"Liverpool Care of the Dying Pathway"

I work on a ward where all patients have either a terminal illness or chronic conditions that will progress and eventually lead to death. As a nurse, I find it distressing that so many relatives do not understand how and why a person is put on the Liverpool care of the dying pathway. All relatives should be consulted and explanations must be given to relatives in order to stop scaremongering and distress among families.

When a doctor places a patient on the Liverpool care of the dying pathway the decision is made as a clinical decision. This is based upon the existing effectiveness of treatment, the person's existing chronic illnesses and the likelihood of them surviving the current illness and/or infection.

There are several strict criteria that have to be met in order to commence the pathway and it does not involve gaining permission from a relative. Legally, a doctor does not have to gain permission from a relative to give or withold treatment. The responsibility lies between patient and doctor.

I find it frustrating that so many comments are made by relatives upset that their permission was not requested before commencing or stopping treatment. I agree that it is a matter of courtesy to speak to relatives and inform them of any decisions but a doctor does not have to gain permission from a relative before acting in the patient's best interest or within the law.