Saturday, 30 June 2012

Liverpool Care Pathway – A Sobering Thought


The Liverpool Care Pathway - an 'unlawful' practice

That reasoning appears perfectly valid. This is the act of taking life, however, and if that taking of life is 'unlawful' then that is murder and that is a sobering thought.

That this taking of life is State-sponsored is not merely frightening, it is scandalous.

This State-sponsorship goes further than merely promoting the LCP protocols, however; it extends to the DOH-sponsored Commissioning for Quality and Innovation (CQUIN) payments made to Trusts to bribe them into setting in place LCP protocols.

Forking out these payments is still the cheaper option compared with providing access to appropriate and adequate palliative care. Thus, the elderly are more likely to be placed on the LCP Death Pathway. A cash-strapped NHS can ill afford recuperative care for someone already on the downhill slope of terminal old age.

The NHS, which provides care free at the point of delivery, is funded from contributions taken at the point of collection - our wage packets. Where is all this money going? Do we have any say where it is going?

We do know that it isn't all going into provision of care to those who have worked all their lives to fund it!

Apart from lining the pockets of an unwieldy superstructure of managers and bureaucrats, a bleeding sore called Private Finance Initiatives (PFI's) is, apparently, preventing 22 NHS trusts from balancing their books.

According to The Telegraph
The price tag for repaying PFI firms will reach £8.6 billion next year alone, with the taxpayer owing a total of £121.4 billion on public projects which are worth only £52.9 billion.
Many PFI deals tie local authorities into expensive catering, cleaning and maintenance contracts, meaning the total bill to the taxpayer is £229 billion. In one case, a school was charged £320 for a plug socket.
An investigation by The Daily Telegraph in January revealed young people starting work this year will pay taxes for the Government’s Private Finance Initiative until they are nearly 70.
Labour’s last health secretary, Andy Burnham, who was in charge of 221 PFI projects, admitted last year: “We made mistakes. I’m not defending every pen-stroke of the PFI contracts we signed.”
Hospitals are facing closure because they cannot pay debts incurred on expensive PFI deals
Hospitals are facing closure because they cannot pay debts incurred on expensive PFI deals

The Telegraph  continues - 

Where is the money going? 
Private contractors who agreed PFI deals with the Government are set to make billions of pounds in profit, with some due to see returns of up to 71 per cent.
An almost unknown City company, Innisfree, with only 14 staff, is the largest single player in the PFI market, owning or co-owning 269 PFI schools and 28 hospitals.
According to accounts filed at Companies House, Innisfree’s profit margin was 53 per cent last year. A successful FTSE 100 company makes margins of around 6 per cent. David Metter, the founder and chief executive of Innisfree, owns almost three-quarters of the company and collected pay and dividends of £8.6 million last year.
The PFI deals include:A hospital which charged £52,000 for a job that cost £750. Demolishing a shelter for smokers resulted in the PFI contractor charging £2,600 a year for the “extra cleaning”.
A hospital in Bromley, south London, which will cost the NHS £1.2billion, more than 10 times what it is worth.

This can not be real! Can it…?

Liverpool Care Pathway – An 'Illegitimate' Practice


The time has come to seriously question our attitudes when the throwaway society has become a throwaway society of throwaway people. The social reality is no longer life-affirming, but death-embracing.

Heroes are no more. Health and safety is the first regard and valorous acts are anathema. Risk assessment and health and safety considerations may actually prevent us from rushing in to the rescue.

And in the Brave New World of the Death Pathway, health and safety is to have no regard for – nor dare it impinge upon the autonomous right of - the suicide to commit their intended act!

What a topsy-turvy world we inhabit. The heroic society is become the invalorous, inglorious society and Death reigns supreme over Life.

More: the right to death is proclaimed above the right to life.

