The banned end-of-life pathway that has never gone away
by Simon Caldwell, TCW:
JULY 15 will be the tenth anniversary of the abolition of the Liverpool Care Pathway (LCP) in every hospital and hospice in the country. The end-of-life-care protocol was scrapped by the Government as a ‘national disgrace’, in the words of Norman Lamb, then Care Services Minister, after a review by Baroness Neuberger found widespread failings and abuses.
More than a thousand families came forward to relay horrendous accounts of poor care under the LCP. These followed prognoses of death, a practice without an evidence base, and clinicians then authorised ‘continuous infusions of strong opioids and sedatives without justification or explanation’, according to Neuberger who referred to this as a ‘chemical cosh’. Food and fluids were simultaneously withdrawn, often without consent, and patients took an average of 36 hours to die from dehydration.
Appalled by her discoveries, Baroness Neuberger singled out deliberate dehydration for specific criticism. ‘There can be no clinical justification for denying a drink to a dying patient who wants one, unless doing so would cause them distress,’ she wrote in More Care, Less Pathway, her final report. ‘The urge to drink when thirsty is very powerful and basic . . . to deny a drink to a thirsty patient is distressing and inhumane.’
She could not have been more emphatic that this was an abuse and must be stopped. Yet last year a report called When End of Life Care Goes Wrong provided evidence to demonstrate that the practice was still common in the NHS.
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