Tuesday, 12 February 2013

Liverpool Care Pathway - In The Best Interests Of The Interested

Many comments are left on these pages and I acknowledge all of these, humbly and respectfully. I would that I could respond to everyone of these individually and accord each one that humble respect it deserves.

Between holding down a job in care and holding down a life and using a fossil of a computer bequeathed to me by my brother, also a victim of our glorious NHS (National-socialist Health Service), I do as I am able in the hope that this is sufficient but in the knowledge that it is not.

This response is called upon me to make, however. It has been brought to my attention to answer the call of one of that exclusive fraternity ascended to Godhead and donned the mantel of deity. These determine, or consider that is their right to do so, when it is that our time has come and which life it is and which life it is not that is not worthy of life.

LCP Facts responds to this -

Comment of concern:

Dr. Richard Hain –

… em, it’s not so much a question of consent to go on the Pathway, it’s the fact that the conversation needs to take place. It was designed to facilitate that kind of communication, not to replace it.

Where the patient lacks capacity, the Mental Capacity Act enables the medical team to act in the patient's "best interests". Consent  is not required. In such cases, the Data Protection Act, also, might exclude relatives/next of kin being party to such a decision being taken. Recent observations by political personalities that this should be otherwise are at variance with this legislation.

This is a legal quagmire.

Comment left on these pages:

  1. It is my experience in 5 years of caring for patients as a doctor on NHS acute medical wards that the vast majority of those deemed suitable for the LCP are unable to give consent. The reason for this is simple - they are, by definition, dying and too ill to do so.

    I believe it is vital that doctors retain the ability to palliate people in their best interests when they cannot give consent. You would not argue that we should not treat seriously ill people who cannot give consent in any other circumstance. Remove the ability of doctors to administer pain relief and prioritise symptom relief in dying people (and this is all that the LCP is designed to do, despite the hysteria in the press), and the result will only be more people dying in pain.

    I feel so passionately about this that I have started a site of my own to try and clarify what the LCP is.

    I have also discussed the BBC's Big Questions - see http://lcpfacts.co.uk/lcp-discussed-on-bbc-the-big-questions/. 

What is "Quality of life"?  [Please click the link and read in full]

What is meant by the expression "Quality of life" and who may determine what level or lack thereof in quality will qualify a person to have their life taken via measures active or neglectful by clinicians bound by oath to protect life and do no harm?

What qualities possessed by clinicians bound by oath to protect life and do no harm may qualify them to take such a momentous and final decision to consign someone to their final destination?

Some years ago, I worked maintaining the grounds of a BUPA hospital now run by Spire. I can say fondly and with pride that those grounds were kept in good order whilst I was there. It is with sadness that I comment that this is no longer so. Standards are dropping everywhere. It was at this hospital that I acquired a booklet, a BMA publication, which was given to me by one of the consultants during one of his impromptu perambulations to view our large pond feature. I quote from this here -

“Patients must be able to trust doctors with their lives and health. To justify that trust you must show respect for human life.”

This and the following extract are mentioned in a post on these pages. Please click here to access these in full.

Doctors at Selly Oak Hospital then told the family that all food, fluids and hydration were to be stopped and that Mrs. Westwood would be given morphine "because she is dying".

Ellen’s daughter, Kathleen Westwood, told the BBC that the decision had been taken because it was "a capacity ruling" and that under current UK law, the family’s wishes do not enter into the equation.

"If you deem somebody to have lost capacity, then the doctors can act in the best interests," she said.

The family had an interview with doctors on a Friday afternoon, in which they were told that Mrs. Westwood was going to die.

"In [the doctors’] view the best interests was for my mother to die - and clearly by Monday she would have been dead," Kathleen told BBC.

The family, however, brought the woman food and water. Hospital officials responded by threatening to report the family to social services for feeding Mrs. Westwood.

"We said we don’t want this to happen and they said ‘it’s happening, sorry’. I had to fight very, very hard to get it stopped."

Eventually the family obtained a second opinion and Mrs. Westwood was able to go home, where she is recovering well and is celebrating her 89th birthday today.

