Yesterday (October 25th) the front page of The Daily Mail in the UK featured the headline ’Doctors to Act on Care Pathway’. A major review is going to take place into what has become the controversial ‘end of life’ treatment regime.
When I first heard about the existence of the Liverpool Care Pathway it sounded a sane and humane system by which, as The Daily Mail reports, ‘doctors identify patients who are dying, and instead of trying to save them, concentrate on trying to ease their suffering.’
However, the Association for Palliative Medicine, which represents 1,000 doctors who work in hospices and specialist hospital wards, will ‘identify and explore concerns’ over the system of caring for patients in their final days. There are growing fears that the care pathway is really a way of hastening the deaths of terminally ill patients. It seems some families have only discovered after the event that their dying family member was put on the pathway without their being asked or informed about it. The first steps in the pathway include the administering of opiates and the withdrawal of food and fluids – measures that would seem to hasten death.
The highly emotive ‘E’ word has even been associated with the practice, through Professor Patrick Pullicino – the consultant neurologist who made known his concerns some months ago about the fact that, as he sees it, ‘euthanasia had become “a standard way of dying on the NHS because of the pathway.”
Interestingly, a friend who only 2 weeks ago supported a mutual friend through dying, was also concerned when she learnt that our friend – a meditator, who wanted to die consciously – could have been put on the pathway without their even knowing it. Happily, the doctor involved understood that staying conscious was a primary concern, so – after some discussion — it was decided not to go the pathway route because that would involve administering diamorphine, way before the dying friend needed it.
So our dying friend was cared for in the way she wanted; but the situation raised alarm bells for my friend doing the supporting. She wondered if it was routine to put someone on the pathway without asking if this was the route they wanted to go; and if, being on it, one could change one’s mind at any point, and so on. The situation also brought home to her the need for any of us in such a position – i.e. dying in hospital – to have someone act as our advocate. She will be happy to hear that others share her concern and that this is now up for debate.
Read a related article on The Daily Mail online