Dying patient’s dignity preserved in new guidelines
On the 29th July Vincents Solicitors reported on the new proposals for end of life pathways within the NHS and welcomed the proposed changes. Finally, the changes have been approved and the focus now rightly, centres round ensuring that patients die with dignity.
The National Institute for Health and Care Excellence (NICE) has finally approved changes to an NHS protocol which has been in existence since the 1990’s. The Liverpool care pathway (LCP) became the focus of significant negative publicity when cases were reported of patients being deprived of water, food and treatment in their final hours.
The fundamental criticism of the LCP was that it was a simple tick box exercise in dealing with the end of life rather than addressing the needs of the actual individual.
Charities across the health sector welcome the new changes, which herald the first national guidelines in England. Amongst the changes is a provision that calls for junior doctors to seek expertise of more experienced staff when having to make difficult decisions about end of care. Staff should allow patients to drink or be hydrated to ensure comfort. Most importantly is the concept that medical practitioners assess the patients need.
The Chief Executive of NICE, Sir Andrew Dillon, commented: “Recognising when we are close to death and helping us to remain comfortable is difficult for everyone involved. The Liverpool care pathway was originally designed to help Doctors and Nurses provide quality end-of-life care. While it helped many to pass away with dignity, it became clear over time that it wasn’t always used in the way it was intended.”
Dr Ros Taylor, the director of Hospice UK welcomes the changes but advises caution, indicating that more training is needed to implement the guidelines, to avoid the pitfalls under the LCP.
Carlos Lopez, head of the clinical negligence team, commented, “This is a much needed and welcome change. The guidelines should prevent a repetition of the terrible events that led to people dying in unnecessary discomfort and in circumstances that deprived them of their dignity. It is only right that the needs of the patient are put first. However, this is the first on many steps needed to address the suffering of those who are dying. The Government also needs to address the imbalance which many families face when bringing claims for the death of a loved one. Current inequalities result in an unfair system which sees family members and partners unable to consider litigation.”
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