Wednesday, 9 February 2011

Isn't anyone allowed to die naturally these days?Problems with the Liverpool Care Pathway

I would like to bring to public attention that under the Liverpool Care Pathway which is the system that dying people are subjected to to help them die as comfortably. I am not recommending that people die in pain  (where possible, they should be given the choice about whether they are sedated or not). To deprive someone of their consciousness possibly never to recover is a big decision and this should not be taken lightly, when my husband was in hospital this nearly happened to him because of careless use of midazolam which some nurses eg S. (night nurse) administer at the drop of a hat (in this case, there was no restlessness or distress or pain,it was just administered as a needless precaution, resulting in 18 hours of near unconsciosness, during his last 3 day of consciousness. Don't worry visiting hours were only 3 hours a day at the hospital even with my husband on his death bed, and he was more alert by the afternoon.
However, the main point is that because in the Liverpool care pathway, the nurse/ doctor is expecting to stop the dying person having a death rattle/ pulmonary oedema which is perfectly natural. The condition does not cause suffering to the dying person, but it is prevented using a syringe driver full of Glycopyrronium/ Glycopyrrolate.(fairly harmless but causes extreme mouth dryness). Most literature on the subject says that the symptoms are prevented for the benefit of the carers. In this case only the family were present although the nurse popped their heads around the door a couple of times. The information given to me was geared to pressuring me to agree to my husband having whatever the palliative care doctor wanted my husband to have, and all so that  little boxes on the forms could be ticked. A dying man cannot breathe normally and my husband was unconscious therefore could not feel any breathlessness, his lung capacity was only reduced to half due to fluid between the pleural layers. However, I was pressured into allowing him to have morphine, as a stat dose. I suppose that I should be grateful that more was not inflicted on him but I am not. One very cruel thing about doctors trying to prevent the natural condition of having death rattle preceding death is that they sometimes prevent the patient form having fluids in the last days of life, this happened to my husband, but not all the time. Given the choice, my husband would have wanted to die naturally.