Liverpool Care Pathway – Comment And Commentary

A spectre is haunting Europe — the spectre of Communitarianism.

The 'E' word. We don't hear it heard often enough these days. Ethics...

The Communitarian spectre stalks the wards and sits in the hospital boardrooms flush with power..

Here is EWTN -

Alleged use of end-of-life care on UK children draws outcry By Hillary Senour

London, England, Dec 5, 2012 / 06:01 am (EWTN News)

A Neonatal Intensive Care Unit nurse checks a newborn.
Credit: USN.

A recent British Medical Journal article has stirred controversy for indicating that an end-of-life care program intended for elderly and terminally-ill adults is being used on infants and children in some U.K. hospitals.

“I am greatly concerned by what is reported that the Liverpool Care Pathway allows: passive euthanasia of the most helpless and vulnerable of human beings,” said Dr. Marie Hilliard, director of bioethics and public policy for the National Catholic Bioethics Center in Philadelphia.

The Liverpool Care Pathway, protocol designed to outline care of terminally ill patients in the U.K., has received criticism that hospitals have misused the guidelines to speed up death of patients.

Outcry against the program arose following a Nov. 1 article in the British Medical Journal, where an anonymous author described the practice being used on a baby suffering from severe birth defects.

Hilliard – who is also a pediatric-prepared nurse and chair of the ethics committee for the National Catholic Partnership on Disability – said if the allegations prove to be true, the implications are particularly troubling for disabled individuals.

“Persons with disabilities, of all ages, are at grave risk for being deemed 'unfit' for contemporary society, and relegated to a pathway of death through dehydration and starvation.”

“This mentality is dangerous because it shows an attitude that only the 'perfect life' – which is non-existent – is 'worth living,'” she told EWTN News Nov. 28.

“This is leading us down the road to a eugenic society, wherein only the perfect person, with social worth, is allowed to exist.”

The anonymous author of the study, who claims to be a doctor in a U.K. hospital that has implemented the program, wrote that parents chose to put their child on the pathway due to “a lengthy list of unexpected congenital anomalies” which they felt were “not consistent with a basic human experience.”

In the article, the author detailed the “unique horror of witnessing a child become smaller and shrunken” due to the withholding of nutrients and hydration as “the only path out of a life that has become excruciating to the patient or to the parents who love their baby.”

The process, in which parents “wish for no suffering” for their child, is very different than the one that actually takes place, the author said.

“Parents and care teams are unprepared for the sometimes severe changes that they will witness in the child’s physical appearance as severe dehydration ensues.”

In the author's experience, the average amount of time “from withdrawal of hydration to death was 10 days.”

Despite the articles controversy, however, the practice of the Liverpool Care Pathway for adults and the terminally ill has garnered support from the country's medical professionals.

A Nov. 7 letter published in The Telegraph and signed by 1,300 doctors – who say they have “been involved in the care of dying patients” – argues that the pathway “is used to care for patients, not to hasten their death.”

“This is how we would wish to be cared for at the end of our lives and our patients deserve to be offered nothing less,” the letter said of the program.

However, Norman Lamb, minister of state for care services, announced that an independent review of the program would take place following claims that elderly patients have been denied food and water “to speed up death” in terminal cases, The Guardian reported Nov. 26.

After meeting with pathway critics and medical experts, Lamb made the decision to appoint an independent chair to oversee three separate reviews that are already underway by the Association of Palliative Medicine, by Dying Matters and by the National Health Service end of life care team.