Why have they kept their silence, and for so long? How could they not speak up and speak out on the monster they have spawned? Something that needs to be said cannot remain unspoken.
And when, at last, they do so it is only to repeat the platitudes, the insipidities; expound upon the altruism of their aims, the nobility of their intent, how harmless was their purpose.
Like Justice blindfolded, they perceive only the objectivity of their intention, askance at the evidence of what is plainly the outcome of their doing.
A word to the wicked: How can you not condemn the travesty your Pathway has become? How can you not accept the error of its conception?
Like Justice blindfolded, they perceive only the objectivity of their intention, askance at the evidence of what is plainly the outcome of their doing.
A word to the wicked: How can you not condemn the travesty your Pathway has become? How can you not accept the error of its conception?
Here is The Liverpool Daily Post –
People behind the controversial Liverpool Care Pathway (LCP) speak out in its defence
by Helen Hunt, The Liverpool Post Nov 15 2012
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| Deborah Murphy, who set up the Liverpool Care Pathway |
THE architects of the Liverpool Care Pathway (LCP) today broke their silence about the controversial model of care that has faced an onslaught of criticism in recent weeks.
One national newspaper has even branded the end of life plan now adopted throughout the UK as being a “pathway to death”.
Worryingly, critics of the LCP said that hospitals are even being given financial rewards worth millions of pounds to put patients on the regime.
Senior cancer doctor Prof Mark Glaser accused NHS managers of using the pathway to clear beds and achieve targets.
But today the people behind the care plan hit back.
Prof John Ellershaw, director of the Marie Curie palliative care institute Liverpool and Deborah Murphy, associate director, said: “The sole purpose of the LCP is to provide the best possible care for people in the last days or hours of their life.
“That was the purpose when we at the Marie Curie and our partners in Liverpool set out in the 1990s to design a framework for health professionals to use to ensure that people who are dying have as comfortable and dignified a death as possible, and it remains the purpose today.
“It was a response to the poor care and suffering of dying patients in hospitals in this country, and we had a simple aim: to bring best care of the dying – of the type that people experienced in hospices – to the wards of general hospitals.
“Since the 1990s, the LCP has been developed, supported by evidence and research of the highest quality. Remaining central to the LCP, however, are good care, compassion and communication.”
It has been reported the LCP involves the withdrawal of life-saving treatment with patients sedated and the majority denied nutrition and fluids by tube. But The Post was told that the LCP is not a ‘one size fits all’ prescription but tailored to each patient.
And medics say the LCP – a document that helps them manage end of life care – does not recommend continuous deep sedation but a review of medications and open discussions with relatives. If possible, patients may stop unnecessary treatments and interventions, shifting the focus of care to comfort and dignity.
Supporters strongly refute the LCP is a form of “euthanasia”.
Families fear loved ones are being put on the pathway to hasten death.
But Prof Ellershaw and Ms Murphy said: “Many, many thousands of patients and their families have benefited from improved care as a result of the LCP.
“The provision or withdrawal of interventions with the direct aim of hastening death is contrary to the rationale of the LCP, contrary to GMC (General Medical Council) guidance, and illegal.”
While Prof Ellershaw and Ms Murphy are the main architects of the LCP, responsibility for day-to-day implementation lies with individual hospitals, GPs and care homes.
Experts argue that before the LCP, there was not such a formal approach to end of life care which led to poor care in the final days of life in some instances, including unnecessary medical treatments.
While written consent is not needed before a patient is put on the plan, Prof Ellershaw and Ms Murphy added that “there should never be an occasion when the relative or carer who is named as the first contact or next of kin is unaware of the diagnosis of dying or of the subsequent care plan”.
Peter Williams, medical director at Royal Liverpool Hospital – part of the collaborative along with Liverpoool University – added: “Hospitals receive payments for ensuring patients are provided with high quality care across a range of measures. These may include preventing patients from dying from pneumonia, stroke and heart disease.
“They may include ensuring patients are kept safe from MRSA or that in the last moments of their life, patients are supported with the type of best practice, evidence-based care outlined in the LCP.
“The key word is ‘Care’. When it comes to my own death, I would like to be supported by the LCP.”
The Anonymous Voices cry out -
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In my opinion, all deaths on the Liverpool pathway are equivocal deaths, because the true cause of death - whether underlying illness, treatments given or withdrawn under the LCP (drugs administered or withdrawn, deliberate dehydration, withdrawal of nutrition) or some combination of these factors, or even complications arising from them - cannot be known.
ReplyDeleteAs I understand it, English law requires a post mortem to be held in the case of all equivocal deaths and requires Inquests to be held in the case of suspicious deaths.
I've read that few post mortems are conducted in the case of those who die on the LCP - yet these must include many equivocal deaths. Is the legal requirement for post mortem being evaded in the case of those who die on the LCP? If so, why?
Also, does the law not require the true cause of death to be recorded on the death certificate? Yet how can the true cause of death be recorded for those who died on the LCP and without post mortems being carried out?
“Since the 1990s, the LCP has been....supported by evidence and research of the highest quality...”
ReplyDeleteHowever, I am concerned about whether there might be considered to be conflicts of interest in respect of some of this research. This is what I was refering to in my message yesterday.
A further, related, concern is the corporate nature of at least some of the charitable organisations carrying out and, or, funding the research into end of life care and the LCP and influencing government policy in this area. Once again, I am concerned about whether this might be considered to represent a conflict of interest. One of these organisations is a multi-million pound concern.