Liverpool Care Pathway – Under Scrutiny?

The Association for Palliative Medicine is to reconsider the Liverpool Care Pathway - 

Dr Bee Wee, president of the Association for Palliative Medicine, has said rather than simply defend the pathway, it is right that experts ‘stand-back’ and look at the issues raised. 

The association intend to conduct research into these concerns and how care of the dying can be improved. 

Dr Wee, a consultant and Oxford academic, wrote: “There are some very real anxieties amongst the public and some professionals about this whole concept.“ 

Instead of simply defending the concept, or reiterating that if only it were used properly, it would be OK, it might be more helpful to stand back a bit, identify and explore the concerns properly, and find ways of addressing those concerns and improve practice. 

“The APM intends to undertake such a piece of work about integrated care pathways for the last days of life, in collaboration with a number of national organisations. 

“Discussions are taking place about the details of the proposal, who else is involved.”

Will this be a case of the burglar investigating the break in, the offender looking into the offence? 

Here is The Telegraph -

 

Doctors to launch investigation into Liverpool Care Pathway

Doctors are to investigate public concerns over the use of the controversial Liverpool Care Pathway, which has been used without family members’ knowledge.

Hundreds of elderly people are being neglected in NHS hospitals Photo: ALAMY

By Rebecca Smith, Medical Editor

11:27AM BST 24 Oct 2012

The technique is supposed to alleviate suffering in the final hours or days of a person’s life and can involve the removal of tubes artificially providing food and fluid.

Families have come forward saying their loved ones were placed on the pathway without their knowledge and argued they were not dying.

A group of senior doctors said this week that decisions that patients are dying are based on no evidence and are often little better than “guesswork”.

They said that once patients were on the pathway with food and fluids withdrawn, the prediction of imminent death became a “self-fulfilling prophecy”.

Dr Bee Wee, president of the Association for Palliative Medicine, has said rather than simply defend the pathway, it is right that experts ‘stand-back’ and look at the issues raised.

The association intend to conduct research into these concerns and how care of the dying can be improved.

Dr Wee, a consultant and Oxford academic, wrote: “There are some very real anxieties amongst the public and some professionals about this whole concept.

“Instead of simply defending the concept, or reiterating that if only it were used properly, it would be OK, it might be more helpful to stand back a bit, identify and explore the concerns properly, and find ways of addressing those concerns and improve practice.

“The APM intends to undertake such a piece of work about integrated care pathways for the last days of life, in collaboration with a number of national organisations.

“Discussions are taking place about the details of the proposal, who else is involved.”

The Association signed up to signed a “consensus agreement” last month saying that the pathway was a “framework for good practice” and was not used “to hasten death” along with the Royal Colleges of General Practitioners, Physicians, and Nursing and the National Council for Palliative Care.

But a coalition of senior doctors, lawyers and pro-life groups is arguing that it is flawed. The coalition is led by Prof Patrick Pullicino, a neurologist who has warned that it has made euthanasia a “standard way of dying on the NHS”.

A statement from the group said: “It is self-evident that stopping fluids whilst giving narcotics and sedatives hastens death.”

It added: “The median time to death on the Liverpool Care Pathway is now 29 hours. Statistics show that even patients with terminal cancer and a poor prognosis may survive months or more if not put on the LCP.”

The group said that diagnoses of impending death were “at best an educated guess”. “An actual misdiagnosis of impending death could result in a wrongful death,” its statement says.

The Liverpool Care Pathway was rolled out across the cou ntry from 2004 but within five years doctors began publicly to air their dissatisfaction.

Earlier this month, Peter Tulloch made a complaint to police of attempted murder after his mother Jean, 83, was isolated and disconnected from food and fluid in an Edinburgh hospital even though she was not imminently dying.

He demanded that her sustenance be restored and it began again after 30 hours. She died two weeks later.

The Department of Health has contined to back the pathway, saying in a statement that it “fully supported its proper use”.