Re: How the Liverpool care pathway has transformed end of life care
As a current FY1; I have recently encountered a number interesting scenarios in my experiences around palliation since qualifying.On reflecting on my undergraduate experience of Care of the Dying, I recall only a handful of significant events; a solitary session on the Liverpool Care Pathway’s existence, a tutorial on DNACPR and being present at a single pronunciation of death.
Whilst recent media perspectives contradict everything we stand for as medical practitioners in allowing patient’s to die with dignity and in the absence of pain, perhaps we are somewhat culpable; culpable in the sense that discussion around death is still seen as a taboo, and also possibly that we are often guilty of not being completely forthright with relatives. It is therefore somewhat understandable that an element of suspicion persists among members of the public.
Having recently placed a number of patient’s on the LCP, I often find myself in a position of being responsible for having the relevant discussion with relatives. While it is often tempting to use archetypal phrases reassuring comfort etc, I now find it appropriate to refer to the LCP by name, and the aspects contained within it, to describe how we anticipate any unpleasant potential sequalae and alleviate them as they might arise. By failing to disclose its use I would simply provide credence to some of the claims being made.
Undoubtedly, those articles published recently have made me reflect on my own practice; how I approach families of a dying patient and how I am perceived by them. Will I forever be the doctor that used the “killing pathway” and never disclosed it, or was I the physician who initiated the LCP and provided compassionate care at the conclusion of life for their loved one? It certainly is a fine line.
Rapid Response:
Re: How the Liverpool care pathway has transformed end of life care
As a current FY1; I have recently encountered a number interesting scenarios in my experiences around palliation since qualifying.On reflecting on my undergraduate experience of Care of the Dying, I recall only a handful of significant events; a solitary session on the Liverpool Care Pathway’s existence, a tutorial on DNACPR and being present at a single pronunciation of death.
Whilst recent media perspectives contradict everything we stand for as medical practitioners in allowing patient’s to die with dignity and in the absence of pain, perhaps we are somewhat culpable; culpable in the sense that discussion around death is still seen as a taboo, and also possibly that we are often guilty of not being completely forthright with relatives. It is therefore somewhat understandable that an element of suspicion persists among members of the public.
Having recently placed a number of patient’s on the LCP, I often find myself in a position of being responsible for having the relevant discussion with relatives. While it is often tempting to use archetypal phrases reassuring comfort etc, I now find it appropriate to refer to the LCP by name, and the aspects contained within it, to describe how we anticipate any unpleasant potential sequalae and alleviate them as they might arise. By failing to disclose its use I would simply provide credence to some of the claims being made.
Undoubtedly, those articles published recently have made me reflect on my own practice; how I approach families of a dying patient and how I am perceived by them. Will I forever be the doctor that used the “killing pathway” and never disclosed it, or was I the physician who initiated the LCP and provided compassionate care at the conclusion of life for their loved one? It certainly is a fine line.
Competing interests: No competing interests