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State rejects archbishop’s call for review of care pathway

By on Friday, 19 October 2012

Archbishop Smith, chairman of the bishops' Department for Christian Responsibility and Citizenship (Photo: Mazur/

Archbishop Smith, chairman of the bishops' Department for Christian Responsibility and Citizenship (Photo: Mazur/

The Department of Health has rejected a call by a senior Catholic archbishop for an official inquiry into the care of terminally ill patients on the Liverpool Care Pathway.

The Archbishop of Southwark wrote to the Secretary of State for Health last month, urging him to launch a “thorough and urgent investigation” into the controversial care pathway.

In a letter dated September 27, Archbishop Peter Smith expressed concern to the Health Secretary Jeremy Hunt about the growing controversy surrounding the Liverpool Care Pathway (LCP).

He wrote: “It does seem to me that a thorough and urgent investigation needs to take place, examining the evidence on which the criticisms that have been made of the LCP rest, so that conclusions can be reached as to whether any corrective action is needed.”

Archbishop Smith added: “If the allegations that are being made can be substantiated, there is serious cause for concern either that the LCP is in some way structurally unsound and needs to be modified or that some doctors and nurses are failing to implement the guidelines as intended.

“Equally, if the allegations are without substance, dying patients and their loved ones are at risk of being caused needless anxiety as a result of which they may well seek to avoid treatment and care from which they would benefit.”

The LCP, which is used by hospitals as a framework to guide medical care of the dying, faced fresh criticism this week after it was reported that an 85-year-old woman had died alone at the Chelsea and Westminster Hospital because medics allegedly did not consult her family before placing her on the pathway.

According to reports, Olive Goom died without family or friends as hospital staff had assured relatives that there was no urgent need to visit, although they had already removed her tubes, which provided food and fluid.

Dr Anthony Cole, the Catholic chairman of the Medical Ethics Alliance, said: “The LCP is inherently hazardous and it is also unnecessary. Excellent end of life care can be delivered without referring to the LCP framework. It is time for an inquiry by the Department of Health into how the LCP is actually operating.”

But a spokeswoman for the Department of Health told The Catholic Herald that it would not be launching an official inquiry into the LCP.

She said: “We would expect all trusts to investigate any reports of abuse or clinical failure and to act accordingly.

“The Liverpool Care Pathway is supported by leading clinicians and charities such as Marie Curie and is NICE [National Institute for Clinical Excellence] recommended. We continue to fully support its proper use as a way of managing a patient’s care with dignity and respect in their last days.”

Jim Dobbin, a Catholic MP and co-chair of the Dying Well All Party Parliamentary Group, which opposes euthanasia and promotes palliative care, has expressed the group’s support for an inquiry.

  • Ben Trovato

    The Archbishop is, of course, right. There are real concerns and they should be investigated thoroughly.  When serious ethical physicians raise such questions, it is simply not good enough to say there is nothing to worry about.

  • paulpriest

    Thank God Archbishop Smith is now listening to these grave concerns…

    We still have a major problem – See this from Peter Saunders Christian medical comment blog:

    Care Not Killing
    David Albert Jones of the Anscombe Centre
    Multiple Catholic Voices Members
    Right to Life executive officer and Herald blogger  Peter Williams
    & many senior clerics and Catholic professionals & academics; together with

    Age UK

    Alzheimer’s Society

    Association for Palliative Medicine of Great Britain and Ireland

    Association of Directors of Adult Social Services

    British Geriatrics Society

    British Heart Foundation

    English Community Care Association

    Help the Hospices

    Lindsey Lodge Hospice

    Macmillan Cancer Support

    Marie Curie Cancer Care

    Motor Neurone Disease Association

    Multiple Sclerosis Society

    National Care Forum

    National Council for Palliative Care

    National End of Life Care Programme

    National Nurse Consultant Group (Palliative Care)

    Nuffield Trust

    Royal College of General Practitioners

    Royal College of Nursing

    Royal College of Physicians

    Sue Ryder

     Have all expressed support for the LCP – saying there’s nothing wrong with its guidelines, safeguards or its practice…

    Other Catholic Ethicists have gone farther as to say it is fully conducive with Catholic teaching…

    Which I repeat is wrong – and either stated through ignorance or deliberate misrepresentation.

    The LCP v12  contravenes Catholic teaching on prognosis-based care, misuse of opiates and the removal of the natural care of nutrition & hydration

    Not only this those senior medical professionals who have expressed long-term vociferous opposition to the LCP have been whispered against, smeared, ridiculed and scathingly dismissed…

    ..not merely accused of ignorant trouble-making…
    but of being lethally, dangerously divisive and playing into the hands of the Pro-Euthanasia lobby

    Now I repeat that the problems of the LCP and its backdoor euthanasia are being wilfully
    denied, repudiated and dismissed in order to save lives and prevent direct euthanasia legislation…
    i.e. the utilitarian Caiaphas Corollary premise that it’s better for a few thousand to be euthanised via the LCP than a few million being killed once assisted suicide and active euthanasia legislation is passed…

    …and the people suppressing the problems of the LCP are for all the best of intentions – fully aware that if we state the LCP is euthanising we will be conceding it’s normative NHS practice and make active-euthanasia legislation more easy to be passed….