The Liverpool Care Pathway is a sanction to act with impunity. [Please click the link and read in full]

I will quote the following in full as it is but brief but may be accessed here -

Liverpool Care Pathway - Not A Pathway, But A Conveyor Belt To Death

Once that chorum of opinion is agreed that death is an innevitable and imminent outcome, that outcome is pursued with an obsession and determination that is frightening to behold. Financial constraints are powering a culture of death that is stalking the corridors of power in the Healthcare industry.

A dark shadow is tramping our hospitals and care homes, eliminating opposition to it with the slur that, to do so, is to disrespect and disregard the patient's best interests. The right to death is becoming paramount over the right to life. The LCP is providing a newfound legitimacy and cover to an unspoken policy that has, actually, been in place for decades.

Anyone who falls into the clutches of the proponents of LCP and ticks all the boxes will be given assisted passage into the next world courtesy of the NHS. This will apply particularly to the elderly who are, in any case, suffering from that most terminal of all conditions - Old-Age! This may apply even contrary to the expressed wishes of patient and family. If you fit the diagnostic category, then so much the worse for you.

Recent years have seen the resurgence of policy that had its roots in the hospitals and the asylums of Hitler's Reich. In 2009, new guidelines on assisted suicide law were published by Keir Starmer, the Director of Public Prosecutions, to clarify when people were likely to be prosecuted.

TheTelegraph reported on this with the headline: 'Assisted suicide could be excuse to kill burdensome elderly, says police chief.'

TheTelegraph also headlined, 'Are we killing our elderly?'

and reported that:
"Care of Britain’s elderly is under intense scrutiny, with a number of reports in recent days highlighting the risks and suffering of patients at the hands of the NHS or family members. Some experts in care for the terminally ill claim new NHS guidance on the treatment of dying patients means some could be given sedation to help them pass away, masking any improvement in their condition.
Earlier, Britain’s most senior policewoman warned relaxation of assisted suicide laws could be exploited by families to kill burdensome elderly relatives. Barbara Wilding says a growing rift between young and old generations, combined with the pressures of an ageing population, is a significant challenge for police."
Under the headline 'Sentenced to death on the NHSThe Telegraph further reported:
"Patients with terminal illnesses are being made to die prematurely under an NHS scheme to help end their lives, leading doctors have warned."
We left the following comment:
"New laws - New guidelines - These only serve to put more easy power into the hard hands of the unscrupulous, the uncaring and the misguided. There is already a culture of 'letting them go' and an unwritten policy of actually 'helping them on their way' set in place. That is, in anyone's terms, euthanasia!
Lest we forget - The holocaust grew its roots in the hospitals and the asylums of Hitler's Reich. The humane ending of a worthless life had its admirers worldwide in the 30's. Its protagonists hailed these bold new approaches, as now do those of euthanasia today. Extraordinary, but it was out of that darkness of 'mercy killing' grew the death camps. A slippery slope is ever a slippery and dangerous slope to tread."


  1. Hi Eldoel,

    I've read on your blog that you have been unwell, how are you now? I hope you are better.

    I haven't posted for a while because I've been unwell too. My GP's taken me off of statins, which I took to reduce my cholesterol levels, as these may have been causing problems. The symptons I had seem much improved since I stopped taking the statins - I'm awaiting blood test results.

  2. I am very suspicious about what is happening in NHS hospitals in relation to the Liverpool Care Pathway. I began to get worried about things when an elderly relative was placed in a care home against her wishes by social services and then was pronounced as lacking capacity. Her one regular visitor was not allowed to visit her. She died five weeks later. So systems are already in place that take control of the elderly and in hospitals they can easily be disposed of. I find this quite disgusting. We must speak out against this system.

  3. Hi Alice,

    I agree with you. One of the many issues of the LCP is that it can all too easily be either abused or used to cover up abuse and mistakes. Dr Shipman would have had a field day with the LCP.

    There are some wonderful doctors and nurses in the NHS - such as the heroic Professor Pullicino - however, from the many scandals emerging in recent times it's clear that there are also appallingly abusive and neglectful medical professionals in the NHS who are unfit to be working with patients. Abusive staff should never be allowed anywhere near the huge amount of control and power over patients lives and deaths that the LCP gives them.