 |
| - The Independent |
The Independent reports that the government is to "test 'end-of-life' protocols for the terminally ill after
complaints from relatives".
The Independent article discloses for public scrutiny what we already know to be the case.
- The Liverpool Care Pathway (LCP) has never been properly tested.
- The LCP has never been subjected to a proper randomised clinical trial.
- Despite verified and verifiable and valid complaints that the LCP is a death machine - including that of a sitting member of the current 'review' - the LCP has continued in use across the UK instead of being suspended - grounded - to await outcome of the 'review'.
- The LCP has been widely adopted throughout the world in various forms (including a 'tweaked' version in Gibraltar).
The Independent doesn't mention that the New Zealand LCP office recently closed down in preparation for rebranding.
The Independent doesn't mention that a recent pilot study in Italy found that there is poor effect for symptom control.
The propaganda machine that is the vast web of entities and
organisations under the self-styled 'umbrella' of the National Council for
Palliative Care (NCPC) and its self-styled 'sister' organisation, the Scottish
Partnership for Palliative Care (SPPC), has been promoting the LCP for years.
The EoLC Strategy for England
The Independent reports -
The Belgian study is recruiting 600 dying patients, half of whom will get usual palliative care, while the others will be cared for using the LCP.
"Although the LCP has been adopted in 21 countries outside the UK and has been recognised to be the gold standard for practice, the evidence supporting such practice is insufficient," say the researchers leading the new trial. "Due to the scarcity of available evidence, recommendations for the use of end-of-life pathways in caring for the dying cannot be made at the present time. Randomised clinical trials or other well designed studies are needed to obtain additional evidence about [its] effectiveness."
Every year, around half a million people die in the UK, and more than half do so in hospitals. Many are elderly people whose deaths come after a period of long-term illness such as heart disease, cancer or dementia.
The LCP, developed by the Royal Liverpool and Broadgreen University Hospitals NHS Trust and the Marie Curie Palliative Care Institute, is designed to help medical professionals focus on care when a death is expected. It is tailored to the individual and includes consideration of their physical, social, spiritual and psychological needs.
The Royal College of Nursing and the National End of Life Care Programme are among 22 organisations who support the treatment, despite widespread criticism.
The new trial into the LCP is being carried out at nine hospitals in Belgium and led by the End-of-Life Research Group.
The Independent repeats the mantra of
propaganda word for word in its article. The point of significance which The
Independent doesn't mention is that a protocol, not properly tried and tested,
has been rolled out across the UK
The British Government have done the medical equivalent of a Microsoft Corp.
When Microsoft rolls out each new, not properly tried and tested platform it relies on the punter's feedback to iron out the problems.
When the British Government have rolled out each new, not properly tried and tested version of the LCP it has relied on an unsuspecting, trusting, vulnerable public. That's why they are now on version 12.
The Independent says that research information will be collected and analysed.
How and in what manner will that data be collected and analysed...?
This BMJ submission concludes -
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| - BMJ |
Conclusion Only 51% of patients received medication to alleviate agitation and restlessness in the last 24 h of life. Median doses were low in comparison to doses recommended for continuous deep sedation, suggesting that there is no ‘blanket’ policy for continuous deep sedation at the end of life for patients whose care is supported by the LCP
The study used datasets from the
National Care Audits of the Dying using LCP version 11. Hospitals were
permitted to submit selected data from 'up to 30' adult patients, the dose
received in the last 24 hours of life and the last dose received for agitation
and restlessness.
- No data is given on
drugs supplied alongside that prescribed for the symptoms mentioned. Has
morphine already started; does it continue?
- Was the patient
already unconscious...?
- This is selected data
from 0.04% of the total number of patients on LCP.
- This is a study based
on biased data.
- Messrs. Ellershaw et
al are allocated funding for this feeble research and actually get away
with it.
- 'Evidence' such as
this has been submitted to the 'review'.
This does not bode well.
What else does The Independent not mention?
The Independent doesn't mention that the Study has been posted to the Clinical Trials.gov website. This is a service of the
This is the aforementioned 'inquiry' into the "Effectiveness
of the Liverpool Care Pathway (LCP)" -
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| - Clinical Trials.gov |
End-of-Life Research Group
Collaborator:
Agentschap voor Innovatie door Wetenschap en Technologie
The aim of this cluster RCT is to evaluate the effectiveness of the Flemish LCP in improving the quality of care and quality of life during the last 48 hours of life of patients dying in acute geriatric hospital wards in Flanders as compared to usual care.
| Official Title: | Improving End-of-life Care in Acute Geriatric Hospital Wards: a Cluster Randomized Trial of the Liverpool Care Pathway |
MedlinePlus related topics: Hospice Care
U.S. FDA Resources
Further study details as provided by End-of-Life Research Group:
Primary Outcome Measures:
- The quality of life and quality of care during the last 48 hours of life of patients dying in acute geriatric hospital wards by using the LCP [ Time Frame: 30 months ] [ Designated as safety issue: No ]From each deceased geriatric patient - who has given informed consent to the nurse - a questionnaire will be filled in by a nurse, a physician and a family caregiver. Those three proxy measurements incorporate information about the quality of life and care during the last 48 hours of life of the geriatric patient.
- Symptom prevalence and symptom burden during the last 48 hours of life of patients dying in acute geriatric hospital wards by using the LCP [ Time Frame: 30 months ] [ Designated as safety issue: No ]This will be measured by a nurse and family caregiver through two different questionnaires.
