Thursday 21 June 2012

LCP - Pathway to Euthanasia

There has been a lot of controversy, not least in the Catholic blogosphere, about the Liverpool Care Pathway.

It was originally developed by Marie Curie hospice in Liverpool, to ease the pain of patients dying from cancer.  

I have immense respect for Marie Curie nurses, from my personal experience - but that does not mean that they necessarily get everything right, and still less that an approach they piloted is not open to abuse.

According to Professor Patrick Pullocino, the LCP is frequently used to dehydrate and starve to death people who are not already imminently about to die.

He told a Medical Ethics Alliance conference in London: If we accept the LCP we accept that euthanasia is part of the standard way of dying as it is now associated with 29 per cent of NHS deaths.

He also revealed that he had taken a patient off the LCP (which had been implemented by a stand-in doctor on a weekend shift), and the patient then lived on for more than a year.  Given that LCP is meant to be for the last hours of life, that is deeply disturbing.

Disturbing, too, is the official line, given by A Spokesman for the Department of Health: ' A patient’s condition is monitored at least ever four hours and if a patient improves, they are taken off the Liverpool Care Pathway and given whatever treatment best suits their new needs.'  If you are sedated, starved and de-hydrated, improvement in your condition is a remote contingency: but that doesn't mean that you would otherwise have died...

I do not know Professor Pullocino, who is the latest in a number of concerned medical professionals to raise questions about the way in which the LCP is used (or abused).  But I do know Dr Philip Howard, both by reputation, and as a friend of friends - and I have heard him speaking on pro-life issues.  So when he speaks, I take it very seriously. 

He says: It (the LCP) is a decision with an end in view. The patient is dying. Why? Because we say they are dying. Why? Because we have decided.

He scarcely needed to add: “That’s a worry when you have the problem of getting it wrong.
Before I get the outraged response of all those who have seen their dying relations' last minutes eased by the LCP, I would simply point this out: I am not saying that the LCP cannot be used ethically; merely that it can (and apparently is) also being used unethically - and that should concern us all.

H/t Diocese of Shrewsbury 


Part-time Pilgrim said...

I think there is a problem with identifying the problem as the LCP itself. My reading of the documentation for the LCP makes me think the LCP can be operated in a way that is consistent with Catholic ethics.

Clearly in the hands of a euthanasia minded physician it can be used to kill patients and equally clearly this is happening. For clarity sake this is what we need to condemn - any hastening of death through dehydration.

I am also worried because some people wrongly use condemnation of the LCP as a test for Catholic orthodoxy.

As for doctors trying to identify whether I am near to death - as a Catholic I really want this. It will enable me to be ministered to by a priest for reconciliation, anointing of the sick and the viaticum.

Ben Trovato said...

A correspondent whose handle contains a vulgarity I do not wish to publish writes;

The Liverpool Care Pathway. The name alone is misleading, it is not just local to Liverpool, the county or the country for that matter. The tentacles of this program are now stretched global. If those that are curious throw it through Google the search will return with sites that are heartbreaking but that paint a pretty picture of caring heroic professionals that are trying their best to make an inevitable end of life as lovely as possible. With a primitive tick box system that is as easy to misread as it is to manipulate and which is sometimes secretive and unjustifiable is a program of death which takes away the right to live. This program is aimed at the most vulnerable whether through illness accident or weakness of the mind When placed on this pathway all medical aid to progression and for life is withdraw. A syringe drive containing a cocktail of drugs sedates leaving a silent victim. This alone would be terrible but then added to this is the withdrawal of all fluid.

Part-time Pilgrim said...

I think Dr Peter Saunders has it about right here.

In particular he points out a simple way of auditing the operation of the LCP to check whether it is being used for euthanasia. I believe if this audit were routinely applied the use of the LCP or similar would actually protect patients from being dehydrated to death.

Who Let Binding and Hoche back into Medicine???? said...

The Nazis ran a 'medical program' for dementia sufferers and the disabled in the 1930s. Like the LCP version 11 fiasco, and v.12, no consent form was required for theirs either. It involved starvation, and overdosages of morphine and sedatives (when the gas ran out natches). I have a photograph of a gentleman leaving Hadamar Hospital sometime after it was liberated by the US Army in WW2. It is captioned 'Hadamar Survivor'. The Nazi's 'wild euthenasia ' phase of their Aktion T4 program used morphine and sedative combinations to kill - same as the liverpool care pathway.
I think the only reason this person 'survived' was that he wasn't given the medications. Likewise, the only reason anyone 'survives' the LCP is that they havent received the prn morphine and sedative/haloperidol overdoses yet...either that, or Nuremberg got it all wrong, and the Nazis were indeed only implementing a medical care program after all!
How perverse Neuberger's 'impartial review' will not even be considering the LCP itself..its like 'NHS Holocaust denial'!