CARE PATHWAY – INFALLIBLE?

“Over here we are getting it totally right” our Hospice Chief Executive claims. Is self-praise really so reassuring? We are told that the Liverpool Care Pathway ‘operates’ in both the Hospice and Nobles Hospital. Yes, I had noticed that it is in use on the island. The description of removal of care did seem familiar to me.

Margaret Simpson assures us that “there isn’t a single example where we have got it wrong.” With complete and utter respect for all Hospice patients it must be noted that there is a clear prognosis. How do these institutions monitor the accuracy of their decisions at varying stages? How would we know if they had got it wrong?

While the thought of having a life of pain and suffering artificially prolonged is abhorrent to me I still believe that life is sacred and that it is not for others to decide how or when it should end.

In my personal experience of the care of loved ones nearing the end of life I cannot recall that anyone stated that morphine would be administered rendering the patient incapable of eating or drinking. Forgive me if I misunderstood things but it really seemed to me that there was an eagerness to administer morphine even though the patient had not complained of pain. Yet we are told that relatives are informed and consulted about the LCP process. Perhaps communication methods need improvement.

Doctors report that they have intervened in the LCP and that patients have been discharged and returned to their families. Some doctors are far from happy with the LCP :

  • ‘We are clear the Liverpool Care Pathway can  only work if each patient is fully consulted, where this is feasible, and their  family involved in all aspects of decision-making. Staff must properly  communicate with the patient and their family – any failure to do so is  unacceptable.’
  • ….Dr Tony Cole, chairman of the Medical  Ethics Alliance pressure group said: ‘If death is accelerated by a single day  that will save the NHS nearly £200 – that is the estimated cost of a patient per  day in hospital.            ‘My position on the LCP is that it is  inherently dangerous and      unnecessary.’

http://www.telegraph.co.uk/health/elderhealth/9343428/Elderly-patients-helped-to-die-to-free-up-beds-warns-doctor.html

http://www.dailymail.co.uk/news/article-2223286/Hospitals-bribed-patients-pathway-death-Cash-incentive-NHS-trusts-meet-targets-Liverpool-Care-Pathway.html?ito=feeds-newsxml

I was left with the feeling – if not conviction – that I had failed those unable to communicate. Yet I know that I had no experience of the situation to draw on. It has left me with only one fixation – that I wear myself out and never require the services of care for the terminally ill.

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