In response to my article on the Liverpool Care Pathway published in The Guardian on Tuesday, I received the following message on Twitter:
Your article on the LCP was wonderful. Needed that, have been called a murderer, angel of death, Beverley Allitt today
The message was from a Staff Nurse who works on a cancer ward. Within those deeply upsetting 140 characters is the reason I felt such a stong need to write the article, and why I am so grateful to The Guardian for publishing it. Her words are shocking enough, but what would make them truly tragic is if she, and hundreds of nurses like her on receiving such abuse, look at their slim pay packets at the end of the month and start to wonder if it’s all worth it.
I have never known such anger among health professionals as has been created by the aggressive media attack on end-of-life care. At last doctors have started to find their voice in the last week, and started fighting back. On Sunday, Max Pemberton – resident medical columnist at The Telegraph – painted a picture of the future where doctors and nurses will be frightened to take an active part in a person’s death, and of the increase in suffering that would be the inevitable consequence:
I know what the repercussions of the recent media frenzy will be and, frankly, I dread them.
The wonderful Kate Granger, who as a terminally ill cancer patient and doctor who has cared for many patients as they are dying must surely have more right to have her voice heard than most, wrote a moving blog on the subject the same day. Kate knows that she is on her GP’s ‘End of Life Care Register’, and is glad of it. She is clear about what she wants for her future:
When my time comes I really hope my care will follow the standardised LCP approach. I fully believe it improves care at the very end of life and results in more ‘good deaths’ with comfortable patients not undergoing futile painful interventions and well-informed, emotionally supported relatives, making the grieving process that little bit easier.
And on Tuesday, Dr Bee Wee, President for the Association of Palliative Medicine of Great Britain and Ireland, published a very measured analysis of the situation in The Spectator:
This is a good opportunity to step back and look at the care we provide for dying patients, without necessarily defending or attacking the LCP, which is only part of the bigger picture of end of life care.
She is right, of course. The medical profession does need to learn from where the LCP has not been properly implemented, and poor communication with patients and relatives should not be allowed to continue. I am not starry-eyed about my profession – I know that there are doctors who communicate poorly, and others who seem not to care. I also know that the time pressures that come from being over-stretched on hospital wards can put even the most caring doctors and nurses to the test, and that ‘compassion fatigue’ is something encountered with sufficient frequency to be a familiar foe. However, I will not concede that doctors are out to murder their patients, or that young men and women go into a career in nursing in order to cause harm.
The stakes are high in this debate. The attack on doctors and nurses has been directed at both the good and the bad, and the collateral damage will have a profound effect on morale. Trust between doctors and their patients is being seriously undermined, and there is a very great danger that we will throw away many of the great strides forward that have been made in palliative care in this country, to the detriment of the patients of the future. If the tide has turned in the last week towards a more balanced debate in the press this is greatly to be welcomed. We can only hope that it is not too late, and that the politicians and policy-makers are still listening.