Tuesday, 1 January 2013

Liverpool Care Pathway – A Compulsory Medical Procedure?

This bears repeating -
“It would be very sad if as a result of something that is a big step forward going wrong in one or two cases we discredited the concept..." (The Health Secretary, Jeremy Hunt)
The LCP has been long discredited! The gentleman is discredited! This is more than just "one or two cases", Mr. Hunt!
Mr. Hunt, it is time for you to find another portfolio.

The Liverpool Care Pathway is a Medical 'end of life' procedure. This procedure is being used without knowledge and, where there is knowledge, without permission or consent. Can this be right?

Both Mr. Hunt and Mr. Lamb have gone on record as saying that it should not be used without knowledge. Would they not agree it should not be used without permission?

The manner in which this medical procedure is being enacted amounts to compulsory medical treatment. The Mental Health Act permits compulsory medical treatment under certain circumstances. In the matter of communicable (contagious) diseases/infections, compulsory medical treatment may also be permitted. That is not the case here.

In the matter of enacting other medical procedures, a consent form is procured and presented to the patient to sign. Why is this not so in the case of the LCP? Is it because the end result and outcome of the Pathway is death in any case? This is all most odd.

In the case of Mr. James, his wishes and those of his family have been overturned and disregarded by order of the court. How can that be?

The tragedy and sorrow of the James family is now complete. This is an outrage.
This is the Liverpool Echo -

Seriously-ill Liverpool grandad dies after hospital wins legal battle to withhold treatment

A DESPERATELY ill Liverpool grandad at the centre of a “right to life” court battle between doctors and family members has died.

Dad-of-three David James passed away in his hospital bed in the early hours of New Year’s Eve with his devoted family by his bedside.

His son Paul said his dad’s heart had stopped beating.
The family are devastated and bitter that medics went to court over the 68-year-old’s care. He lost his fight for life just over a week after the hospital trust won an appeal giving staff the right to withhold treatment.
Paul, 37, said: “It’s been absolutely horrendous at what was already a difficult time.
“And what gets me is that with this court case, all that’s been discussed, nothing has ever been brought up about why he ended up in that situation. And what led to his deterioration. That’s been pushed under the carpet.
“We’ve still got questions that need answers and we’re not going to stop.”
Mr James, who had brain and kidney damage, was well known on the Liverpool music circuit as a guitarist and had a hit record with a band called Candlewick Green.
Earlier in December the hospital where Mr James was being cared for – it cannot be named for legal reasons – went to court to try to get a judge to back their wish to withhold treatment should his condition deteriorate.
His family – led by his wife of 50 years May, 67 – initially successfully blocked doctors’ moves.

The hospital did not want to resuscitate him if he suffered a cardiac arrest or give him invasive support for low blood pressure or kidney failure if his condition worsened, claiming to do so would be “overly burdensome” and “futile”.
They said he was in a “minimally conscious state” and that it was highly unlikely he would ever leave the intensive care unit.
But Justice Peter Jackson declined the hospital’s application, saying Mr James’s quality of life was not non-existent or awful – despite being limited – and his family life was of the “closest and most meaningful kind”.
Quoting a previous case, he said: “A life from which others may recoil can yet be precious”.
He said: “Although Mr James’s condition is in many respects grim, I am not persuaded that treatment would be futile or overly burdensome or that there is no prospect of recovery. Although the burdens of treatment are very great indeed, they have to be weighed against the benefits of a continued existence.”
But the hospital took the case to the Court of Appeal on December 21, saying they needed clarification on Mr James’s ongoing treatment and won.
This meant they had the legal right to not offer “invasive” treatments they did not feel were in Mr James’s best interests.
The family planned to take Mr James’s case to the Supreme Court after Christmas before he suffered the fatal cardiac arrest.

Liverpool family’s fury and upset over dad’s death after court battle over his treatment

THE family of David James today spoke of their fury after their dad died just over a week after a hospital won a legal battle to withhold treatment if his health deteriorated.

Son Paul said the family was devastated and angry. Paying tribute to his dad, who had been in hospital since May, he said: “He fought and fought until the very end. And we will keep fighting to get justice for him.”

Paul said that his dad, who was left bedridden after developing pneumonia in hospital, had suffered sepsis (a severe infection) before his death. And although medics did not want to give him blood pressure treatment, he said they had relented at the family’s insistence but refused to increase the dose.
Paul said: “They said he had kidney failure. We had a lengthy discussion with a consultant and he said there was no way he would put him on dialysis and if he had a cardiac arrest they wouldn’t resuscitate him.
“We begged for the blood pressure treatment and they put him on a small dose. We asked for higher but they wouldn’t increase it. If they had I don’t think he would have died.”
Daughter Julie, 48, added that last Thursday their dad had looked “well” and was talking about clubs he had played. She said: “All along all we have wanted was for dad to have the chance, to have all the treatments on offer. Who knows whether he would have survived if he had had the higher dose or the kidney dialysis?”
She is also convinced her dad was on the Liverpool Care Pathway, although this has been flatly denied by doctors and the court accepted he was not on that plan.
A hospital spokesman said: "Mr James suffered a cardiac arrest and died at 5am. We’ve had close communication with Mr James' family throughout this process and if there are any issues they would like to discuss further we’d welcome that. Our thoughts and condolences are with the family at this difficult time.”
It is understood all treatment given to Mr James was in line with the court ruling, which concluded that CPR was not in Mr James’ best interests if his condition deteriorated.

The unnamed hospital insists that Mr.James was not put on the LCP. The unnamed hospital still has much to answer for.

Mr James walked into hospital seven months ago with a stomach complaint, but later that month became critically ill after contracting hospital-acquired pneumonia that led to multiple organ failure.
"This is one of the terrible things. Aside from the pneumonia, we’ve never really had a diagnosis. All we know is that from the moment he went into hospital, he went catastrophically downhill." (May James)
The unnamed hospital must bear some responsibility for this outcome, then. Has the unnamed hospital no apologies, no explanation ready for this family?
“And what gets me is that with this court case, all that’s been discussed, nothing has ever been brought up about why he ended up in that situation. And what led to his deterioration. That’s been pushed under the carpet. 
“We’ve still got questions that need answers and we’re not going to stop.”(Paul James)
Is there more that the unnamed hospital is not telling this brave family? Why was there such a determination to withhold treatment that they went to the court to enable them to do so?

When is enough enough? The decision not to use 'invasive' treatments has to lie with the patient. Or the patient's family. This patient, this family, clearly, had not given up on his life as easily as did his doctors.

Clearly, the decision not to use 'invasive' treatments has more to do with cost-cutting decisions and adherence to the precepts of an emerging Communitarian Health Service...

And also that there is something more to hide...?

Would it be improper to suggest the doctors wanted to bury their mistake(s)?

Hospitals can seriously impede your chances of recovery.

In Ray Bradbury's surreal world, the firemen came to set fire to your books.

In our surreal world, the hospitals give you infections and the doctors fight to end your life! And take your life.

This is the 21st century? This is the 21st century!


  1. They'll have done something like injected an air bubble in his vein...something that wont show up on a post mortem....

    1. they know a thousand ways to do it in Intensive Care departments...and its always when the relatives have left....