The Needle reasons thus -  
As you can see, ‘unlawful’ yet officially sanctioned euthanasia, in an often cruel form, is systemic within the NHS, accounting for almost one third of deaths in the UK’s hospitals. I say ‘unlawful’ because there has not been a single Act of Parliament passed which would ‘legitimise’ this practice. Few people realise that clinicians consider food and water as medicines, and so the withdrawal of medication includes the denial of nourishment and hydration.
That reasoning appears perfectly valid. This is the act of taking life, however, and if that taking of life is 'unlawful' then that is murder. That is a sobering thought.

That this taking of life is State-sponsored is, actually, quite frightening.

Liverpool Care Pathway – An 'Unlawful' Pathway


The Needle reported on the Liverpool Care Pathway recently. An update follows here -

Update: Liverpool Care Pathway, The Dirty Secret of the NHS.

Some readers of ‘The Needle’ may recall that I wrote a personal account of the death of my Mother-in-Law‘The Liverpool Care Pathway, The Dirty Secret of the NHS’, since then I’ve been in contact with Macmillan, Marie Curie, and Southampton General Hospital. More on those communications later.
First, I just want to direct readers to this story today in The Daily Mail, ‘Top doctor’s chilling claim: The NHS kills off 130,000 elderly patients every year.’

Professor Patrick Pullicino
“NHS doctors are prematurely ending the lives of thousands of elderly hospital patients because they are difficult to manage or to free up beds, a senior consultant claimed yesterday.
Professor Patrick Pullicino said doctors had turned the use of a controversial ‘death pathway’ into the equivalent of euthanasia of the elderly.
He claimed there was often a lack of clear evidence for initiating the Liverpool Care Pathway, a method of looking after terminally ill patients that is used in hospitals across the country.
It is designed to come into force when doctors believe it is impossible for a patient to recover and death is imminent.
It can include withdrawal of treatment – including the provision of water and nourishment by tube – and on average brings a patient to death in 33 hours.
There are around 450,000 deaths in Britain each year of people who are in hospital or under NHS care. Around 29 per cent – 130,000 – are of patients who were on the LCP.”
As you can see, ‘unlawful’ yet officially sanctioned euthanasia, in an often cruel form, is systemic within the NHS, accounting for almost one third of deaths in the UK’s hospitals. I say ‘unlawful’ because there has not been a single Act of Parliament passed which would ‘legitimise’ this practice. Few people realise that clinicians consider food and water as medicines, and so the withdrawal of medication includes the denial of nourishment and hydration.
Unlike those with long term debilitating illnesses who are able to campaign, often for years, for an humane death. The elderly and those with terminal conditions often never find out how they will meet their end, and so never have the time or opportunity to raise this issue into public consciousness.
As I wrote at the beginning of this article, I have been in contact with three organisations.
It is extremely difficult to choose between Marie Curie and Southampton General Hospital as to which, of the two, gave the worst response to the issues and concerns I raised.
The Head of Public Relations at Marie Curie responded promptly with a reply literally copied and pasted from here. [Marie Curie helped develop the LCP.]
While a ‘Patient Experience Advisor’ (Hospitals don’t have complaints departments as this would mean accepting that they have complaints) atSouthampton General Hospital took 3 weeks to reply, suggesting that I make a formal complaint, but as I replied:
“I think the problems of, lack of specialized palliative staff (you only have 4 part time nurses at Southampton), lack of training of ward staff, and a lax and cavalier attitude to the implementation of the LCP (a legally dubious procedure anyway), I think these are systemic problems at Southampton General Hospital and the NHS as a whole. To look at my mother-in-law’s case in isolation allows you to focus on a single tree and avoid looking at the wood.”
Head and shoulders above the other two have been Macmillan who have been fantastic, even if I do not agree with their position. They were genuinely concerned by the points I raised and urged me to make a formal complaint. But they still support the principles of The Liverpool Care Pathway, writing:
“You asked what Macmillan’s position was in relation to the Liverpool Care Pathway (LCP)and we are supportive of it. We are in support of the principles of the LCP, however would not condone poor practice or standards of care. The LCP is also recommended in the national strategy on end of life care for England.
The LCP is a research based tool intended to ensure that patients receive the best care in the last days and hours of life. As with any model, guidelines or pathway, the LCP is only as good as the healthcare professionals who are using it. A robust education and training programme regarding care of the dying should be in place within the organisation. The LCP aims to support but does not replace the clinical judgement and decision making of the doctors and nurses. The responsibility for use of the LCP document as part of a continuous quality improvement programme sits within the governance of the organisation and must be underpinned by a robust education and training programme.
The LCP as with any other tool is only as good as those who use it and is not an excuse for poor care. Poor care of the dying is completely unacceptable.”
My own response was thus;
” My own view is that the Liverpool Care Pathway is a utopian procedure, an ideal which, due to lack of training, human nature, and constraints on resources is unlikely to be realised in the real world. I personally consider it intellectually dishonest for any organisation to defend it’s general use on the basis of an unrealisable ideal. In the ‘real’ world hospital staff avoid consulting with the patient, even when it’s possible to do so, they do not consult with the family until after the decision has been taken and the LCP has already been embarked upon, ward staff are not trained adequately, if at all, and too many patients are left to die an agonising and often public death in an open ward.  That is the day to day reality of the LCP and hiding behind the ideal may be some comfort for organisations like Macmillan and Marie Curie who support it but it is a position which lacks any intellectual courage in the face of the facts on the ground.”
I should just point out that by pursuing this I am not looking for any financial compensation. My Mother-in-Law is dead and she would have been dead by now regardless of what treatment she received. My concerns are over the manner of her death and I just want others to be better informed than I was.
Knowledge is Power.

