Sunday 25 October 2015

Liverpool Care Pathway - And Who Is The Victim?

Once you're the star of the show, it's hard to just step off the stage. You're in  the spotlight and the Super Troupers take charge.



She was a political activist. She was an advocate for the use of killing as a therapy and a treatment.

The solidarity of common cause reinforces resolve and commitment to the idea. She became the bandwagon advertising campaign success story which finally rolled out the California Act permitting people to be legally killed.

She is Brittany Maynard.


Compassion & Choices

The bandwagon was given its roll by Compassion & Choices.

They got the right PR people on board and made her the star of the show. There was no going back then.

The best response in any debate is the counter response which counters the argument, not with argument, but which uses that same argument to make a counter point.

They made her into a reality show with a spiritual, almost 'religious' quality about its presentation.

And pulled the rug from under the feet of the opposition.

They will take this to the very steps of the Capitol and milk it for the very last dreg of political capital they can make from it.

The man behind Compassion & Choices is ex-Brit Derek Humphrey who was a founder of The Hemlock Society.

The Hemlock Society was founded in 1980. This later became End-of-Life Choices. In 2005, it merged with Compassion in Dying to form Compassion & Choices headed up by Barbara Coombs Lee.

The Act affords the 'Right to Death'. This is, according to Barbara Coombs Lee and Compassion & Choices, a Right afforded by the US constitution.

The Constitution already affords and plainly states a Right to Life and Liberty but this ‘Right’ is a negative Right. It is the Right to not have life.

The President has already made the complaint that the Constitution is a constitution of negative liberties, stating what the State may not do...
Liverpool Care Pathway – Fur Das Wohl Des Staates
Liverpool Care Pathway - And The Right To Life
Is everything to be turned on its head such that it shall be a constitution of positive liberties and negative rights?
Declaration of Independence 

Then is America America no more.

If it is self-evident that all are born possessing certain rights, among these Life and Liberty, then these things may only be denied, not given.

Therefore, a 'right' to die is not a right at all except a right to not have life.

So, who is the Fool, the Hero and the Villain? And who is the victim? Are we all taken in?

Cultural attitudes have been chipped away, subtly but surely: unnoticed perhaps, and imperceptibly, but profoundly altered.


Compassion & Choices is a political bandwagon that has nothing to do with charity. It is still a US ‘trusted charity’, tax exempt and tax deductible.

There is need for charity reform. This is a mockery of charity, a crass caricature.

The video is a family celebration. It is joyous but we are applauding death.

There is an unsettling 'normality' about it all but we are watching the suicide on the ledge and tipping them over with our applause and approval.

When death stalks you and stares you in the face, do you capitulate and surrender, assist death in its work?


A ‘prognosis’: what is that? And if we say, "Six weeks, six months, what's the difference; she is going to die anyway," then what is nine months, a year, two?

is life so insignificant? Is it the highest common factor or the lowest common denominator?

Every day is a bonus; life is precious and living matters.

Should we determine when we die like Beverley Broadbent, live a ‘complete life’ of our own defining, end it at a high spot and go out with a bang?

They say:
“no one should have to uproot their life in the middle of a grave illness”
 Compassion & Choices
In the middle of a grave illness (Good choice of word there!) your life is already uprooted.

It is death which 'uproots' life. It is the Terminator, the final finality in life.

It takes our loved ones from us and removes us from our loved ones.


California has stepped through the Looking Glass.

The fire is in the grate, yes, but this is a different reality.The world may not appear at all different; what changes there are are almost imperceptible but will only become plain when we peer back through that glass darkly.
If all what is is what it isn’t
Would we know; could we tell?
And all that isn’t isn’t? Well...
I’m not so sure that you could tell
What is what and who is who
If I am I and you are you.
Killing is now both treatment and therapy.

Incidental reading...
Liverpool Care Pathway - So Readily Do Perceptions Change...
Death does ‘uproot’ life.

Euthanasia/Assisted Suicide is killing. Can killing become a cost-cutting exercise? It may be the cheaper option to put you down than keep you going.

The State is always in denial of its crimes. It may try to reach an accommodation but b
ecause the State says it is so, that does not make it so.

