A controversial method of hastening death for terminally-ill patients has been scrapped, reports the BBC.
The Liverpool Care Pathway (LCP), developed by Royal Liverpool University Hospital and the Marie Curie cancer charity, involved the withdrawal of medication, food and fluids. Patients were sedated, starved and dehydrated to death.
In October 2012 figures released under the Freedom of Information Act showed that some two thirds of NHS trusts had received incentive payments for meeting “targets” for using the LCP, and that such payments totalled £12 million or more.
But now, England’s health watchdog, the National Institute for Clinical Excellence (NICE), has put forward new draft guidance to improve the care of adults in their last few days of life.
The NICE proposals make no mention of lists or tick boxes, much criticised in the LCP approach.
But crucially, there are calls now for basic daily checks to make make sure patients are well hydrated and nourished, a radical departure from the LCP. Families should be encouraged to be more closely involved in care if appropriate and safe – for example helping to give loved ones sips of water – and there is a demand from NICE for clear communication and the involvement of patients and relatives in decisions.
Two years ago, a review chaired by crossbench peer Julia Baroness Neuberger called for the LCP to be scrapped. The review applied only to England.
Many hospitals in England apparently ditched the LCP but it has taken two years for NICE to come up with an alternative.
The Scottish Government announced in December 2013 that the LCP would be phased out.
In Northern Ireland the Liverpool Care Pathway remained, as at July 2014, according to the General Medical Council, one of ‘several tools to help deliver palliative and end of life care’, although a review of the use of the LCP was said by the Macmillan cancer charity to be taking place.
In Wales, an ‘Integrated Care Pathway (ICP) for the last days of life‘ was implemented in 2000, overhauled in 2010 and amended in 2012 ‘primarily to clarify issues around sedation, hydration and prescribing’.
An All-Wales Palliative Care Conference is to take place at Gregynog in Powys on 8th & 9th October 2015. The current ICP for Wales is downloadable HERE. It still retains the ‘check-box’ approach and the ‘pathway’ name, but hydration is a goal in it and there is no apparent specific mention of the withdrawal of food.
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“A controversial method of hastening death for terminally-ill patients” which is only used in this country because the more humane controversial methods used in some other civilised countries are illegal here. . It’s not really “a method”, it’s the only method allowed, or at least a relatively refined version of the only method allowed.
More humane? We are not talking about injured animals, mate.
The word “humane” does actually apply to human beings rather than animals ! This makes it all the more extraordinary, as many have remarked, that animals are treated more humanely than human beings when they are in pain and definitely approaching the end of their life.
You do surprise me with this objection, because it is Muslims who follow their divinely revealed laws with no thought of being “humane”, for example cutting off the hands of thieves. Christians are normally noted for being humane, abolishing the death penalty and so on.
The hospice movement is at the forefront of alleviating pain. You are advocating euthanasia. We put animals ‘to sleep’ because it is ‘kind’ for them, and in theological terms, mankind has dominion over them. ‘Ye are of more value than many sparrows’ (Luke 12:7). But for human beings, because God alone is the author of life and we are not our own, we do not and should not allow suicide in any form.
Yes, there will be individual cases which tug at the heart-strings, but it is almost impossible to exercise what we might see as compassion in those hard cases while retaining the standard. And the practical argument is that if the door is opened, there will be pressure brought to bear on the elderly and infirm to give up.
If abolishing the death penalty for you is being ‘humane’, it just shows how that word leads to trouble. The death penalty expresses respect for innocent human life and embodies the principle of restorative justice. It says that a human life is worth rather more than twelve years in jail. Abolishing it shows no compassion for the victim.
It is interesting that in secular thought the penalty for theft is a time inside, as if the state has been wounded rather than the person stolen from. In Biblical thought the penalty is to restore the amount stolen with a addition. For Muslims the penalty is to cut off the hand of the thief. It may (or not) be a deterrent, but how does that help the person stolen from to get his money back? They have now stopped a man from working and made him a burden. Like many things Islamic, it is barbaric.
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