Friday, 29 June 2012

Liverpool Care Pathway – Working With Finite Budgets

This is the report that appeared in The Express. Charlotte Meredith's Express article on the subject is linked with reports elsewhere of financial perils that threaten the NHS and a warning that  the health service "looks like a supertanker heading for an iceberg.”

NHS DOCTORS “ENDING THE LIVES OF THOUSANDS OF ELDERLY PATIENTS TO FREE BEDS"


Thousands of elderly patients are being 'helped to die' according to a top doctor
Thousands of elderly patients are being "helped to die" according to a top doctor
Wednesday June 20,2012

By Charlotte Meredith for express.co.uk


ILL elderly patients are prematurely being “helped to die” because their care is too time consuming and there are not enough beds, claimed a senior health consultant yesterday.

The chilling news came to light after Professor Patrick Pullicino revealed NHS doctors are using the controversial ‘death pathway’ as a form of euthanasia for the elderly.

The Liverpool Care Pathway (LCP) is more commonly used in hospitals for the severely ill, when doctors consider it impossible for a patient to recover and death is imminent.

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Predicting death in a time frame of three to four days, is not possible scientifically
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Professor Pullicino
Under the pathway, doctors can withdraw treatment, food and water while patients are heavily sedated in an attempt to make their final days pass quickly and comfortably– normally resulting in a patients death within 33 hours.

Professor Pullicino said that in many cases LCP was being initiated without clear evidence of it being required.

Speaking to the Daily Mail, he claimed that the “pressure on beds and difficulty with nursing confused or difficult-to-manage elderly patients” resulted in an increase of the radical treatment,

Of the estimated 450,000 NHS care and hospital deaths in Britain each year, around 29 per cent – 130,000 – are of patients who were on the LCP.

Professor Pullicino, who revealed one patient he took off the LCP went on to be successfully treated, claimed that elderly patients who could live longer are being put on an “assisted death pathway rather than a care pathway.”

The consultant neurologist for East Kent Hospitals said that often claims that a patient required LCP because they had hours or days left are “palpably false”. 

He said: “Predicting death in a time frame of three to four days, or even at any other specific time, is not possible scientifically.” 

A Department of Health spokesman said: “The Liverpool Care Pathway is not euthanasia and we do not recognise these figures. The pathway is recommended by NICE and has overwhelming support from clinicians – at home and abroad – including the Royal College of Physicians.” 

