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What does the LCP look like

The Liverpool Care Pathway for the Dying Patient (LCP) December 2009 Version 12.

You can download the 19 page document here:

You will find a document which includes just 2 pages for relatives. Whilst it’s important to recognise that a set of medical guidelines for a doctor or nurse, in this case, is bound to be fuller it does seem that information for the relative is thin on the ground. Certainly if you take a brief look at some of our relatives experiences RELATIVES SPEAK OUT  even the basic advice on the ‘information sheet’ was not carried out.

The LCP is made up of guidelines, algorithms, (a process or set of rules used for calculation), assessments, reassessments, initial assessments, ongoing assessments – day by day, goals (a to q,) ongoing assessment ‘review if’ (a to q) tick boxes, tick boxes and more tick boxes, 54 in all. And variance analysis sheets used, presumably if you don’t know what else to say or the patient improves, unlikely in many ways, given that most of the nurses and doctors time will be taken up filling in these sheets.

For all this bluff it’s worth noting that doctors still only get between 6 and 20 hours of training in end of life care even today. Although nurses can do training course in the use of the LCP on line…….very thorough.

Wesley J Smith, Senior Fellow in human rights and bioethics at the Discovery Institute has this to say,

The problem with such a protocol is that no matter how well motivated — and undoubtedly, the Pathway’s creators had good intentions — follow-the-dots medical protocols often lead to patients’ being treated as members of a category rather than as individuals. At that point, nuance often goes out the door, and mistakes, neglect, and even oppression frequently follow.”