Friday, December 02, 2011

The Death Pathway.

Terrifying article on front page of today's Telegraph. It reports that tens of thousands of patients with terminal illnesses are being put on a 'death pathway' without their families being told. The Liverpool Care Pathway requires doctors who feel that a patient is reaching the final days of life, to withdraw food and drink after consultation with next of kin. This is an area of the greatest possible sensitivity, and it does not bear thinking about that this should ever happen without discussion with the patient's family. In my opinion, there should always be the added safeguard of a second opinion - completely disconnected with the patient's doctor. The Report claims that 2500 families were not informed when the 'death pathway' was activated. If true, this would be a shocking scandal - warranting a full scale inquiry.

Palliative care is an increasingly important area, as our medical knowledge extends life. More and more people will be reaching a stage of frailty when they might already have died in the past. I perfectly accept that deciding not to force feed suffering terminally ill patients, and helping them cope with the final days with sedation is humane and proper. But safeguards are absolutely crucial. No patient, should ever be put on the Liverpool Care Pathway, without both an independent second opinion and consultation with next of kin. We really should get to a position where any doctor who does not act according the proper rules should be suspended.

I believe it is time that Parliament discussed the issue of the proper way to help people at the end of life. While 'assisted suicide' must remain illegal, there must be a 100% safe approach to proper palliative care. A civilised society requires nothing less.


Alison said...

Another thing you might want to look into. My father was in Shrewsbury hosp recently. He was prescribed a drug - which he needed - and the doctor subsequently realised he lived in Wales. He said that he couldn't have it and crossed it out. Apparently Wales won't pay for it; the drug is prescribed if you live in England.

Same hospital, health care discrimination based on which side of the border you live. So are some patients at a higher risk of dying sooner, on the basis they live in Wales?

Anonymous said...

It's a shame the Daily Telegraph has not seen fit to examine the LCP process in detail. It is here..

You will see that immediately after terminal diagnosis is a section relating to input to the decision making process the patient (if possible) and SECONDLY the relative or carer. It is not true that LCP specifically excludes such secondary input. However, such secondary input from the family is commonly declined BY THE PATIENT for various reasons.

The key word in the Telegraph article is 'when' and not 'because of'. To quote .... "Concerns about the pathway were raised first in The Daily Telegraph in 2009 when experts warned that in some cases patients have been put on the pathway only to recover when their families intervened." .......There are instances where at a certain stage in the process an unexpected change in clinical condition of the patient can occur leading to recovery, this is not effected by families, it happens rarely, and regardless of whether or not the family are aware what form of palliative care has been initiated.

It is wrong to conclude the family saved a dying patient, although emotions at such a time lead them to feel they have.

I accept the Daily Telegraph has papers to flog off using a cursory investigation into such a sensitive issue, but expect better from a member of parliament who should examine the detail before inaccurately mouthing off about it on his blog. Especially using the rather offensive and crude 'soundbite' death pathway. We are all on that unless the Tories have discovered immortality.

Have you considered raising the issue with the Health Minister in Wales?

Anonymous said...

Here Here Glyn.

Anonymous said...

Talking of death, as a whole, your blogs are very morbid.
Can we request an uplifting blog before Christmas to get us all in the festive spirit.

Anonymous said...

anonymous, its not just one national newspapers who state that the pathway is open to abuse but four newspapers, surely they all cant be telling lies, hundreds of relatives say it should be abolished and thats for every patient, it should be and will be stopped completely, its nothing more than back door euthanasia that means its cold blooded murder. to do it vote out david cameron, and petition against it, and stop all these early deaths, sorry murders.