“A patient’s condition is monitored at least every four hours and, if a patient improves, they are taken off the Liverpool Care Pathway and given whatever treatments best suit their new needs,” he added.

Meanwhile, the publication of reforms to social care for the elderly has been postponed yet again, forcing a Labour peer to warn that the system is in danger of collapse.

The Government is “drifting” towards perilous social care reform and those in nursing and residential care homes are most at risk of receiving sub-standard care, despite huge costs, according to Lord Warner.

He said: “We have actually got a situation where relatively poor people are spending all their assets to pay for their care.”

The head of the NHS confederation warned today that the health service "looks like a supertanker heading for an iceberg.”

Speaking at an annual conference in Manchester Mike Farrar, chief executive of the confederation which represents organisations providing NHS services, said: "Despite huge efforts to maintain standards of patient care in the current financial year, healthcare leaders are deeply concerned about the storm clouds that are gathering around the NHS.

"Many NHS leaders see finances getting worse and that this is already having a growing impact on their patients," he added.

The comments come as a survey revealed almost half of NHS officials think patients will be given a dramatically reduced quality of care over the next year because of cuts to costs.

Some 47 per cent of the NHS leaders present at the conference said that they fear growing financial pressures on the nation’s health service will damage patients' quality of care, saying that the economic burden on the health service is "very serious."

Mr Farrar added: "Frankly, without action on the way we provide health and social care, the NHS looks like a supertanker heading for an iceberg. The danger is clearly in view and looming ever-larger.”
A senior economist waded in on the NHS debacle this morning saying that proposed efficiency savings are simply not realistic.

John Appleby, chief economist at the King's Fund, said asking the NHS to find nearly £50 billion in efficiency savings by 2019 to 2020 would be "frankly undoable," in an article published on bmj.com.

Mr Appleby warned that the NHS is destined for failure, stretching it’s already "barely achievable" productivity challenge another four years.

He said: "To be inefficient is not just to waste money, it's to waste lives. So, there should be no let-up in finding new and better ways of using finite budgets to do good things for people who use the NHS. But maybe it's time for some realism."

“New and better ways of using finite budgets.” What does that mean?

The DOH sponsored Commissioning for Quality and Innovation (CQUIN) payments made to Trusts for setting in place LCP protocols are still the cheaper option compared with access to appropriate and adequate palliative care.

The elderly are more likely to be placed on the LCP death pathway. A cash-strapped NHS can ill afford recuperative care for someone already on the downhill slope of terminal old age!

Wednesday, 27 June 2012

Liverpool Care Pathway – The Scandal Unfolds


The much-respected bio-ethics website, BioEdge, finds this article in The Daily Mail to be a sensationalised report, comparing The Mail with the tabloid Sun. However, the figures supplied in the banner headline are, arguably, a valid projection of the available statistics.

MailOnline - news, sport, celebrity, science and health stories
Top doctor's chilling claim: The NHS kills off 130,000 elderly patients every year
  • Professor says doctors use 'death pathway' to euthenasia of the elderly
  • Treatment on average brings a patient to death in 33 hours
  • Around 29 per cent of patients that die in hospital are on controversial 'care pathway'
  • Pensioner admitted to hospital given treatment by doctor on weekend shift


Worrying claim: Professor Patrick Pullicino said doctors had turned the use of a controversial ¿death pathway¿ into the equivalent of euthanasia of the elderly
Worrying claim: Professor Patrick Pullicino said doctors had turned the use of a controversial 'death pathway' into the equivalent of euthanasia of the elderly


NHS doctors are prematurely ending the lives of thousands of elderly hospital patients because they are difficult to manage or to free up beds, a senior consultant claimed yesterday.

Professor Patrick Pullicino said doctors had turned the use of a controversial ‘death pathway’ into the equivalent of euthanasia of the elderly.

He claimed there was often a lack of clear evidence for initiating the Liverpool Care Pathway, a method of looking after terminally ill patients that is used in hospitals across the country.

It is designed to come into force when doctors believe it is impossible for a patient to recover and death is imminent.

