Thursday, 14 March 2013

Liverpool Care Pathway - In Denial

When The Mail is in error, it is admitted and owned up to.

Right up until the last minute of the announcement of the review, the protagonists and propagandists of the Liverpool Care Pathway were in absolute denial that anything could be amiss with their precious protocol. Most now do admit of tragic and awful, awful, terrible things to have occurred but put this down to failings in its interpretation. The protocol itself still sits secure upon its gold standard pedestal in their eyes and they stand firm in their denial.

The Daily Mail has published a retraction -

Clarifications and corrections
PUBLISHED: 00:47, 13 March 2013 | UPDATED: 00:47, 13 March 2013

In common with other newspapers, an article on 29 November 2012 about the Liverpool Care Pathway (LCP) for terminally ill children included the account of a doctor, previously published in the British Medical Journal, describing how it feels to withdraw feeding from newborn babies. We are happy to clarify that the doctor in question does not practise in the UK and that his account does not refer to the LCP.

This report includes an account by a hospice paediatric nurse who does practice in this country. This is the Mail Online -

The LCP for children has been developed in the North West, where the LCP itself was pioneered in the 1990s. It involves the discharge to home or to a hospice of children who are given a document detailing their ‘end of life’ care.
One seen by the Mail, called ‘Liverpool Pathway for the Dying Child’ is issued by the Royal Liverpool Children’s NHS Trust in conjunction with the flagship children’s hospital Alder Hey. It includes tick boxes, filled out by hospital doctors, on medicines, nutrients and fluids to be stopped.  

The LCP was devised by the Marie Curie Palliative Care Institute in Liverpool for care of dying adult patients more than a decade ago. It has since been developed, with paediatric staff at Alder Hey Hospital, to cover children. Parents have to agree to their child going on the death pathway, often being told by doctors it is in the child’s ‘best interests’ because their survival is ‘futile’. 
Bernadette Lloyd, a hospice paediatric nurse, has written to the Cabinet Office and the Department of Health to criticise the use of death pathways for children. 


She said: ‘The parents feel coerced, at a very traumatic time, into agreeing that this is correct for their child whom they are told by doctors has only has a few days to live. It is very difficult to predict death. I have seen a “reasonable” number of children recover after being taken off the pathway. 
‘I have also seen children die in terrible thirst because fluids are withdrawn from them until they die. 
‘I witnessed a 14 year-old boy with cancer die with his tongue stuck to the roof of his mouth when doctors refused to give him liquids by tube. His death was agonising for him, and for us nurses to watch. This is euthanasia by the backdoor.’

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