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Is the Liverpool Care Pathway badly maligned?

Claim that thousands of patients are being killed appears sensational

By on Thursday, 28 June 2012

There was an article in the Daily Mail last week, picked up by the Telegraph and The Catholic Herald, with the headline: “Top doctor’s chilling claim: the NHS kills off 130,000 elderly patients every year.”

Apparently Professor Patrick Pullicino, a consultant neurologist for East Kent Hospitals and Professor of Clinical neurosciences at Kent University, stated in an address to the Royal Society of Medicine: “The lack of evidence for initiating the Liverpool Care Pathway makes it an assisted death pathway rather than a care pathway. Very likely many elderly patients who could live substantially longer are being killed by the LCP. Patients are frequently put on the pathway without a proper analysis of their condition. Predicting death in a time frame of three to four days, or even at any other specific time, is not possible scientifically.”

For those not familiar with the LCP it is a response to a patient perceived to be dying developed in a Liverpool hospice that involves heavy sedation, coupled with withdrawal of food and fluids. Professor Pullicino went on to comment that “This determination in the LCP leads to a self-fulfilling prophecy. The personal views of the physician or other medical team members of perceived quality of life or low likelihood of a good outcome are probably central in putting a patient on the LCP. If we accept the LCP we accept that euthanasia is part of the standard way of dying as it is now associated with 29% of NHS deaths.” It seems the Daily Mail then calculated the figure of 130,000 being “killed off.”

I would have been inclined to believe all this, having read anecdotal evidence in the past of the hazards of the LCP, though I wondered why, if it were true, it did not dominate the next day’s headlines and news stories. Then I read BioEdge, an online commentary on bioethics, which pointed out that the article was full of general speculations such as the phrase “very likely”, the words “probably” and “if” and “associated with”. It was opinion rather than fact, which the Mail, in its sensationalist fashion, managed to turn into an emotion-grabbing story. (BioEdge thinks the Mail has taken up the discarded mantle of the late News of the World; I think that’s going too far.)

Dr Peter Saunders, head of the Christian Medical Fellowship and a strong opponent of euthanasia, commented: “The overwhelming majority of people on the LCP are experiencing much better care at the end of life than they would have had if it had not been chosen.” It would be interesting to know the medical reasons why people are being put on it, though; and the statement also implies that a minority of people might be experiencing worse care ie inappropriate measures that are deliberately ending their life too soon.

Yet Dr Philip Howard, an NHS doctor from Surrey, is pessimistic about the benefits of the LCP; he feels it means large-scale euthanasia by stealth and that the practice would gradually make it irrelevant whether euthanasia should be legalised. He commented: “It is a decision with an end in view. The patient is dying. Why? Because we say they are dying. Why? Because we have decided.”

Yesterday on the radio I heard that in the near future local councils will have to ditch all their other commitments (apart from emptying the bins), such as the maintenance of local roads and providing public libraries, in order to pay for the end of life care of their elderly local residents. It strikes me that wheeling out the LCP alongside the wheelie bins will look like an increasingly attractive option to our health and social services. This is my opinion rather than fact, obviously.

  • follyscorner

    Sadly David you have hit the nail on the head. Now link this with the Bilderberg agenda. Our ability to now share previously unknown, or suppressed information over the social networking sites will eventually bring the politicians to their knees.
    The only reason I have a grievance over the so called care pathway is the untimely, unnecessary death of my late partner.
    In the absence of any history of cancer, following a day surgery procedure she suffered a post-op respiratory collapse, was rushed to ITU, diagnosed with tongue cancer and died 3 weeks later after being placed on the LCP without her, or anyone elses knowledge. An undated DNR notice was also surreptitiously made and only discovered when I obtained her medical notes.
    After 7 years of the NHS complaints procedure a solicitor is finally taking action for the now proven erroneous death. Despite her tongue cancer diagnosis her sole cause of death is registered as lung cancer, but 2 medical reports, and an independent medical expert conclude that the lung cancer nodules on the CT scans were pulmonary embolisms. If the medics and radiologist had have correctly interpreted the CT scan and began anticoagulation treatment the LCP would never have been implemented.
    I’m going for the jugular with breaches of articles 2,3,8 and 10 of the Human Rights Act. It sickens me that when the NHS are brought to book they’re common response is, “we have learned by our mistakes”. And if you listen to their carefully worded statement you will detect a “common purpose” training. I intend to make sure this lesson will be learnt.