It can include withdrawal of treatment – including the provision of water and nourishment by tube – and on average brings a patient to death in 33 hours.

There are around 450,000 deaths in Britain each year of people who are in hospital or under NHS care. Around 29 per cent – 130,000 – are of patients who were on the LCP.

Professor Pullicino claimed that far too often elderly patients who could live longer are placed on the LCP and it had now become an ‘assisted death pathway rather than a care pathway’.

He cited ‘pressure on beds and difficulty with nursing confused or difficult-to-manage elderly patients’ as factors.


Professor Pullicino revealed he had personally intervened to take a patient off the LCP who went on to be successfully treated.

He said this showed that claims they had hours or days left are ‘palpably false’. 

In the example he revealed a 71-year-old who was admitted to hospital suffering from pneumonia and epilepsy was put on the LCP by a covering doctor on a weekend shift.

Distressing: The professor has claimed an approved technique of looking after the terminally ill is not being used in all hospitals
Distressing: The professor has claimed an approved technique of looking after the terminally ill is not being used in all hospitals


Professor Pullicino said he had returned to work after a weekend to find the patient unresponsive and his family upset because they had not agreed to place him on the LCP.

‘I removed the patient from the LCP despite significant resistance,’ he said.

‘His seizures came under control and four weeks later he was discharged home to his family,’ he said.

Professor Pullicino, a consultant neurologist for East Kent Hospitals and Professor of Clinical Neurosciences at the University of Kent, was speaking to the Royal Society of Medicine in London.

He said: ‘The lack of evidence for initiating the Liverpool Care Pathway makes it an assisted death pathway rather than a care pathway.


‘Very likely many elderly patients who could live substantially longer are being killed by the LCP. 

‘Patients are frequently put on the pathway without a proper analysis of their condition. 

‘Predicting death in a time frame of three to four days, or even at any other specific time, is not possible scientifically. 

This determination in the LCP leads to a self-fulfilling prophecy. The personal views of the physician or other medical team members of perceived quality of life or low likelihood of a good outcome are probably central in putting a patient on the LCP.’

He added: ‘If we accept the Liverpool Care Pathway we accept that euthanasia is part of the standard way of dying as it is now associated with 29 per cent of NHS deaths.’

The LCP was developed in the North West during the 1990s and recommended to hospitals by the National Institute for Health and Clinical Excellence in 2004. 

Medical criticisms of the Liverpool Care Pathway were voiced nearly three years ago. 

Experts including Peter Millard, emeritus professor of geriatrics at the University of London, and Dr Peter Hargreaves, palliative care consultant at St Luke’s cancer centre in Guildford, Surrey, warned of ‘backdoor euthanasia’ and the risk that economic factors were being brought into the treatment of vulnerable patients.

In the example of the 71-year-old, Professor Pullicino revealed he had given the patient another 14 months of life by demanding the man be removed from the LCP.

Professor Pullicino said the patient was an Italian who spoke poor English, but was living with a ‘supportive wife and daughter’. He had a history of cerebral haemorrhage and subsequent seizures.



Professor Pullicino said: ‘I found him deeply unresponsive on a Monday morning and was told he had been put on the LCP. He was on morphine via a syringe driver.’ He added: ‘I removed the patient from the LCP despite significant resistance.’

The patient’s extra 14 months of life came at considerable cost to the NHS and the taxpayer, Professor Pullicino indicated.

He said he needed extensive support with wheelchair, ramps and nursing. 

After 14 months the patient was admitted to a different hospital with pneumonia and put on the LCP. The man died five hours later. 

A Department of Health spokesman said: ‘The Liverpool Care Pathway is not euthanasia and we do not recognise these figures. The pathway is recommended by NICE and has overwhelming support from clinicians – at home and abroad – including the Royal College of Physicians.

‘A patient’s condition is monitored at least every four hours and, if a patient improves, they are taken off the Liverpool Care Pathway and given whatever treatments best suit their new needs.’

