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Re-the Liverpool Care Pathway
As a pioneer of the Hospice Movement – I was Dane Cicely Saunders’ first junior, and the first Consultant in Palliative Medicine in the NHS – I enthusiastically welcomed the Liverpool Care Pathway when my friend Dr John Ellershaw first produced it for use in the Liverpool Marie Curie Home.
When he visited dying patients at home he was able to give the GP a copy of the Pathway to guide him in appropriate terminal care. Likewise, when hospital consultants asked him to see a dying patient in the ward, he could commence the Care Pathway.
We were shattered to hear that copies were being passed around to Geriatricians to use on patients who were NOT dying. No doubt it saved the hospital money to stop giving food and water to elderly patients with strokes, pneumonias or fractured hips, and to sedate them to death, but that is certainly not what the Pathway was designed for.
The last section of it is used in Hospices for people who are in the process of dying of diseases like cancer, for a day or two at the end, when it was obvious that death is imminent and inevitable. In these circumstances the early Hospices had a struggle to persuade doctors to stop inappropriate resuscitation and to teach them how to gently sedate someone who was becoming restless before death.
As long as everyone can swallow, a Hospice nurse would give them oral fluids – even if only by dipping a sponge stick in the drink and letting them suck it. If someone could not swallow but still showed any signs of consciousness, we could rehydrate them a little with a rectal tube, which causes less discomfort than infusions with needles or gastric tubes.
To use our knowledge and methods to kill off patients because the doctor doesn’t know how to care for them properly or because the hospital administrator once the bed cleared is inexcusable. And criminal.
I can’t help being reminded that Hitler called these patients “useless eaters”.
Dr Richard Lamerton (Retired)
Leading doctor’s fears about Liverpool Care Pathway. Read more »
Dr. Richard Lamerton was trained by and worked alongside Cicely Saunders here he offers his comment on the LCP.
To use our knowledge and methods to kill off patients because the doctor doesn’t know how to care for them properly, or because the hospital administrator wants the bed cleared, is inexcusable. And criminal.”
THE LIVERPOOL CARE PATHWAY IS NOT SAFE Published in the BMJ 6th March 2013 By Dr. ADRIAN TRELOAR Consultant of Old Age Psychiatry. Read more »
Wesley J Smith, Senior Fellow in human rights and bioethics at the Discovery Institute has this to say. Read more »
This is what PATRICK PULLICINO, professor of Clinical Neurosciences, University of Kent, has to say about it. Read more »
DR ANTHONY COLE, CHAIRMAN OF THE MEDICAL ETHICS ALLIANCE said in a meeting (arranged by Baroness Knight) at the House of Lords 23rd January 2013. Read more »
Dr Cole quoted from Dr. Peter McCullough Read more » a senior researcher at John Curtin School of Medicine. Dr. McCullough has written extensively on this subject in an article entitled THIRST IN RELATION TO WITHDRAWAL OF HYDRATION. (February 1996 Catholic Medical Quarterly)
Dr. Patrick Pullicino in letters sent from him and Dr Philip Howard, chairman of the Joint Medical Ethics Committee of the Catholic Medical Association, has this to say about these decisions. Read more »
“Patients can become semi-conscious and confused as a side effect of pain-killing drugs such as morphine, if they are also dehydrated, for instance.” Dr. Peter Hargreaves, a consultant in Palliative Medicine at St Luke’s cancer centre in Guildford. Read more »
Dr. Patrick Pullicino in a letter sent to The Catholic Herald in which he comments on the kind of medicine being practised under the LCP. Read more »
OTHER STORIES AND WRITINGS FROM DOCTORS AND LAWYERS
Cancer expert who treated Mo Mowlan brands Liverpool Care Pathway ‘the most corrupt practice in British medicine.’ Read more »
“Top doctors chilling claim: The NHS kills off 130,000 elderly patients every year.” Read more »
Challenging Medical Ethics 1 No Water-No Life: Hydration in the Dying Dr. Jill Craig book review. Read more »