Liverpool Care Pathway - A Banality Of Arrogance

The Pathway is a medical procedure enacted with an off-hand banality that is frightening. It is compulsory mass non-medication. 

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NHS patients being placed on controversial 'death pathway' by doctors who have never previously been involved in their care

• Claims Liverpool Care Pathway patients left to die based on 'bedside evidence' only
• Medics tell Channel 4's Dispatches that situation is 'inhumane'

By MAIL ON SUNDAY

PUBLISHED: 22:02, 2 March 2013 | UPDATED: 22:02, 2 March 2013

Leading doctors have claimed NHS patients are being routinely placed on the controversial Liverpool Care Pathway by out-of-hours medics who are ‘strangers’ who have never been involved in their care.

The claims suggest patients are often left to die on the end-of-life regime, which involves being deprived of drugs, food and water, after doctors make decisions based on ‘bedside evidence’ alone and without fully understanding the patients’ condition or medical history.

The Liverpool Care Pathway is designed to ease suffering in the final hours or days of those suffering a terminal illness.

But the Government is reviewing the procedure after relatives complained their loved ones were placed on it without their knowledge. Now doctors speaking to Channel 4’s Dispatches programme, to be broadcast tomorrow evening, have described the situation as ‘inhumane’.

The programme highlights the case of Sammy De Francisci, who was put on the pathway by out-of-hours doctors after suffering a series of strokes and dementia but went on to live for a further 14 months after his own doctor reversed the decision.

The Liverpool Care Pathway has been the subject of much debate since it was introduced in the 1990s.

More than 130,000 people are put on it each year but it was revealed in December 60,000 patients die on the procedure each year without giving their consent.

Concerns have been raised that clinical judgments are being skewed by incentives for hospitals to use the pathway. 

Health trusts are thought to have been rewarded with an extra £30million for putting more patients on the LCP.

Critics say it is a self-fulfilling prophecy because there is no scientific method of predicting when death will come.

Norman Lamb, the care services minister, launched a review in November, saying there had been too many cases of families not being consulted and hospitals will not longer be able to make financial gains from the procedure.

But some people say it allows the terminally ill to die with dignity. Health Secretary Jeremy Hunt said last year the scheme is a 'fantastic step forward' for those who are near death and that it is designed to bring 'hospice-style care' to hospitals.

The Pathway is just something that is 'done'; far more than just a framework, it is deemed the 'appropriate' response.

The Pathway is enacted with a predetermined set of outcomes already in sight, without question, with a banality of arrogance that astounds and shocks. Secure in the protection the protocol affords, to the enactor it is given to interpret and set it in place, absolved of all responsibility for consequence of outcome - for the outcome is already predetermined.

Ejus est interpretari cujus est condere - It is for him to interpret who enacts it.