Doctors criticise DoH palliative care model

The government-backed treatment pattern of palliative care being rolled out to hospitals, nursing and residential homes is flawed, according to leading doctors.

Palliative care model was criticised (Photograph: Paul Starr)
Palliative care model was criticised (Photograph: Paul Starr)

In a letter to The Daily Telegraph, the doctors wrote: ‘We would like to draw attention to the new ‘gold standard’ treatment of those categorised as ‘dying’. Forecasting death is an inexact science.

‘The government is rolling out a new treatment pattern of palliative care into hospitals, nursing and residential homes. It is based on experience in a Liverpool hospice. If you tick all the right boxes in the Liverpool Care Pathway, the inevitable outcome of the consequent treatment is death.

‘As a result, a nationwide wave of discontent is building up, as family and friends witness the denial of fluids and food to patients. Syringe drivers are being used to give continuous terminal sedation, without regard to the fact that the diagnosis could be wrong.

‘It is disturbing that in the year 2007/8 16.5% of deaths came about after terminal sedation. Experienced doctors know that sometimes, when all but essential drugs are stopped, ‘dying’ patients get better.’

The letter is co-signed by Peter Millard, emeritus professor of geriatrics at the University of London, Dr Anthony Cole, chairman of the Medical Ethics Alliance, Dr Peter Hargreaves, consultant in palliative medicine, Dr David Hill, fellow of the Faculty of Anaesthetists of the Royal College of Surgeons, Dr Elizabeth Negus, lecturer at Barking University in east London, and Dowager Lady Salisbury, chairman of Choose Life.

A DoH spokesman said: ‘People coming to the end of their lives should have a right to high quality, compassionate and dignified care.

‘The Liverpool Care Pathway is an established and recommended tool that provides clinicians with an evidence-based framework to help delivery of high quality care for people at the end of their lives. It has been recommended in the supportive and palliative care guidance issued by NICE.

‘Many people receive excellent care at the end of their lives. We are investing £286 million over the two years to 2011 to support implementation of the End of Life Care Strategy to help improve end of life care for all adults, regardless of where they live.’

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