Liverpool Care Pathway: Relatives 'must be informed'

Elderly man's hands There will be a 12-week consultation on the proposed changes to the NHS constitution

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Relatives of terminally-ill patients would have to be consulted before a decision to withdraw food or water is taken, under new government proposals.

It comes after some patients were placed on the Liverpool Care Pathway - designed to relieve suffering - without their relatives' knowledge.

The government wants to ensure families are told of life and death decisions.

The instruction will be included in a number of proposed changes to the NHS Constitution to be unveiled on Monday.

The Liverpool Care Pathway was developed at the Royal Liverpool University Hospital and the city's Marie Curie hospice to relieve suffering in dying patients, setting out principles for their treatment in their final days and hours.

Supporters say it can make the end of a patient's life as comfortable as possible and the method is also widely backed by doctors and many health charities.

However, critics argue it can be inhumane.

The government has now said that the rules needed to be stricter, meaning relatives of patients are always consulted before the technique is applied.

'New right'

A Department of Health (DoH) spokesman said the proposed changes would set out a "new right" under the NHS Constitution, which was established by the Health Act 2009, but he stopped short of describing the move as a "legal requirement".

However, the spokesman added: "Anybody providing NHS services is required by law to take account of it [the NHS constitution] in their decisions and actions."

Some reports suggested health trusts that failed to involve patients and families in decisions could be sued, while doctors could face being struck off.

The DoH spokesman said it was unlikely policy had been developed on this as the proposal was still at an early stage.

Health Secretary Jeremy Hunt will launch a 12-week consultation on the proposed changes to the constitution - the formal statement of patients' rights - on Monday.

Health minister Norman Lamb said this week that it was "completely wrong" for terminally-ill patients to be put on a "pathway" to death without relatives being consulted.

Mr Lamb has called a meeting of doctors and patients to discuss worries about the pathway.

Meanwhile, Conservative peer Baroness Knight called for an inquiry into claims some people might have survived had they not received this treatment.


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  • rate this

    Comment number 108.

    Not everybody is lucky enough to have a sudden catastrophic event at the end. For most people death takes several days and is often distressing for both patients and relatives. The LCP allows professionals to alleviate symptoms of agitation, pain and breathlessness at the end of life and let a patient die with some dignity and peace. To suggest this is murder or inhumane is staggering.

  • rate this

    Comment number 85.

    Consulting the relatives on hand is the good practice of most hospitals. But turning it into law? The words "have to be consulted" leaves hanging in the air what happens if the views of the relatives are perverse, they disagree with each other, are estranged and hate the dying person or scattered half way around the world. Not sure this has been thought through.

  • rate this

    Comment number 46.

    My nan was put on pathway 18 months ago, the family were informed of what would happen and as she had been refusing food herself we felt it was the right thing rather than them force feeding her. At no point did I ever see any suffering,and it seemed she had decided herself it was time to go. 6 days later my nan got herself out of bed and said the "que was too long". She's still with us.

  • rate this

    Comment number 22.

    The needs of the patient should come before the needs of the family. If you've ever seen someone battle a long illness then come to what everyone agrees is the end of their life, it is frustrating to see them suffer because the NHS is so concerned about litigation their instinct is to prolong life when to live is nothing more than to be unconscious to everything but pain.

  • rate this

    Comment number 19.

    I'm a doctor in elderly care and have regularly made use of the Liverpool Care Pathway of the Dying Patient. I am disappointed by the misrepresentation of the LCP. We do not kill patients. We recognise when they are approaching death and keep them comfortable. The evidence is that fluid hydration does not relieve thirst, good mouth care does. LCP = Symptom relief and good quality care at the end.


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