Observations Palliative Care

The birth and death of the Liverpool care pathway

BMJ 2013; 347 doi: http://dx.doi.org/10.1136/bmj.f4669 (Published 24 July 2013) Cite this as: BMJ 2013;347:f4669
  1. Krishna Chinthapalli, clinical fellow, BMJ
  1. kchinthapalli{at}bmj.com

Last week the Neuberger review advised phasing out the Liverpool care pathway, a development in care at the end of life with its seeds in the early 20th century

It was near Mont Blanc, 80 years ago, that Marie Curie arrived at a sanatorium in the foothills of the Alps to spend her final days. But these days were not pleasant: “At times [her daughter] had to leave the room, because she could not bear to see her mother in such agony.” Her physician at the sanatorium wrote, “The disease was an aplastic pernicious anemia of rapid, feverish development. The bone marrow did not react, probably because it had been injured by a long accumulation of radiation.”1

During the first world war Curie had used her discovery of radiation to set up and drive mobile radiography units to the frontline, exposing her bone marrow to the deadly rays. After the war she funded centres around Europe to treat cancer with radium. One of these centres was in Hampstead, London.

After the second world war the Hampstead hospital was facing closure. However, the hospital committee wanted to perpetuate Marie Curie’s name and was inspired by Winston Churchill’s comment that “casualties from cancer were far worse than those caused by hostilities.” Thus the committee set up a foundation for the care of …

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