- Medications prescribed and administered during the last 48 hours of life of patients dying in acute geriatric hospital wards by using the LCP [ Time Frame: 30 months ] [ Designated as safety issue: No ]This will be measured by a physician through a questionnaire.
- Medical and nursing interventions during the last 48 hours of life of patients dying in acute geriatric hospital wards by using the LCP [ Time Frame: 30 months ] [ Designated as safety issue: No ]This will be measured by a nurse and physician through two different questionnaires.
- Communication among clinical staff and between clinical staff and patients/relatives during the last 48 hours of life of patients dying in acute geriatric hospital wards by using the LCP [ Time Frame: 30 months ] [ Designated as safety issue: No ]
- The level of satisfaction of the relatives with the delivered end-of-life care during the last 48 hours of life of patients dying in acute geriatric hospital wards by using the LCP [ Time Frame: 30 months ] [ Designated as safety issue: No ]This will be measured by a family caregiver a questionnaire.
- Level of bereavement of the relatives of patients who died in acute geriatric hospital wards by using the LCP [ Time Frame: 30 months ] [ Designated as safety issue: No ]This will be measured by a family caregiver through a questionnaire.
Estimated Enrollment: 600
Study Start Date: September 2012
Estimated Primary Completion Date: March 2015 (Final data collection date for primary outcome measure)
| Ages Eligible for Study: | 60 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
Criteria
Inclusion Criteria:
- patient is admitted to an acute geriatric hospital ward
- patient is hospitalized for more than 48 hours
- patient has given informed consent
Contacts
Contact: Rebecca Verhofstede, Junior Researcher 09 332 11 83 rebecca.verhofstede@vub.ac.be
Locations
| Belgium | |
| St Lucas Brugge | Recruiting |
| Brugge, Belgium | |
| Contact: Rebecca Verhofstede | |
| St Jan Brugge | Recruiting |
| Brugge, Belgium | |
| Contact: Rebecca Verhofstede | |
| AZ Sint Blasius | Recruiting |
| Dendermonde, Belgium | |
| Contact: Rebecca Verhofstede | |
| Jessa Ziekenhuis Hasselt | Recruiting |
| Hasselt, Belgium | |
| Contact: Rebecca Verhofstede | |
| Sint Jozefskliniek Izegem | Recruiting |
| Izegem, Belgium | |
| Contact: Rebecca Verhofstede | |
| AZ Lokeren | Recruiting |
| Lokeren, Belgium | |
| Contact: Rebecca Verhofstede | |
| H. Hartziekenhuis Menen | Recruiting |
| Menen, Belgium | |
| Contact: Rebecca Verhofstede | |
| Sin Rembertziekenhuis Torhout | Recruiting |
| Torhout, Belgium | |
| Contact: Rebecca Verhofstede | |
| Sint Augustinuskliniek Veurne | Recruiting |
| Veurne, Belgium | |
| Contact: Rebecca Verhofstede | |
The Independent said:
The Belgian study is recruiting 600 dying patients, half of whom will get usual palliative care, while the others will be cared for using the LCP.The Study document said:
The aim of this cluster RCT is to evaluate the effectiveness of the Flemish LCP in improving the quality of care and quality of life during the last 48 hours of life of patients dying in acute geriatric hospital wards in Flanders as compared to usual care.Really...?
It is a century has passed, in the blink of an eye, and the dead
in Flanders fields raise up their shout. Once
more, Flanders fields are killing fields.
'Life-ending acts' without explicit request are proceeding in Flanders, but performed more often in hospital and by clinical specialists. [CMAJ]
In cases where the decision had not been discussed with the patient, the physician specified as reason(s) that the patient was comatose (70.1% of cases) or had dementia (21.1%); in 40.4% of cases, the physician indicated that the patient had previously expressed a wish for ending life (not equivalent to an explicit request for euthanasia). Physicians specified that the decision had not been discussed with the patient because the decision was in the patient’s best interest (17.0%) or because discussion would have been harmful (8.2%).Compared with drugs used in euthanasia and assisted suicide, opioids are used far more often in the ending of life without an explicit patient request, especially when used as the sole drug. In these cases, the dosage is strongly increased in the last 24 hours in 45.8%, and the physician indicated it to be higher than needed to alleviate the patient’s symptoms in 46.8%. Nurses were more often involved in the administration of the drugs when there was no explicit request from the patient than in cases of euthanasia or assisted suicide.
Are these poor souls the ones to be
'recruited'?
InFlanders ' killing wards is this 'inquiry'
to take place?
The "usual palliative care" inFlanders'
wards...
This is a test of two killing machines, the blatant and the subtle. It's plain which one they'll choose.
If you're 60 or over, healthy or not, you can volunteer for this one way ticket to the next world...
In
The "usual palliative care" in
This is a test of two killing machines, the blatant and the subtle. It's plain which one they'll choose.
If you're 60 or over, healthy or not, you can volunteer for this one way ticket to the next world...
Between the crosses, row on row,
That mark our place; and in the sky
The larks, still bravely singing, fly
Scarce heard amid the guns below.
We are the Dead. Short days ago
We lived, felt dawn, saw sunset glow,
Loved and were loved, and now we lie
In Flanders fields.
Take up our quarrel with the foe:
To you from failing hands we throw
The torch; be yours to hold it high.
If ye break faith with us who die
We shall not sleep, though poppies grow
In Flanders fields.
- Lieutenant Colonel John Alexander McCrae, MD
Further reading -
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