Worth reading the whole thing actually but:
One of Britain\’s leading neurologists has revealed his fears about the use of the Liverpool Care Pathway as he disclosed how one of his patients survived for 14 months after being taken off it.
The consultant neurologist said the case demonstrates that doctors should not be allowed to forecast death, which became a \”self-fulfilling prophecy\” once treatment and sustenance were withdrawn.
Prof Pullicino said: \”There is no objective criteria to say whether a person is dying or not – there is no scientific way to know, and that means the system is open to terrific abuse.
\”If you stop treating someone for their condition they are unlikely to improve. If, on top of that, you sedate them heavily, you are unlikely to see any improvement even if it does occur. That is why putting patients on the pathway becomes a self-fulfilling prophecy.\”
The consultant said he believed that doctors taking such decisions were often making a judgement about the patient\’s quality of life, not about whether they were close to death.
Prof Sam Ahmedzai, a leading palliative care doctor, said he was worried that \”inhumane\” decisions were being taken by doctors who did not know the patient being discussed, and were in a poor position to make judgements about their prognosis.
He said: \”What often happens though is that the decision is taken out of hours, at weekends, basically by strangers who have never seen that patient before and never will again.\”
It was \”unforgiveable,\” said Prof Ahmedzai, professor of palliative care at the University of Sheffield, for life and death decisions to be made in such a way.
There\’s a difficult line here. Obviously.
Someone whose going to be dead tomorrow from their lung cancer probably doesn\’t need the crash team to break their ribs as they restart their heart after it stops. But that\’s rather different from stopping the antibiotics and water going into someone with pneumonia who could, as above, survive another 14 months.
And let me be honest about my worry here: bureaucracies really don\’t deal well with such fine lines.