Pullicino was reported as saying doctors had turned the use of the Liverpool Care Pathway into the equivalent of euthanasia of the elderly. The Liverpool Care Pathway, which was created at the Marie Curie Hospice in Liverpool in the 1990s, is used in New Zealand with Ministry of Health funding.

"It is alarmist to say that patients ‘are being killed' by The Liverpool Care Pathway (LCP). It is incorrect to say, as reported, that it brings about the death of patients in the sense of causing their death. For persons who are dying the LCP is designed to provide caregivers with a set of standards that define quality care," Kleinsman said.

"It arose out of the hospice care system and has been developed as a way of ensuring excellence in, and consistency of, care. The overwhelming majority of people are able to experience better care at the end of life than they would have previously. It provides a mechanism for accountability and a means to standardise care across the country."

"It is a mistake to equate the introduction of LCP with euthanasia. Of course, like any tool, it is only as good as those who are using it. We do need to maintain vigilance to make sure that patients are receiving the level of care that accords with their human dignity," said Kleinsman.

Source

• The Nathaniel Centre
• Image: Bedfordnow.co.uk

Professor Patrick Pullicino said doctors had turned the use of the Liverpool Care Pathway into the equivalent of euthanasia of the elderly.

Professor Pullicino, a consultant neurologist for East Kent Hospitals and Professor of Clinical Neurosciences at the University of Kent, was speaking to the Royal Society of Medicine in London.

The Liverpool Care Pathway, which was created at the Marie Curie Hospice in Liverpool in the 1990s, is used in New Zealand with Ministry of Health funding.

It is designed to come into force when doctors believe it is impossible for a patient to recover and death is imminent.

The pathway can include withdrawal of treatment — including the provision of water and nourishment by tube — and on average brings a patient to death in 33 hours.

Professor Pullicino claimed there was often a lack of clear evidence for initiating the LCP programme.

Far too often, he said, elderly patients who could live longer were placed on the LCP and it had now become an "assisted death pathway rather than a care pathway".

He cited "pressure on beds and difficulty with nursing confused or difficult-to-manage elderly patients" as factors.

Professor Pullicino revealed he had personally intervened to take a patient off the LCP who went on to be successfully treated.

"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.

"Predicting death in a time frame of three to four days, or even at any other specific time, is not possible scientifically."

Sources

• Christian Post
• Daily Mail
• National Liverpool Care Pathway (NZ)
• MacDoctor
• Image: Mark Hillary