The Liverpool Care Pathway, what's happening?

LCP.
I came to terms with this procedure not so along ago. I was on a shift at a local hospice where I volunteer at and during the handover with nurses I was told that a patient, let's call them 'X', was put on 'LCP'. Now, I'm going to admit that I had never heard of this 'LCP' before this time and I was instantly curious to find out what it actually entailed. So I asked. The reply was: 'LCP is for end of life care, when the patient is nearing the last few hours or days of their life'. The answer wasn't very detailed so I decided to look into it more myself.

Now, LCP was proposed by the Royal Liverpool Hospital and the Marie Curie hospice during the late 1990's. Let's get this straight, LCP is not a treatment but is merely a sort of process in which specific care is brought to the patients when their time of death approaches. The proposed idea was to enable the patient to have all their needs, be it spiritual, psychological and physical met by the senior doctor in charge of their care.

Problems started to arise when it became difficult to tell when a patient was nearing the end of their life. How could doctors tell? It was simply a guessing game.

I liked the idea of the LCP. I liked the idea of it being used as a 'framework' for good practice. I liked the idea that health care professionals would talk through plans with the patient and their families carefully and ensure that their needs would be met. I liked the idea that good communication between the health care team and the patient & their family would be a vital and key part of the proposed idea. Most of all, I liked the idea that the LCP was reserved as a last resort, a resort to which should be looked at when the entire team had reached a consensus that the patient was nearing death.

However (yes there is always an 'however') what I didn't like at all was the fact that these principles and guidelines set by the LCP were not being met. From the stories plastered all over the news lately I've grown to question weather the LCP is the way forward. They've been disturbing stories from patients families who have said that nurses would often deny the patient a drink and so patients would often go days without having their thirst quenched. This is simply inhumane and unlawful.

It's a shame that the LCP and their guidelines haven't been met by everyone as I think if it was applied properly it would be a very successful way to care for end of life.

From the concerns that have been raised by numerous different patients the health minister, Norman Lamb, has announced that the LCP will be phased out over the next 6-12 months. Instead, a individual and tailored end of life approach set by a senior doctor will be introduced, carried out and reviewed through its implementation.

It's a real shame that the previous guidelines were not met.

Let me know what you think. Comment, e-mail go for it.

Some more info for you below:
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/212706/100715_letter_to_trusts.pdf
 http://www.mariecurie.org.uk/Documents/HEALTHCARE-PROFESSIONALS/Innovation/Liverpool-Care-Pathway_FAQ-23-August-2012.pdf
http://www.bbc.co.uk/news/health-23315865
http://www.dailymail.co.uk/news/article-2364029/How-Liverpool-Care-Pathway-used-excuse-appalling-care.html
http://www.bbc.co.uk/news/health-23301360

''Martin''

The big 'S'.


SUICIDE. Or specifically in this case, assisted suicide.


Such a controversial topic, there are many opinions and many factors to consider. Now, I am only referring to assisted suicide in the case where a health professional aids a terminally ill patient in speeding up their death. Here in England this is of course illegal.


The big question on everyone's mind nowadays is not the arguments for or against assisted suicide, but it's the arguments for or against the law on this being interfered with due to special cases. One of the biggest 'grey' areas surrounding this matter is the ability of these patients and their families to travel to places such as Switzerland (where assisted suicide is legal) without being prosecuted.


Let's talk about ''Martin''. Now ''Martin'' is a man who suffers from the locked-in syndrome. This is a syndrome that strips a person from their ability to move their limbs so movement sometimes is limited to simple eye movement and/or limited speech. Essentially you are 'locked' in your body, and in the case of England you are forced to stay that way until death creeps up upon you naturally. A heart-breaking condition.


Now ''Martin'' is a man who would have liked to have the power to chose when to end his life and would have gone to any means to do so, even if it meant travelling abroad to Switzerland, Dignitas (assisted suicide centre). As I said before the law states that assisted side is illegal, however the question is how does it affect family members who somewhat aid these patients in travelling to such places? To sort this out ''Martin'' did in fact 'manage to persuade two of three appeal court judges that the law on assisted suicide needs further clarification'. The Supreme Court is now being looked at for final clarity surrounding this topic.


One of the most powerful statements I have heard on this topic is 'This is not about denying people the right to take their own lives, but about making legal the act of taking someone else's'.

This is a new way of looking at it and it's made me thing of the criteria of a murderer. Now in the eyes of the law euthanasia provided by a doctor e.g. active euthanasia (for instance deliberately injecting a patient with lethal drugs) is seen as manslaughter.

So my question to you is, is assisted suicide then manslaughter?

Is relieving your mother/father/daughter etc from endless pain and suffering by helping them in ending their life manslaughter?


Let me know what you all think. Comment below or e-mail me. Thanks for reading!

Food for thought:

http://www.bbc.co.uk/news/health-23520391

http://www.theguardian.com/society/2009/nov/18/assisted-suicide-dignitas-house

http://www.bbc.co.uk/news/health-22198464