More on the Liverpool Care Pathway Controversy

Lost in the news about the election yesterday was an article in the Daily Telegraph on the uproar surrounding the Liverpool Care Pathway, or as it is known to some, Crematorium Lane. Over 1,300 doctors, nurses, and caregivers wrote to defend the policy, which is used in almost all UK hospitals today.

Since the inception of the concept in the 1990′s, doctors have been struggling with end of life care. The LCP is a multidisciplinary process of assessing and treating seriously ill patients with little hope of recovery. Solutions include cessation of treatment, withholding of food and water, and even of IV drips.

It is not an evil process in itself, but rather in its application. death comes to us all and death with dignity is a right.

But it has been revealed that many hospitals stand to reap performance bonuses for ‚ÄúCommissioning for Quality and Innovation‚ÄĚ (CQUIN), or setting targets for the number of patients who are treated using this regimen.

In 6% of all cases, the families were never informed that their loved one had been placed on the Liverpool Pathway, and in 25% of the hospitals participating doctors and nurses had failed to inform the families in half of all cases. Strange statistics indeed. Consultation with the family is a centerpiece of the Pathway as written. There have been several calls for a parliamentary inquiry.

Statism is a way of life where bureaucracy takes over the simplest and most complex of decision making processes. In an article only the day before, the Telegraph reported on the case before the High Court of accident victims being placed on “do not resuscitate” orders without their families consent. There has been a litany of similar cases in the UK press of late.

In an article only a few weeks ago, family physicians are being asked to identify patients likely to di, which really, is all of us, in order to make the process more efficient. from those guidelines:

“Doctors are told to pick out such patients during routine consultations that show ‘indicators of frailty and deterioration’ and are told that ‘older people are a priority to consider”.

They are also told to use feedback from district nurses or hospital consultants, while patients in care homes should be “actively considered for your register”, the advice states.

So it is up to you. The brother of Rahm Emmanuel, Dr. Ezekiel Emmanuel, has argued eloquently for patient rights and against euthanasia. The Liverpool Care Pathway recognizes that same human dignity, but is failing in its application. When the sorts of abuses and potential abuses reported in the UK press are considered, we must once again reconsider state sponsored medicine.

 

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