10 Responses to “New bmj articles – free links”

  1. steve November 1, 2012 at 3:31 pm #

    The assault on the LCP by the Daily Mail is appalling but so utterly predictable. But I guess if you produce a toilet roll newspaper you end up speaking out of your backside.
    For a more coherent and balanced view try this article instead from the New York Times:
    http://www.nytimes.com/2012/10/08/opinion/keller-how-to-die.html?pagewanted=all

  2. steve November 1, 2012 at 5:29 pm #

    Sorry – should have said Daily Torygraph

  3. Malvolio November 1, 2012 at 7:32 pm #

    @steve – pity you didn’t apologise for your appalling spelling too.

  4. steve November 2, 2012 at 10:18 am #

    Ach well – it was late at night. Poor excuse I know :-)

    Margaret – any chance of an “edit” facility on your site?

  5. steve November 2, 2012 at 10:19 am #

    Though not late when I actually posted it so definitely no excuse!! Back to school for me…

  6. Carerplus November 2, 2012 at 6:36 pm #

    But surely the question is whether it can be categorically asserted that LCP has never been used inappropriately by any team in any hospital at any time, without looking further into the matter. There are risks in automatically dismissing all patient and carer accounts indicating possible misuse (in the context of a target culture) of what is a valuable approach, rather as some initially regarded Mid Staffs concerns as unwarranted.

  7. Margaret McCartney
    margaretmccartney November 2, 2012 at 8:26 pm #

    hope that’s ok Steve

    Careplus, I would not suggest that there has never been any inappropriate use of the LCP ever. And I would, absolutely, want patient and carer views to be embedded in how the pathway was used. Doctors must always act in the patients’ best interest, and this will sometimes, rarely, mean conflict with families. I found the coverage alarmist and did not take account of the fact that the LCP can be very useful in many cases. We need balance, and an understanding of why we are where we are, and I don’t think the coverage produced that, and risked alarming and distressing terminally ill people and their families. I’ve already heard from some healthcare professionals afraid of giving adequate analgesia because of fears expressed by families.

  8. Carerplus November 3, 2012 at 7:45 pm #

    Certainly LCP is valuable when correctly used. as I have witnessed in the end-of-life care of two relatives for whom I was caring, where palliative care specialists worked closely with other medical personnel, family members and the patient. However current NHS pressures, combined perhaps with an approach by health policymakers that does not always reflect the untidiness of the dying process, so that doctors are almost regarded as having failed if someone terminally ill dies other than on LCP, do not help. (See for example, the Derbyshire EOL guidance on http://www.dchs.nhs.uk/assets/public/dchs/dchs_about_us/End-Of-Life-Care/51636-End-of-Life-Care-16pp-final.pdf, with much useful information but also a rather prescriptive pattern for people’s final year that is far removed from many patients’ experience, and set of signs for a ‘dying phase’ that are rather broad though hopefully, in practice, knowledge of a particular patient would enable a doctor to make their own judgement.)

  9. steve November 3, 2012 at 10:32 pm #

    There’s clearly a discussion to be had and no system is perfect. But compared to what went before the LCP has been a godsend for many. I am regularly involved in palliative care and I have also experienced at a very personal level. The idea that it prohibits fluid and encourages us to thirst people to death is simply not true. The vitriol heaped on the LCP in some quarters is frankly lothesome. Perhaps if some of those making these remarks actually spent some time in hospices or on a palliative care unit they might have the right to comment.

  10. Sliepnir2006 February 19, 2013 at 12:09 pm #

    The view on the Daily Mail articles, all depends whether you regard those who feel their relatives have been murdered or not, personally speaking for me the LCP is nothing more than either murder or euthanasia by proxy.

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