Bad press over Liverpool care pathway has scared patients and doctors, say experts

BMJ 2013; 346 doi: (Published 10 January 2013) Cite this as: BMJ 2013;346:f175

Re: Bad press over Liverpool care pathway has scared patients and doctors, say experts

As a medical student I have been exposed to some aspects of palliative care, particularly in the community when GPs have been involved in the LCP. I could not emphasise enough how much families of patients who are dying have been grateful for such a tool to exist. The amount of respect and sensitivity I have seen from GPs makes it hard to believe that there is such a great fear of the LCP.

I fully support the principles of the LCP and I think all doctors are dedicated to ensuring the highest standard of care for the dying patients. The review should be welcomed as we are always striving for improvement in all aspects of healthcare.

One particular aspect that maybe needs to be looked at is how medical students are taught about palliative care. I have not had the same exposure to palliative care in the hospital as I have had in the community and even that was because the GP in question had a special interest in the field. We are the doctors of the future and will be the ones on the ward when the patients deteriorate and the ones families approach as a first point of contact. Often we will be the last ever contact patients have with healthcare professionals. This is the time our empathy and sensitivity will be most crucial and we should be equipped well to deal with these situations. It is clear junior doctors are often scared to approach dilemmas such withholding treatment as the ethical and moral issues are so vast.

I believe a more structured approach and a greater emphasis on palliative care is needed in medical schools. GPs and other palliative care specialists should be more involved in designing components of the programme and ethics and debate should have a greater role in medical education. This may be something that could be extended to other healthcare professionals in hospitals to ensure we all have the adequate training and skills to make the "last hours and days as comfortable as possible" for our patients.

Taking care of the dying is the ultimate test of compassion and this is the field where I believe a true difference can be made. It is our last chance to do something for our patients so we must get it right.

Competing interests: No competing interests

02 February 2013
Tasleema Begum
Medical student
University of Manchester
Oxford road, Manchester, M13 9PL