The Liverpool Care Pathway: ‘Tick box’ approach not encouraged

Abstract

The UK’s Daily Telegraph published a letter criticizing the Liverpool Care Pathway (LCP) on 3 September, and accompanied it with the front page headlines ‘Sentenced to death on the NHS’ and ‘Palliative care is in crisis, warn leading doctors.’ Further articles expressing concerns about the LCP have appeared in the days since then. The nub of the criticisms is a fear that the LCP encourages ‘a tick box approach to the management of death’, leading to the premature withholding of artificial nutrition and hydration accompanied by continuous deep sedation. To put it more crudely: that patients are being dehydrated and sedated to a premature death.