Elderly and vulnerable people are still being put on an end-of-life ‘death pathway’, hard-hitting report reveals – even though it was officially abolished almost a decade ago
- Elderly and vulnerable people are still being put on an end-of-life pathway
- Pathway continues despite being abolished almost a decade ago, report claims
- The report, commissioned by MPs and peers, is set to be published on Tuesday
Elderly and vulnerable people are still being put on an end-of-life ‘death pathway’, despite the fact that it was officially abolished almost a decade ago, a report will claim this week.
The controversial Liverpool Care Pathway – a series of guidelines that can involve the withdrawal of life-saving treatment from dying patients – was banned in 2014 after reports that people were put on it who might otherwise have survived.
But a report commissioned by MPs and peers, to be published on Tuesday, will conclude the LCP is still being practised ‘in all but name’.
The report details 16 cases where patients died after being given LCP-style treatment. The youngest was just 21.
One of the report’s authors, retired palliative care consultant Professor Sam Ahmedzai, last night said he was ‘shocked’ to hear how they had been treated ‘at the hands of those who should have known better’.
Under the ‘LCP’, patients were sometimes placed on the pathway too soon. They were then given large doses of sedatives and painkillers – ostensibly to ease their pain – and often denied nutrition and hydration. Severely weakened, death became all but inevitable.
Elderly and vulnerable people are still being put on an end-of-life ‘death pathway’, despite the fact that it was officially abolished almost a decade ago
Despite it being stopped, Prof Ahmedzai found LCP-style treatments ‘persist to this day’.
The 16 suffered from medics implementing a ‘one-size fits all, tick-box approach’, he wrote, adding: ‘Thus in many of our case studies, patients … were experiencing an end-of-life care pathway which was similar to the LCP in all but name.’
In 10 cases relatives challenged doctors about whether the LCP was being applied but ‘this was met with denial,’ said Prof Ahmedzai.
Some patients were subjected to ‘indefensible end-of-life decisions’ made ‘unilaterally’ by doctors.
Laura Jane Booth, 21, who had the genetic disorder Patau’s syndrome, died in October 2016, after going into hospital for an eye operation.
Her parents said: ‘She had no nutrition for the entire three-and-a-half weeks she was in.’
Even during three days in intensive care, ‘still nobody did anything about Laura not feeding’.
When she died, they still thought she was in hospital for routine surgery. ‘Nobody ever told us that she was on an end-of-life care pathway.’
But a report commissioned by MPs and peers, to be published on Tuesday, will conclude the LCP is still being practised ‘in all but name’ (Stock Image)
Initially, Laura’s death certificate stated she had died of natural causes. After pushing for an inquest, which finally took place in 2021, a second was issued stating that ‘malnutrition contributed to her death’.
Her parents claimed at inquest medics ‘tried to say that Laura had outlived her time with multiple conditions’.
In another case, an 84-year-old man died after a nurse told his family he had been put on ‘the pathway’.
David (no surname given), who suffered from heart failure, went into hospital in late August 2021 thinking he would be in for a quick procedure to ease fluid retention. He never left.
Two days after being admitted, a consultant told his family David was ‘actively dying’ and said he had refused further treatment.
Fluid, nutrition and his normal heart failure drugs were stopped. The doctor saying these would only ‘prolong his suffering’, his family recalled. A nurse told them he had been put on ‘the pathway’.
He died a few days later. His family believe the withholding of hydration, nutrition and his drugs hastened his death.
Prof Ahmedzai said the consultant’s conversation with the family ‘bears the hallmarks of the types of conversation carried out [before 2014] when the LCP was still in use’. Some places had been ‘reluctant’ to drop the LCP and made ‘merely cosmetic changes’.
The 16 were taken from hundreds of families’ experiences, collated by Denise Charlesworth-Smith, who helped lead opposition against the LCP following her own father’s death.
She said while ‘things looked good’ after the LCP was binned, by 2018 she was being contacted by ‘more and more’ families saying new guidelines were being ignored.
The report was commissioned by the Lords and Commons Family and Child Protection Group. Its chair, DUP MP Carla Lockhart, said it exposed ‘unacceptable’ practice.
An NHS spokeswoman said: ‘Local health systems are responsible for setting out end of life care plans in line with NICE guidelines which make clear that people should be given an individual end of life care plan.
‘NHS England has also established the medical examiner programme which aims to provide a better service for the bereaved, including giving the opportunity for families to speak to an independent doctor not involved in the care of their loved one to ask questions and raise any concerns.’
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