Demise of the LCP: villain or scapegoat?. Issue 8 (20th January 2015)

• Record Type: Journal Article
• Authors: MacKintosh, David
• Is Part Of: Journal of medical ethics. Volume 41:Issue 8(2015)
• Page Start: 650
• Page End: 651
• Publication Date: 2015-01-20
• Subjects: Care of the Dying Patient -- Clinical Ethics -- Decision-making -- End of Life Care; Medical ethics -- Periodicals; 174.2
• DOI: 10.1136/medethics-2014-102424
• Languages: English
• ISSNs: 0306-6800

Abstract

Abstract : The winding down and withdrawal of the Liverpool Care Pathway (LCP) following the Neuberger Report has been met with mixed reviews. It appears that responsibility for failures of clinical care has been laid at the feet of a care pathway rather than the practitioners who used it, a rather curious outcome given that the LCP was primarily a system of documentation, a tool with no intrinsic therapeutic properties. The Neuberger inquiry was the result of persistent and repeated reports of poor-quality end-of-life care associated with the use of the LCP. There were indeed problems with the LCP regarding the process of diagnosing dying and its approach to supportive care, particularly artificial nutrition and hydration. Some of the problems were the product of personal or professional ideology influencing goals of care rather than patient-centred considerations. These problems were not insurmountable, however, and were being addressed by the organisation responsible for the LCP. With the removal of the LCP, we are left with no bench mark for end-of-life care, only aspirational goals for individualised care plans. It seems unlikely that practitioners who could not provide appropriate care with the LCP will do so without it.