TY - JOUR T1 - The Liverpool Care Pathway for the dying: what went wrong? JF - British Journal of General Practice JO - Br J Gen Pract SP - 509 LP - 510 DO - 10.3399/bjgp13X673559 VL - 63 IS - 615 AU - Daniel Knights AU - Diana Wood AU - Stephen Barclay Y1 - 2013/10/01 UR - http://bjgp.org/content/63/615/509.abstract N2 - The recent Independent Review led by Baroness Neuberger1 recommended discontinuation of the Liverpool Care Pathway for the Dying (LCP). Developed in the 1990s to address barriers to the delivery of excellent care in the final days of life, the LCP was designed to support the high standard of palliative care prevalent in hospices to other clinical settings. It provided guidelines for best practice, focusing on symptom control, appropriate discontinuation of active treatments, psychological, social, and spiritual care of patients and their families, and frequent patient reassessment.However, in recent months the LCP has come under intense media scrutiny, with the Daily Mail describing it as ‘a pathway to euthanasia’,2 compromising patient autonomy, used to ‘free up hospital beds’ and even for NHS trusts’ financial gain. Despite widespread support across the majority of the healthcare professions,3 the Review report is unequivocal: use of the LCP must cease. To examine the underlying issues that have fuelled this controversy, it is pertinent to consider the extent to which the Review’s recommendations represent a proper response to legitimate concerns or whether a good clinical tool is being sacrificed to a media furore.The debate surrounding the LCP has revealed a deep reluctance in UK society to address issues of mortality, by patients, relatives and healthcare professionals alike. Hospitals are seen as places to heal and prolong life; acceptance of dying and death is interpreted as giving up, ceasing to try, even as approaching euthanasia. Doctors may have a sense of failure and fear complaints or litigation for not doing enough. Yet from ancient times it has been an integral part of the doctor’s role to ease a patient’s pathway to death when the time has come, neither hastening death nor prolonging suffering. General Medical Council … ER -