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Care programme for dying 'is not euthanasia'
Oxfordshire health staff have defended the use of a controversial care programme for patients who are dying.
The Liverpool Care Pathway was set up in Liverpool in the 1990s, and allows doctors to withdraw care from patients but this has led to accusations it is a “backdoor form of euthanasia”.
The pathway was introduced in Oxfordshire about three years ago and it remains in use on a number of wards at the John Radcliffe and Churchill hospitals in Oxford and the Horton Hospital in Banbury.
Care Services Mnister Norman Lamb launched a review into the nationwide service November, over concerns families were not being properly consulted on the care of their loved ones.
The results of the independent inquiry are due to be published in the summer.
Compared with other parts of the country, the Liverpool Care Pathway has not been widely used in Oxfordshire.
About 3,000 people a year die in Oxford University Hospitals NHS Trust hospitals and the trust’s Sobell House hospice, representing about half of the total number of deaths a year. The pathway was used in 209 cases in 2011/12, while nationally it is thought to be used in the deaths of 130,000 hospital patients each year.
The trust’s assistant medical director, Dr Ian Reckless, says he does not know of a single local complaint about the pathway from families or doctors within the trust.
Dr Reckless, who treats elderly patients as a geratology consultant, believes the pathway has a useful role.
It is not a treatment, he maintains – it is not something that puts people on particular drugs, deprives dying patients of food and drink or something to hasten a patient’s death.
“This is it,” he says, dropping a small folder on the table. “It’s a bundle of papers.”
The crucial thing for patients, families and the wider public to understand, Dr Reckless argues, is that the Liverpool Care Pathway is merely a framework for good practice in helping deliver the best care to patients in the last hours or days of life. In some cases that means delivering a comfortable and dignified death.
His colleague at Sobell House, Dr Bee Wee, is president of the Association of Palliative Medicine and can expect to contribute to the independent inquiry.
She said: “The Liverpool Care Pathway is really just a check list for things to consider when someone is recognised to be in the last days and last hours of life. It tells them, ‘you need to think about this’.
“The great frustration for me is that the pathway issue has diverted attention from the need to developing good palliative care.”
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