  • watchman

    if they cannot apply the l c p properly why are they being allowed to use it, or is it your personnel excuse to cover the wrongdoings, if you use it you will agree  with it, its your  bread and butter i believe it is adolf hitlers t 4 programe being used once again, it was wrong then and it is wrong now, my father fought in the 2nd world war to stop these henchmen and now its back again by the back door in other words deceitfull, they were hung for it after the war. i know its not a war crime no, in fact its worse  we are not engaged in war, its all about  killing for money.

  • watchman

    dont blame yourself codelou7 i did exactly as you you put trust in the medical profession but they are doing as there gods tell them that is the dr gods in charge, if not they will be sacked  try to be very brave your mum would want you to live your own life without  any worry good luck and i will pray for you.

  • concerned

    well calculated david it is all about money not saving lives terminal or otherwise, in the freedom of rights act it says for doctors to put patients on this LCP nastyway they get paid loads of money looks like bribary to me, and  £200.00 saved on a bed its all about cost, but yet david cameron tells us heis giving 7.5 billion to bandit countries its a disgrace, you can bet he his a millionair like tony blair and his cronies when they are voted out of power.

  • watchman

    this liverpool pathway is monster unleashed  its not just used in england they are selling it abroad just imagine mass executions all over the world, but china will be omited they are a race who look to there elders. its right name should read frankinsteins liverpool culling pathway.

  • Max

     Please don’t try and sell us the Liverpool Death Pathway we have seen our loved ones suffering a terrible death on this loved ones who were not terminally ill. You found the articles extremely distressing well so did I how can a so called Doctor do this to a vulnerable human being I just don’t know. Thank God they are not all the same the Good Doctors know this pathway for what it is MURDER. I can not understand what needs to happen before the Church decides to speak out one of the ten commandments is being broken and they are allowing it to happen.

  • John Humphreys4

    Professor Pullicino said pathway, what about the Liverpool railroad, ask Beatric Fraenkel, Jon Murphy and Ged Fitzgerald about the killing of Helen Sheila Cowley and the cover up by Liverpool

  • John Humphreys4

    The Social Worker called saying Criminal Neglect and everyone covered up the fact Mum had been poisoned by Penicillin which she was allergic to, they ran away when they realised she was going to die of Kidney failure but attempted to send her home with us to die. 
    But when we knew about her Alzheimers they ran like Cowards and best of SCUM that is Liverpool protected them.
    They Killed her for money, they were not there when she died screaming with pain or the 5 years she suffered with Alzheimers , no one humane would do this to a animal, the best comparison would be the Nazis and the final solution, who killed after stealing their wealth which is what Merseycare NHS did only Liverpool Council still came for their pieces of silver they give SCUM a bad name.
    Forgive me Father for what I must do.


    DawnBreaking I’m a Catholic and well aware of the medical and ethical teaching of the church, and NHS practice. Like you I have experience of parents’ deaths. Like you I think that the LCP is effective and compassionate. My father’s death was not managed well. He was in a care home but refusing food and acting erratically and sometimes violently. He was transferred to hospital where he was basically neglected on a trolley and died within hours unaware what was happining.
    Mum was carefully managed and we were all advised what was happening. She told me a week before that she would die soon and later I’ll die today. She was unable to take food.
    In the last 24 hours a large oxygen mask caused great distress and nasal tubes were not helping so I turned off the oxygen myself (under advise). All the family were able to talk to her on the last day. This could not happen without the LCP as we’d not be able to get to see her except by chance. I’m sorry he couldn’t see the priest of his choice, but he was able to receive the sacraments.

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