Monday, 25 March 2013

Liverpool Care Pathway - Live And Let Die

It is one thing to cite such a tragic and extreme case as is promoted here to support a proposition that, actually, the cure may not be a ‘cure’ at all.

It is quite another to cite such a case as evidence in support of a blanket introduction of a protocol that is all-encompassing and applied without thought or measure.

It is, in fact, an argument that every case is an individual case and that every individual is individual.

This is Huffington Post  -

A 52-year-old woman came into our hospital in New York bleeding to death.She had advanced stage throat cancer. Her tumor, on the left side of her neck, was both pushing into her airway and a major artery. As the tumor grew, the woman could no longer breathe, and when her artery ruptured, blood started pouring into her lungs.
She would die by drowning in her own blood. 
Her husband was understandably overwhelmed and distraught. He instructed us to take any measures possible to keep her alive. She was too weak to contradict her impassioned and dedicated husband. 
This was, in my view, the wrong choice from an ethical and clinical perspective. How could I uphold my oath to do no harm when I knew she would die a particularly gruesome death, and I was instructed by her husband to keep her alive and in this state? I would have to crack her ribs during chest compressions and electrocute her to attempt to restart her heart. Regardless of whether we could keep her heart beating, the rest of her body would still be irreparably consumed by cancer. It was anguishing to be forced to inflict this sort of violence on this dying woman.

 [The Independant]

The recent focus on autonomy over decisions at the end of life in the UK, through Tracey's court case as well as controversy over the Liverpool Care Pathway, highlight the need for continued dialogue and clarity on these issues. The lawyers involved in the Tracey case have rightly affirmed that these decisions should not be made in the courts - a process that encourages suspicion and public anxiety.

[BBC News Cambridgeshire]

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