Those on the receiving end will take exception to the DOH view and will not be mislead one wit by any recommendation from NICE.

What is required is access to appropriate, adequate palliative care tailored to individual needs. A protocol or pathway cannot provide this because everyone is an individual.

Replacing one Death Pathway (LCP) for another (euthanasia) is misguided and unacceptable.

The concept that dying can be ‘diagnosed’ is preposterous and absurd.

Tuesday, 26 June 2012

Liverpool Care Pathway – The New Holocaust


What follows is frightening to read. What follows is frightening, period. That this is the here and now plain truth of reality in 21st century Britain beggars belief. This the Mail Online -

We killed my dad. So should we do the same for my mum?

By LIZ JONES



Dilemma: Liz Jones is watching her mother die and says she no longer knows what to do to help herIn 1997, the year Diana died (so it was a tearful year all round), my dad, in his 80s, found out he had cancer. He went downhill quickly. I remember visiting him in hospital, shocked no one had brushed his teeth. We brought him home. 

Despite the fact that he would shout with pain in the middle of the night, my mum insisted on sleeping alongside him. A devastatingly handsome war veteran, he was ashamed to be ill. He was never going to get better. And so we killed him.

The district nurse decided treatment should be withdrawn. He was given more and more morphine. I think my mum  was involved in the decision, although we never talked about it. I remember standing in the box room, asking the nurses whether or not he should still be given water. ‘Could he not be placed on a drip?’

I was told this would only prolong his pain. It all seemed to make sense. He hated being ill, he was in pain, he was old. Death seemed imminent. 
I’m now watching my mum die. Last year, there were times when she could not even take fluid from a pipette squeezed into her mouth, and just lay there, mouth gaping, like a corpse. I thought, then, that not giving her food and water was the right thing to do. 

Most of the time she doesn’t realise the state she’s in. Although occasionally her eyes will leak fluid and she will say: ‘Lizzie, I can’t stand it.’ 
She’s ready to die. She says she sees her husband and her mother standing in her room. But then, after a long spell of inertia, she opens her eyes and wants a cup of tea.

I had thought not feeding her or giving her water was kind, although God only knows why. 

'A U.S. website for hospice patients likens the use of morphine, terminal sedation  and withholding food and water...to the Holocaust. And yet such methods are used on 130,000 NHS patients each year.'
Of course she cannot feed herself. She is given baby food and water from a pipette, and  so is on life support in a way.  But then neither can a baby lift a spoon and we continue to feed it.

I started reading up on the subject. A US website for hospice patients likens the use of morphine, terminal sedation  and withholding food and water – a method of euthanasia known as the ‘Third Way’ or the ‘Liverpool Care Pathway’ – to the Holocaust. And yet such methods are used on 130,000 NHS patients each year. 

Is it a dignified, pain-free, distress-free death? No. This kind of death is horrible to undergo and to watch.

Nurses and other healthcare workers have expressed revulsion at having to participate in cases where the patient is starved and dehydrated. It is also unpleasant for the patient’s family. 

I have never starved myself to death, although, as a recovering anorexic, I’ve tried. There is something pure about not eating, divine. I think that is partly why this Third Way is so common. There is no smell from the swill you find on most wards going in one end and coming out the other.

Fears: The 'Third Way' or 'Liverpool Care Pathway' is used on 130,000 NHS patients each year. Last week, senior consultant Professor Patrick Pullicino said doctors had turned its use into the equivalent of euthanasia for the elderly
Fears: The 'Third Way' or 'Liverpool Care Pathway' is used on 130,000 NHS patients each year. Last week, senior consultant Professor Patrick Pullicino (pictured) said doctors had turned its use into the equivalent of euthanasia for the elderly
It would be so easy for the carer not to give water to my mum, but she goes on doing it. 

Thank goodness most carers these days are deeply religious Africans, or Catholic Eastern Europeans, who have more respect for life than most of us.

But I don’t want Mum to suffer any longer. She has no quality of life. I no longer know what to do or think for the best. So let me tell you what I did for my 24-year-old cat, Squeaky. 

