Perhaps, it always was.

What follows is another tragic tale of the LCP (Liverpool Care Pathway) in action. The author’s opinions must be respected for his is a personal account and he is as much the victim of what transpired as his poor father who was forced to endure the torture the LCP protocols inflicted upon him.

From a personal standpoint, I would propose that replacing one death pathway (LCP) with another (euthanasia) is not the answer.

What is required is access to appropriate and adequate palliative care tailored to individual needs.

Certainly, the concept of 'diagnosing' dying should be thrown out the window!

This is from Cambridge News -Cambridge News

Don't withhold the final act of mercy

As the Commission on Assisted Dying argues there is a “strong case” for allowing assisted suicide of terminally ill patients, the News’ PAUL KIRKLEY makes a very personal plea for a more humane approach to end-of-life care.

THREE Christmases ago, I watched my father die slowly, in some pain and distress, not as a result of his illness, but as a direct consequence of this country’s archaic laws.
Dad was suffering from a condition called pulmonary fibrosis, which causes excess fibrous tissue to develop on the lungs, and slowly steals your breath away. His condition was complicated by a stroke six weeks before his death that left him partially paralysed and unable to speak, or even swallow.
After around five weeks in hospital, doctors concluded there was nothing more they could do for him, and advised implementing the Liverpool Care Pathway. Under this system, developed by the Royal Liverpool Hospital and the city’s Marie Curie hospice in the late 1990s, doctors can withdraw fluids and drugs from patients if they are deemed close to death.
As a family, we agreed to this because we were told it was the best thing we could do for Dad. What we didn’t expect – and what the consultant in charge later admitted he hadn’t expected either – was that Dad would live for almost another week after the fluids and drugs had been withdrawn.
Except you can’t call it living, because you don’t need to be a doctor to work out what happens to the body when it is denied any type of food or drink for days on end. Anyone who’s woken up with a hangover knows how it feels to be dehydrated – imagine that feeling massively intensified and dragged out day after day, night after night.
On the Friday before he died, I drove from Cambridge to Leeds, having been told the end was hours away: desperate to arrive in time, I spent the whole journey panicking that I would be too late to say goodbye.
What actually happened was worse: Dad hung on until the following Wednesday morning. And whereas before he had simply seemed confused and bewildered, breathing with the aid of oxygen, now he was clearly in pain, constantly putting his hand to his head, which must have been screaming from the dehydration.

Paul Kirkley
Paul Kirkley
Of course, he was being treated with morphine to control the pain. But it was clearly not enough: in the end, I demanded to see the consultant and asked if it was normal for someone to be in that much distress in their final days.
He apologised, and agreed to increase the morphine – though I still had to argue with a nurse to get her to carry out his instructions – and that made a huge difference. It is reassuring to know Dad spent his last day and night in relative peace and comfort.
What the consultant also admitted was that, at 69, Dad was younger than the average person on the Liverpool Care Pathway, and that is probably why his body had fought for life longer than expected.
But what I really wanted to know – and still want to know – is why my father, and the people who loved him, were forced to endure this medieval practice in the first place: why it is considered acceptable in a civilised society to actively intervene to end someone’s life by withdrawing treatment, leading to pain and suffering, but not to actively intervene to end that life in a calm, dignified and controlled manner.
In this sense, the current argument about “assisted dying” is a false one. Patients are already being assisted to die, it is just that the only option available is messy, protracted and painful, when it could be swift, painless and merciful. It’s a cliché, I know, but we really do treat dogs more humanely when it comes to saying goodbye.
And it all seems predicated on a bizarre logical loophole: that by withdrawing food and treatment, we are somehow allowing the patient to die “naturally”. But why is starving someone to death any more natural than administering an injection?
The opposition to assisted dying seems to stem from two main quarters. One is the idea that legalised euthanasia would be open to abuse – which is surely equally true of any area of medicine – or might leave doctors vulnerable to legal action. But strict guidelines and a legal framework that protects medical professionals is surely not beyond the wit of man. It’s a bit like banning everyone from driving because some people can’t be trusted behind the wheel.
The other area of opposition is the charge that human life is sacred and no-one should be allowed to “play God”.
Well, I’m sorry but, as an atheist, I find it outrageous that I should be forced to watch my father die in agony just to avoid offending the sensibilities of people with different beliefs to mine. How dare they presume to know better than me what’s in the best interests for the people I love?
Of course, the irony for my family is that, even if they were adopted, the Commission for Assisted Dying’s recommendations wouldn’t have helped my dad, as it would have been almost impossible to satisfy the doctors he was of sound enough mind to give consent.
I still hold out hope, though, for a more civilised approach to end-of-life care in the future, and would urge you to support the excellent Dignity in Dying campaign – co-sponsors of this week’s report – by visiting

The Commission for Assisted Dying to which the author of the above article refers is not an independent commission. Lord Falconer’s commission was funded by right-to-die campaigner Sir Terry Pratchett.

Death Pathways, intended or otherwise, are open to abuse. Replacing one death pathway (LCP) with another (euthanasia) is not the answer. The Death Pathway proclaims the right to death above the right to life.
“Put simply, the most effective safeguard against abuse is to leave the law as it is. What Lord Falconer has done is to argue that it is morally acceptable to put many vulnerable people at increased risk so that the aspirations of a small number of individuals, to control the time, place and means of their deaths, might be met. Such a calculus of risk is unnecessary and wholly unacceptable.” (Bishop Newcome)
This is from The Telegraph -  


Church of England calls assisted suicide plan morally unacceptable

A senior bishop has described plans to allow assisted suicide for the terminally ill as morally unacceptable.

Church of England calls assisted suicide plan morally unacceptable
The Rt Rev James Newcome, Bishop of Carlisle 

11:40AM GMT 05 Jan 2012

The Rt Rev James Newcome, Bishop of Carlisle, said the best safeguard for vulnerable people would be to keep the existing law in place.
He also claimed the Commission on Assisted Dying, a group of peers and academics chaired by the former Labour minister Lord Falconer, was a “self-appointed” group that excluded anyone who objected to legalising assisted suicide.
It had “singularly failed” to prove that vulnerable people would be safer under the new proposals than under the existing law, which is rarely used but means anyone who helps another person kill themselves can be jailed for up to 14 years.

I, too, hold out hope “for a more civilised approach” but the Death Pathway is not merely uncivilised, it is barbarism; it is the road to perdition.

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