I joined many others in pounding the apparent abuse of the UK’s Liverpool Care Pathway, both in articles here–and during my recent debate/speech tour of Scotland/London. Readers may recall that the Pathway puts people near death into an artificial coma. I do not object to “palliative sedation” properly applied–which is not dehydrating people to death as seems to have happened in some cases. But I worried that with a whopping 16.5% sedation rate, dying people were being treated as a member of a category rather than as individuals, meaning that some were being sedated even when not warranted by their symptoms.
Well, now some important changes are apparently going to be made. From the story :
The architects of the LCP are seeking to address these concerns with a revised version of the guidelines which they will launch on Wednesday. They will include the requirement that patients and their families are consulted before the LCP is commenced, and will stipulate that food, fluids and non-palliative medication should be withdrawn only if they are harmful or burdensome to a dying patient.
“The most important thing is communication,” says Debbie Murphy, co-author and lead nurse of the LCP. “We are looking at articulating more clearly the absolute need to make these clinical decisions in the best interests of the patient, and to support them with a conversation with families so that we don’t get a situation where a relative or carer doesn’t understand that their loved one is actually expected to die now. We do not advise a blanket approach and we are not saying that food and fluids should stop. We are just saying that doctors need to stop and think and consider what’s best.”
Much better. Good for the medical authorities in the UK fpr responding to properly addressed concerns. Still, the treatment of these patients should be closely monitored by administrators and patient care activists to ensure that each person considered for the Pathway actually requires that level of palliative intervention.