It is not possible for me to love anyone or anything more than I loved that little cat. I slept with her every night and always put her first. 

I talked to her all the time. I was tactile. Three weeks before she died, I noticed her breathing was rapid, her tummy swollen. I called out the vet at 10pm on a Friday night. I made a fuss. I stood up for my cat, as she couldn’t speak for herself.

She was pumped full of drugs. I put her on the bed, surrounded by dishes of her favourite food. I lay down next to her. She had painkillers and steroids. 


She smelled, so I bathed her bottom gently, cooing all the while. I syringed tepid water into her open mouth. After two weeks of this, she lay on her side, mouth open. I called the vet. She was put to sleep in my arms.

I would never have left Squeaky alone to die of dehydration. But I sat, for almost a week, at the bedside of my mum and I didn’t syringe water into her mouth, or bathe her, or kiss the top of her head, cooing all the while. 

Mum frightened me for the first time in my life, as she has always been so soft, so comfy. Pets get better deaths than people. It’s time to redress the balance.


What is required is access to appropriate, adequate palliative care tailored to individual needs. A protocol or pathway cannot provide this because everyone is an individual.

Replacing one Death Pathway (LCP) for another (euthanasia) is misguided and unacceptable.

The concept that dying can be ‘diagnosed’ is preposterous and absurd.

Monday, 25 June 2012

Liverpool Care Pathway – The Road To Perdition


The NHS promised universal care. Today, this care is cost-driven. Perhaps, it always was.

What follows is another tragic tale of the LCP (Liverpool Care Pathway) in action. The author’s opinions must be respected for his is a personal account and he is as much the victim of what transpired as his poor father who was forced to endure the torture the LCP protocols inflicted upon him.

From a personal standpoint, I would propose that replacing one death pathway (LCP) with another (euthanasia) is not the answer.

What is required is access to appropriate and adequate palliative care tailored to individual needs.

Certainly, the concept of 'diagnosing' dying should be thrown out the window!

This is from Cambridge News -Cambridge News

Don't withhold the final act of mercy

As the Commission on Assisted Dying argues there is a “strong case” for allowing assisted suicide of terminally ill patients, the News’ PAUL KIRKLEY makes a very personal plea for a more humane approach to end-of-life care.

THREE Christmases ago, I watched my father die slowly, in some pain and distress, not as a result of his illness, but as a direct consequence of this country’s archaic laws.
Dad was suffering from a condition called pulmonary fibrosis, which causes excess fibrous tissue to develop on the lungs, and slowly steals your breath away. His condition was complicated by a stroke six weeks before his death that left him partially paralysed and unable to speak, or even swallow.
After around five weeks in hospital, doctors concluded there was nothing more they could do for him, and advised implementing the Liverpool Care Pathway. Under this system, developed by the Royal Liverpool Hospital and the city’s Marie Curie hospice in the late 1990s, doctors can withdraw fluids and drugs from patients if they are deemed close to death.
As a family, we agreed to this because we were told it was the best thing we could do for Dad. What we didn’t expect – and what the consultant in charge later admitted he hadn’t expected either – was that Dad would live for almost another week after the fluids and drugs had been withdrawn.
Except you can’t call it living, because you don’t need to be a doctor to work out what happens to the body when it is denied any type of food or drink for days on end. Anyone who’s woken up with a hangover knows how it feels to be dehydrated – imagine that feeling massively intensified and dragged out day after day, night after night.
On the Friday before he died, I drove from Cambridge to Leeds, having been told the end was hours away: desperate to arrive in time, I spent the whole journey panicking that I would be too late to say goodbye.
What actually happened was worse: Dad hung on until the following Wednesday morning. And whereas before he had simply seemed confused and bewildered, breathing with the aid of oxygen, now he was clearly in pain, constantly putting his hand to his head, which must have been screaming from the dehydration.

