Scottish Catholic Observer

By Mary McGinty

Sr Rita Dawson, one of the most respected opinions in palliative care, has added her voice to the debate surrounding the Liverpool Care Pathway (LCP). The goal of the pathway is to ensure as dignified and peaceful dying as possible but it has been beset by recent controversy and criticism. Sr Rita, St Margaret of Scotland Hospice’s chief executive, spoke out in favour of an inquiry.

The LCP has come under scrutiny following revelations that patients have been put on the pathway without their families’ knowledge and claims that some were not dying. This week, Health Minister Norman Lamb announced that hospitals will be legally obliged to consult patients and their families about end of life care decisions.

Sr Rita (above) has supported calls for an inquiry into the pathway saying ‘anything that reassures the public has got to be a good thing when so much doubt has occurred.’

“Good education and communication delivered by a multi-professional team with empathy, experience and maturity are essential,” Sr Rita said. “The problem with the LCP is the frailties in its implementation and it is dangerous in the wrong hands. When staff are busy the first thing to go is communication but that is an inexcusable failure.”

According to palliative care physician Professor John Welsh, the failings of the LCP are in non-hospice settings.

Sr Rita warned about the over-reliance on frameworks and guidelines at the expense of basic care.

Barrister James Bogle, who practices in health and mental capacity law, told the SCO that many legal and medical professionals have been concerned about the LCP for some time and the fact that the pathway is now on version 12 is indicative of ‘some disquiet.’

“What concerns many professionals is the extent to which their professional experiences with the pathway, and with the results and effects of the pathway, have sometimes been rather airily dismissed as merely ‘anecdotal’ by some non-clinicians,” he said

Morality

This week, senior oncologist Professor Mark Glaser branded the LCP ‘morally bad medicine.’

“Senior clinicians of the quality of Professors Mark Glaser and Patrick Pullicino, have raised important questions about the pathway and have been critical of it,” Mr Bogle said

The LCP was developed in the late 1990s at the Royal Liverpool University Hospital in association with the Marie Curie Palliative Care Institute. It was intended to give the best quality care to dying patients in their last days and hours whether in home, hospital, care home or hospice.