    …but the price of silence is too high…

    My opposition to the Liverpool Care Pathway has been denounced as ‘unconscionable’ and I have endured years of ridicule, vilification and abuse for it – even on this very blog…

    ..but that is nothing compared with the heroes who have fought tooth and nail to save lives at risk , change the LCP and make the safeguards safer, I know of some who have risked so much and lost so much simply because they knew the LCP was wrong, was dangerous and it remains deadly…

    Maybe now we might start listening to Drs Phillip Howard, Gillian Craig, Adrian Treloar,, Clare Walker, Patrick Pullicino and a host of other heroes who have fought this battle for years…

    NOW Bishops Conference is finally listening…and lives might be saved.

    Please Archbishop Smith – DON’T LET US DOWN!!!!

  • la catholic state

    They are a law unto themselves.  They don’t even seem to care about their patients anymore.  It’s nearly all about ideology now.  It really is time to think about the return of Catholic hopsitals. The NHS gets scarier by the day.

  • Michael Carroll

    It is good news that a Catholic Bishop has finally started to listen to all our concerns regarding the Liverpool Care Pathway, and acted upon them. This is finally a step in the right direction.

    What is now required is for the CBCEW to finally step up to the mark and clearly tell Catholics where the Catholic Church (not the CBCEW) stand on LCP.

    There should be no more long theological diatribes (where their final stance is buried in a sea of words) This keeps the faithful ignorant.

    The faithful now need a solid YES or NO so that those who remain faithful to the Magisterium can write correctly worded living wills for their end of life care.

  • Nora Mccarthy

    The Liverpool Care Pathway was devised to be used in palliative care not end of life for other condtions.   It is flawed it is unwisely used and the public are entitled to be reassured that they or their loved ones will not be taken down this road without full consultation.   Also the doctors who set up the pathway must be fully trained in it’s use.   As far as I know only doctors who have worked in palliative care have had this training.   My husband has end stage dementia and I am very fearful that if he goes into hospital he would be put on this pathway.
    Please be honest with the public and admit that this is a money saving exercise and also a way of relieving beds.
    Thank goodness for people like Archbishop Smith who have the courage to sopeak out.   Medical and nursing staff are afraid for their jobs.

  • paulpriest
  • Sam Brackenbury

    This is so scary, as a disabled man, a practising Catholic, and an activist, I hear the distant “Hiss” of a “shower”…..  We must appose this agenda at all costs!!!

  • Ian Wright123

    The amount of scaremongering and alarm being caused about this pathway is irresponsible. It does not prescribe anything, let alone the withdrawal of food & fluids. It is an attempt to standardise the care given to those who are very ill, and in many cases terminal. Many people in this position cannot even swallow fluids, let alone chew food! It is a plan of prompts and potential interventions to ensure as much comfort as possible when pts are in this condition. I would welcome an inquiry, so as to reassure the public after so much irresponsible journalism.

  • Ben Trovato

    If ti were merely journalists sounding the alarm, I would be tempted to agree with you. However, when it is serious ethical physicians and nurses, such as Professor P Pullicino
    (Prof of Neurosciences), Dr P Howard (Chairman Joint Medico Ethical Committee Catholic Union), Dr R Hardie (President Catholic Medical Association), Dr A Cole (Chairman Medical Ethics Alliance), Dr M Knowles (Secretary First Do No Harm), Mrs N McCarthy (Catholic Nurses Association), Ms T Lynch (Chairman Nurses Opposed to Euthanasia), and Mr R Balfour (President Doctors who Respect Human Life), then I think we have genuine cause for concern.

  • Peter

    More people should read  THE NAZI DOCTORS: Medical Killing and the Psychology of Genocide
      by Dr.Robert J Lifton online at: 

    It details how the medical profession in Germany was taken over by ambitious ‘party’ types, who owned cars at a time when ordinary people were cold and hungry in the Depression…the 10 years preceding WW2 saw the state turn human beings into ‘economic units’ – costed up their value and decided to get rid of the demented first.
    They experimented on prisoners first I believe, which has already started in Belgium and Holland and China.
    Then the demented.
    Then…disabled children, then…almost everyone – including nurses who objected.

    The riots in the streets all over Germany merely pushed the practice underground.

  • Peter

     What ‘terminal illness ‘ did Rusty Lee’s mother have again Ian ?

  • witchdoctor

    its not scaremongering it is true facts patients who are supposed to be dying have been taken off and are still alive and kicking i had a friend put on this cruel pathway he was eating and drinking, but not when they had finished with him he was put into an induced coma with starvation and morpine syringe driven he was taken off it by relatives its only by luck he is still alive today, it was fortunately taken off before his organs began to shut down thats what happens, when starved and poisoned, look at all the whistleblowers professors and a vast amount of doctors working in this field of work, its  a cruel system to be used and should be exterminated itself instead of the poor patients the british government should be ashamed its nothing but mass murder and will go down in history that it was a wrong.treatment if you can call it that starvation and poison.  

  • true roman catholic

    to paul, i could give the so called catholic pj saunders a much larger list of people against the lcp, who have lost loved ones to this murderous lazarus pathway, keep up your truthfull work paul.

  • Max

    Well said I don’t understand what Archbishop Nichols has remained silent. Top Doctors know it for what it is MURDER.  They are even paying Doctors a bonus to put people on it . What a agonizing death . And still Archbishop Nichols remains silent how many more must be put to death before he acts? 

  • Max

    Archbishop Nichols this is Murder it is breaking one of the ten commandments and you Archbishop Nichols remain Silent

  • Max

    Archbishop Smith it did not help matters that the Catholic Bishops of England and Wales voted for the Liverpool care pathway and did not listen to the advice of Doctors who warned them what would happen . And now after all these people have been put to an agonizing death YOU are asking for a review?