Elderly patients ‘helped to die to free up beds’, warns doctor

Donna Bowater – Telegraph.co.uk June 20, 2012

Professor Patrick Pullicino has claimed that doctors are using a care pathway designed to help make people’s final days more comfortable as an equivalent to euthanasia.

The Liverpool Care Pathway (LCP) is used in hospitals for patients who are terminally ill or are expected to die imminently. Under the pathway, doctors can withdraw treatment, food and water while patients are heavily sedated.

Almost a third of patients – 130,000 – who die in hospital or under NHS care a year are on the LCP.

Professor Pullicino said he believed the LCP was being used as an “assisted death pathway” with patients placed on the LCP without clear evidence, according to the the Daily Mail.

The senior consultant at East Kent Hospitals told the Royal Society of Medicine he had personally intervened to have a 71-year-old man taken off the LCP and be treated successfully, despite claims he was expected to die within hours or days. He had arrived in hospital with pneumonia and epilepsy.

“I removed the patient from the LCP despite significant resistance,” he said. “His seizures came under control and four weeks later he was discharged home to his family.

“The lack of evidence for initiating the Liverpool Care Pathway makes it an assisted death pathway rather than a care pathway.”

Professor Pullicino said the 71-year-old man lived for another 14 months before he suffered pneumonia again and was admitted to a different hospital. He was put on the LCP and died five hours later.

“Very likely many elderly patients who could live substantially longer are being killed by the LCP. Patients are frequently put on the pathway without a proper analysis of their condition,” he added.

“Predicting death in a time frame of three to four days, or even at any other specific time, is not possible scientifically. This determination in the LCP leads to a self-fulfilling prophecy.

“The personal views of the physician or other medical team members of perceived quality of life or low likelihood of a good outcome are probably central in putting a patient on the LCP.”

He said those who went on to come off the LCP and live longer than expected were costly to the taxpayer because of the extra health care and support needed.

The LCP was developed as a template for health workers to make the last days of terminally ill patients comfortable.

The guidance recommends patients’ on the pathway are regularly assessed, and they can be taken off the LCP if they are no longer close to death.

A Department of Health spokesman said: “The Liverpool Care Pathway is not euthanasia and we do not recognise these figures. The pathway is recommended by NICE and has overwhelming support from clinicians – at home and abroad – including the Royal College of Physicians.

“A patient’s condition is monitored at least every four hours and if a patient improves, they are taken off the Liverpool Care Pathway and given whatever treatments best suit their new needs.”

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