Death Becomes Us - The Liverpool Care Pathway
Death Becomes Us - The Liverpool Care Pathway
It might seem obvious to some that one should start at the beginning, but I am something of an obtuse character, so choose instead, to start at the end.
If there is one thing that humankind intrinsically excels at, it is dying. Everyone will do this eventually, if they have not done so already. I personally can think of no other activity for which we can claim such a flawless track record. Therefore, as unpalatable as the topic matter is, it is perhaps not one from which we should shy excessively.
A recent press column has recently brought attention to the “Liverpool Care Pathway” or “LCP.” For those who do not know, this is a protocol designed to guide patient care in the final stages of life.
I must admit that the idea left me with an unpleasant taste in my mouth when first implemented. The concept gave me the impression of an expectation for patients to “die to order” and therefore stifling potential for individualised care.
After several years of its use though, my feelings have changed. Dying is a frightening experience. Often not for the patient in their final moments, but it is frightening for family, as well as for doctors and nurses. As a consequence, it could easily be handled badly. A dying patient must have the absolute right to the highest quality of care at this final opportunity.
The LCP brings together the recognised best practices of patient terminal care, while allowing families and professionals a small respite from the psychological trauma of wondering whether they could be missing something vital. A patient death on the LCP tends to be a peaceful and gentle closure on life, with much of the dreadfulness of death removed.
It frightens me to think that the media might drive some families to push for their loved ones to die with needless cruelty as a consequence of Media induced fear of the LCP, yet it is easy to see how the Medical Profession can be seen as a soft target to gain sensational headlines. We are all terrified about defending ourselves, for fear of being struck off our professional registers for bringing the profession into disrepute. Even without such a fear, it is difficult to create a defence without breaking medical confidentiality.
So, as a final thought – a request, in fact – please let me care for my patients without well intended, but ignorant attacks on the profession.
