Specialists in Palliative Medicine need to act swiftly to respond to these five key concerns about the LCP

Yesterday I mentioned that the Association for Palliative Medicine (APM) had announced plans to launch an investigation into the controversial Liverpool Care pathway.

Today both the Daily Telegraph and the Daily Mail have run the story.

In addition a Daily Mail editorial today welcomes the investigation and outlines the major concerns that have been expressed by people contacting them as follows:

1. People have been put on the LCP without the knowledge or consent of their families

2. It is cruel to deny fluids to sentient beings

3. Doctors cannot accurately predict that someone is dying within hours or days

4. When doctors withdraw all treatment and nourishment, believing their patients have only days left, the prediction becomes self-fulfilling

5. When well over 100,000 are dying on the LCP each year, the suspicion inevitably arises that the pathway is being used to hasten death and free up beds

The editorial concludes that these are the fears the profession must address and allay if the LCP is to remain official practice.

These questions I would have thought are not difficult to answer and should be able to be addressed easily by any specialist in palliative medicine.

I would gladly attempt it myself but it would be much better if a specialist were to do it. It should not take more than 800-1,000 words.

I gladly offer this blog to anyone prepared to do so and will do all I can to draw it to media attention or to get the story placed in a major paper as an op ed piece.

Ideally it needs a named author but if you wish to remain anonymous that is fine.

Please contact me via this blog or DT me on twitter at @drpetersaunders

I see that the APM has today issued a fresh statement to the media as follows:

‘Our president’s blog has reported that we have recognised there is ongoing debate around Integrated Care Pathways, and the work we are proposing will identify and explore any concerns properly, and find ways of addressing those concerns and improving practice. The APM intends to join others in undertaking this piece of work. We would be very concerned if this proposal was conveyed in any other way. The members of the Association for Palliative Medicine continue to deliver, and support the delivery of, high quality palliative care, including listening and responding to concerns and anxieties experienced by our patients and their families about many different aspects of their illness and treatment, as part our holistic approach to their care.’

I understand that the National End of Life Strategy has also announced that they are going to carry out ‘a short snapshot review of complaints relating to end of life care within acute hospitals' with partnership organisations.

This will 'include complaints relating to the use of the Liverpool Care Pathway and any communication or perceived communication issues’.

It has invited specialists in palliative medicine to take part.

This are helpful and admirable statements and plans but the real priority now is to address the unanswered questions outlined above.

That is what is required to defuse the current controversy and to stop the Daily Telegraph and the Daily Mail continuing their criticism of the LCP.