By Simon Caldwell – JULY 15 will be the tenth anniversary of the abolition of the Liverpool Care Pathway (LCP) in every hospital and hospice in the country. The end-of-life-care protocol was scrapped by the Government as a ‘national disgrace’, in the words of Norman Lamb, then Care Services Minister, after a review by Baroness Neuberger found widespread failings and abuses.
More than a thousand families came forward to relay horrendous accounts of poor care under the LCP. These followed prognoses of death, a practice without an evidence base, and clinicians then authorised ‘continuous infusions of strong opioids and sedatives without justification or explanation’, according to Neuberger who referred to this as a ‘chemical cosh’. Food and fluids were simultaneously withdrawn, often without consent, and patients took an average of 36 hours to die from dehydration.
Appalled by her discoveries, Baroness Neuberger singled out deliberate dehydration for specific criticism. ‘There can be no clinical justification for denying a drink to a dying patient who wants one, unless doing so would cause them distress,’ she wrote in More Care, Less Pathway, her final report. ‘The urge to drink when thirsty is very powerful and basic . . . to deny a drink to a thirsty patient is distressing and inhumane.’
She could not have been more emphatic that this was an abuse and must be stopped. Yet last year a report called When End of Life Care Goes Wrong provided evidence to demonstrate that the practice was still common in the NHS.
The Lords and Commons Family and Child Protection Group, which conducted the study, drew on 17 cases of about 600 to hand. New cases continue to be reported, and one of the most recent involves an 89-year-old Indian grandmother who died this month, 11 days after fluids were withdrawn. The family went to the Court of Protection to halt the actions of the doctors but a judge sitting in secret decided it was not in the patient’s ‘best interests’ to receive continued nutrition and hydration. The Bland judgement of 1993 redefined food and fluid as ‘treatment’ so they could be taken away by Airedale NHS Trust. Neuberger was severely critical of the broad interpretation of this legal precedent to mean that doctors could starve and dehydrate their patients to death whenever they predicted, rightly or wrongly, that death was imminent.
Yet the Court of Protection always seems to side with the doctors who want to kill, and this latest case provides another example of why this sinister institution is Orwellian to the point of having a name which contradicts its actual purpose. It was the same court which in effect sanctioned and covered up the killing of a 19-year-old woman in September.
Just as in the case of ‘ST’, the court in this latest case denied this family the publicity they sought by imposing restrictions on the identity of the grandmother, the staff ‘treating’ her and even the hospital where she spent her final days. Such tyrannical edicts prevent public scrutiny of matters of life and death, precisely where accountability and transparency are most vital in any normally functioning democratic society.
One member of the family, who may not be named because of the gagging order, said: ‘Our mother would find it unacceptable and morally reprehensible to starve and dehydrate anyone to death like this. We will have to live with the acute trauma from watching this happen to our dear defenceless mother for the rest of our lives.’
Read More: The Banned End-of-Life Pathway That Has Never Gone Away.