Care for the dying
It is most unfortunate that paranoia is being promoted around the use of the Liverpool Care Pathway (your report, 27 October). It is simply a tool to aid medical and nursing staff in managing the end of life, a state that can frequently be recognised when death is both expected and unavoidable within a short period of time.
It prompts medical staff to prepare to alleviate any distressing symptoms at the end of life with the aim of achieving a “good death” whether the patient is at home, in hospital or in a care setting.
This formal management of death has long been practised within the palliative care and hospice movements in the treatment of cancer patients who are terminally ill.
The recognition that people dying from other causes may not receive the best management in their terminal days has driven the wider introduction of the pathway outwith traditional palliative care settings.
As a supporter of Margo MacDonald’s attempts to give terminally ill people more control over their death, I am disappointed that she has chosen to be apparently disingenuous in her interpretation of the pathway as “doctors being paid more to end life”. She should be embracing the move to minimise suffering at the end of life.
The failure of the medical profession in the recently reported case may have been in inadequate communication with her relatives about her prognosis. Some relatives need help to accept that their loved one has reached the end of their life and that the aim should be to achieve a peaceful and pain-free death.
Unfortunately, it seems that in this case life was not prolonged but death may have been protracted.
(Dr) Lesley Duncan
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