Paul Kirkley
Paul Kirkley
Of course, he was being treated with morphine to control the pain. But it was clearly not enough: in the end, I demanded to see the consultant and asked if it was normal for someone to be in that much distress in their final days.
He apologised, and agreed to increase the morphine – though I still had to argue with a nurse to get her to carry out his instructions – and that made a huge difference. It is reassuring to know Dad spent his last day and night in relative peace and comfort.
What the consultant also admitted was that, at 69, Dad was younger than the average person on the Liverpool Care Pathway, and that is probably why his body had fought for life longer than expected.
But what I really wanted to know – and still want to know – is why my father, and the people who loved him, were forced to endure this medieval practice in the first place: why it is considered acceptable in a civilised society to actively intervene to end someone’s life by withdrawing treatment, leading to pain and suffering, but not to actively intervene to end that life in a calm, dignified and controlled manner.
In this sense, the current argument about “assisted dying” is a false one. Patients are already being assisted to die, it is just that the only option available is messy, protracted and painful, when it could be swift, painless and merciful. It’s a cliché, I know, but we really do treat dogs more humanely when it comes to saying goodbye.
And it all seems predicated on a bizarre logical loophole: that by withdrawing food and treatment, we are somehow allowing the patient to die “naturally”. But why is starving someone to death any more natural than administering an injection?
The opposition to assisted dying seems to stem from two main quarters. One is the idea that legalised euthanasia would be open to abuse – which is surely equally true of any area of medicine – or might leave doctors vulnerable to legal action. But strict guidelines and a legal framework that protects medical professionals is surely not beyond the wit of man. It’s a bit like banning everyone from driving because some people can’t be trusted behind the wheel.
The other area of opposition is the charge that human life is sacred and no-one should be allowed to “play God”.
Well, I’m sorry but, as an atheist, I find it outrageous that I should be forced to watch my father die in agony just to avoid offending the sensibilities of people with different beliefs to mine. How dare they presume to know better than me what’s in the best interests for the people I love?
Of course, the irony for my family is that, even if they were adopted, the Commission for Assisted Dying’s recommendations wouldn’t have helped my dad, as it would have been almost impossible to satisfy the doctors he was of sound enough mind to give consent.
I still hold out hope, though, for a more civilised approach to end-of-life care in the future, and would urge you to support the excellent Dignity in Dying campaign – co-sponsors of this week’s report – by visiting www.dignityindying.org.uk.

The Commission for Assisted Dying to which the author of the above article refers is not an independent commission. Lord Falconer’s commission was funded by right-to-die campaigner Sir Terry Pratchett.

Death Pathways, intended or otherwise, are open to abuse. Replacing one death pathway (LCP) with another (euthanasia) is not the answer. The Death Pathway proclaims the right to death above the right to life.
“Put simply, the most effective safeguard against abuse is to leave the law as it is. What Lord Falconer has done is to argue that it is morally acceptable to put many vulnerable people at increased risk so that the aspirations of a small number of individuals, to control the time, place and means of their deaths, might be met. Such a calculus of risk is unnecessary and wholly unacceptable.” (Bishop Newcome)
This is from The Telegraph -  



Teleg
                                   



Church of England calls assisted suicide plan morally unacceptable

A senior bishop has described plans to allow assisted suicide for the terminally ill as morally unacceptable.


Church of England calls assisted suicide plan morally unacceptable
The Rt Rev James Newcome, Bishop of Carlisle 















11:40AM GMT 05 Jan 2012



The Rt Rev James Newcome, Bishop of Carlisle, said the best safeguard for vulnerable people would be to keep the existing law in place.
He also claimed the Commission on Assisted Dying, a group of peers and academics chaired by the former Labour minister Lord Falconer, was a “self-appointed” group that excluded anyone who objected to legalising assisted suicide.
It had “singularly failed” to prove that vulnerable people would be safer under the new proposals than under the existing law, which is rarely used but means anyone who helps another person kill themselves can be jailed for up to 14 years.



I, too, hold out hope “for a more civilised approach” but the Death Pathway is not merely uncivilised, it is barbarism; it is the road to perdition.