This world is more Orwellian than even Orwell could ever have imagined in any nightmarish vision of future past.

According to the LGA (Local Government Association) -
The failure to properly fund services for elderly and disabled people is already leaving councils having to severely strip back or axe other key services. It also means there is less money to properly recruit, train and keep the best staff and risks essential residential and home care providers going out of business if councils can't afford to pay the cost of the care being provided.
The current combined pressures of insufficient funding, growing demand and extra costs mean that adult social care is facing a funding gap that is growing by at least £700 million a year, estimated to reach £2.9 billion by the end of the decade, even before the cost of the National Living Wage is taken into account in full.
The LGC (Local Government Chronicle) says -


Care minister Alistair Burt has indicated social care will benefit from the additional £8bn funding promised to the NHS, despite NHS England arguing all the money is needed for the health service.

Mr Burt’s comments came during his speech to the National Children’s and Adults Services Conference on Friday, in which he said he wanted social care to be afforded greater status by the NHS.

He said: “I am very keen to see social care have the same priority in [the] NHS as is given to hospitals and GPs and other things.”

The Health and Social Care Economy has arrived. Health is taking over social care, seamlessly, in a joint funding operation.

Background reading -
Liverpool Care Pathway - Transformation

Liverpool Care Pathway - When Justice Must Be Bought And Those Who Seek It Punished

Liverpool Care Pathway - Reports And Reports Of Reports
Care options and expectations have been downsized. They are hiring EoLC Facilitators at a Town Hall near you...
Liverpool Care Pathway - When The Funding Had To Stop
This is Halton Borough Council –
The Gold Standard Framework (GSF) is a system designed to support this process supported by GSF Prognostic Indicator Guidance. This guidance is to assist GP’s in identifying symptoms that would indicate a patient is approaching the last 12 months of life. Once this identification has been made they should then be added to an End of Life register within their GP Practice. By adding a patient to an End of Life register, this will allow regular multi-disciplinary discussions to take place to discuss that patients care. These discussions will ensure clarification of patient needs, the ability to provide pro-active support and act as a mechanism to prompt advanced care planning discussions.

The aim in Halton is for all GP’s to adopt GSF principles in order to provide seamless care at end of life.
Evidence suggests that most people, if given the choice would prefer to die at home. If a patient has been identified as approaching the end of life it is necessary for the team caring for the patient to initiate discussions to establish what the patient wishes are in relation to their care.

In order for this to happen, we need to ensure that staff and healthcare professionals feel comfortable in initiating these conversations with patients and families and feel confident in explaining the decisions that can be put in place to ensure patient wishes are adhered to.

To facilitate this, an Advanced Care Planning Team has been established within Halton, which includes an End of Life Care Facilitator and a Project Support Officer who are supported by the wider Palliative care network. The role of the Advanced Care Planning team is to provide staff within both health and social care settings with the skills and training to be able to initiate discussions and effectively communicate with patients and families.

To date, a number of initiatives have taken place to improve end of life skills across health and social care including;
• Bespoke training with GP Practices including all staff.
• Half day training events on end of life tools
• Commencement of the Six Steps training programme in 11 Care Homes
The Six Steps to Success is the North West End-of-life Care Model.

The GSF Prognostic Guidance includes the Barton Method to identify likely recruits for the Death Lists.

And we’re all looking back through the Looking Glass.
Beware the Jabberwock he says:
He’ll eye you up and down besides.
Watch out his Barton Method gaze,
the driver’s maw as in it slides!

The Jabberwock will size you up,
his eyes all sneaky beams.
And everything is what it isn't
For nothing's what it seems.

Once something is accepted in principle, that principle will creep with a certitude and inevitability.

Here, Jukka Varelius, writes in Bioethics -

Killing is being considered not because that has been sought nor because permission has been given but precisely because it hasn't.



Killing becomes an entirely physician determined decision.

Thus is the circle complete?

Of positive liberties, negative rights and negated decisions... thus through the Looking Glass do we tumble?

Further reading -
Liverpool Care Pathway - And "Rational" Suicide

Liverpool Care Pathway - A Perverse Symmetry


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