New guidance on how dying patients should be treated urges care staff to stop making "snap decisions" about their care and to treat them with respect and compassion.
The new guidance, issued by health watchdog NICE, asks doctors and nurses to treat dying patients as individuals with specific needs. It replaces the Liverpool Care Pathway, a system set up in the 1990s as an attempt to ensure people had a dignified and comfortable death. The Pathway required care staff to use a checklist, prompting them to consider whether certain aspects of a dying patient's care should be withdrawn in the later stages of life.
After serious concerns were raised about a “tick box culture”, the Pathway began to be phased out in 2014.
What the New Guidance Says
The new guidance aims to improve end-of-life care for dying patients in England and encourages the following:
Communication – both with the dying patient and their family or friends
Establishing specific needs – communication and collaboration between health professionals is encouraged to establish a patient's specific requirements
Care reviews – care staff should review a patient's care at least once a day, and ask more experienced staff if they are unsure about anything
A change in attitude that ensures staff have more respect for the care of dying patients has been called for by Professor Sam Ahmedzai, expert advisor to NICE. In an interview with the BBC Radio 4 Today Programme, he said: "You have to look at each individual person and respect them as an individual person, ask them about their wishes.”
"Some people may want interventions, may want tests to carry on. Others may want to stop all those things. Some people may want fluids, others may not want fluids. So respecting the individual and not having a one-size-fits-all approach."
I think it’s encouraging to see compassion and appropriate care being highlighted and changes being made to make a difficult time more personal, reflecting individual choice and control as opposed to assuming any individuals preference and adhering to the fixed system the Pathway appeared to have become.
Now, it’s time to see if the new approach delivers what it promises and offers a more dignified way of dealing with sensitive issues.
Liz Perry is a disability rights lawyer at Slater and Gordon in Manchester.
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