Monday, 5 November 2012
Palliative Care, Negligence Or Murder?
The older I become the more aware I am of my own mortality.
It's not just the increase in the number of funerals I attend or hearing of friends who are no longer able to do tasks they could do ten years ago (that includes myself), but it's a deepening knowledge that I'm in the 'danger zone'. In the past five years two close friends have died and although one had been ill for some time, the other died suddenly in the night. Not even his retired wife, a highly qualified senior nurse, could save him and each day she is haunted by her perception that she could have done more. The knowledge that her husband of 44 didn't suffer for more than a few minutes is of slight comfort, but every little crumb of comfort matters in situations where death is involved.
The Liverpool Care Pathway was developed at the Royal Liverpool University Hospital and the city's Marie Curie hospice, to relieve suffering in dying patients. It sets out principles for terminally ill people in their final days and hours and the method is widely backed by doctors and many health charities.
Now a prominent oncologist, Professor Mark Glaser, has spoken out and said the LCP 'is employed by Health Service managers to clear bed spaces and to achieve targets that bring more money into their hospitals.' He added he would go to America because he doesn't trust the NHS and that he has removed 'dozens' of his own patients from the Liverpool Care Pathway.
A few years ago, after a court case, a medic I knew was struck off the medical register for professional misconduct. Dr Martin believed if one of his patients wished to die with dignity at home then it was his job to make their suffering as minimal as possible. He was suspended for five years while police investigated him yet I doubt if there will be any police investigation into the case mention here and others like it. That's because the patient was put on the LCP by her doctors who are supported by the BMA and other medical organisations.
On the Marie Curie website the LCP is described as 'an integrated care pathway tat is used at the bedside to drive up sustained quality of the dying in the last hours and days of life'. Fluid, food and medication is withdrawn from the patient and they're left to succumb to a death which may be horrific for the patient. It has yet to be scientifically proved whether dying patients suffer pain once unconscious.
The fact that hospitals have targets and receive financial incentives for patients associated with the Liverpool Care Pathway is obscene.
Last week the Department of Health's End of Life Care Programme opened an inquiry into the LCP. The result of the investigation should be a halt to this treatment of the dying and a study of how patients can be sent home, if possible, to die in familiar surroundings with local nurses attending to their needs. That is palliative care.
I've placed a poll in the sidebar about this issue.