Assurances over care for dying

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THE head of Hospice Isle of Man has moved to allay fears about a treatment programme for dying patients.

Margaret Simpson, Hospice chief executive, said although the Liverpool Care Pathway is the subject of some controversy in the UK and questions have been raised about its usage here in the Isle of Man, relatives have nothing to fear.

In Tynwald last week, Liberal Vannin member and Douglas South MHK Kate Beecroft tabled a motion asking the Department of Health to investigate using the Welsh system of end of life care. Mrs Beecroft withdrew the motion.

She told the Manx Independent she withdrew it because of negative articles in the UK: ‘I did not want people on the island to worry that it was being misused here as we are particularly fortunate to have our Hospice and its staff.

‘Their standards are exceptionally high and give no cause for concern. As has been evidenced by the occurrences in the UK, the safeguards for the LCP need to be as stringent as possible, particularly if it is to be used more widely, but the withdrawal of the motion was purely timing.’

Critics say the LCP advocates the withdrawal of food, drink and some treatment and is therefore barbaric. But Mrs Simpson said the LCP ethos is the exact opposite.

‘It is used purely to prevent dying patients from having distress or receiving treatment or tests that are not beneficial any longer to them and can cause them harm and not good,’ she said.

‘For instance, if a patient can no longer swallow, it is counter productive to force them to take medication which will not have an effect on the outcome. Drinking when a patient is in this condition can also lead to ‘‘bubbling’’ or choking.’

It is this, she said, that people interpret as a withdrawal of treatment. ‘It doesn’t change the fact of death, it makes the death that little bit better because everything is thought about,’ she said.

A patient is put on to the pathway only with the signatures of the most senior doctor present, the relative/carer and, if possible, the patient. The decision can be reversed.

Mrs Simpson said the LCP had been improved and adapted to best practice over the years and that the Welsh version, although similar in many ways to the LCP, was a not as up-to-date.

The LCP operates both at the Hospice and Noble’s Hospital. The issue of whether or not the pathway is followed correctly is not a problem in the island, said Mrs Simpson. ‘We have been lucky we have got the right personnel and education,’ she said.

Referring to adverse publicity, she said: ‘People who have had loved ones on the LCP in the past will now get very anxious, thinking “have I agreed to something that maybe I shouldn’t’ve agreed to?”.

‘In my own experience as a professional, I can say they don’t always get it 100 per cent right in the UK but over here we are getting it totally right.

‘There isn’t a single example where we have got it wrong.’

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