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Ethics and end of life care: the Liverpool Care Pathway and the Neuberger Review

Wrigley

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Abstract

The Liverpool Care Pathway for the Dying has recently been the topic of substantial media interest and also been subject to the independent Neuberger Review. This review has identified clear failings in some areas of care and recommended the Liverpool Care Pathway be phased out. I argue that while the evidence gathered of poor incidences of practice by the Review is of genuine concern for end of life care, the inferences drawn from this evidence are inconsistent with the causes for the concern. Seeking to end an approach that is widely seen as best practice and which can genuinely deliver high quality care because of negative impressions that have been formed from failing to implement it properly is not a good basis for radically overhauling our approach to end of life care. I conclude that improvements in training, communication and ethical decision-making, without the added demand to end the Liverpool Care Pathway, would have resulted in a genuine advance in end of life care.

Acceptance Date Mar 26, 2014
Publication Date May 21, 2014
Journal Journal of Medical Ethics
Print ISSN 0306-6800
Publisher BMJ Publishing Group
Pages 639-643
DOI https://doi.org/10.1136/medethics-2013-101780
Keywords Liverpool Care Pathway, Neuberger Review, end of life care
Publisher URL https://doi.org/10.1136/medethics-2013-101780

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