The highly controversial Liverpool Care Pathway has been slammed in the British Medical Journal. In a scathing letter, psychiatrist Eugene Breen has criticised the protocol as vague and easily abused.

The highly controversial Liverpool Care Pathway has been slammed in the British Medical Journal. In a scathing letter, psychiatrist Eugene Breen has criticised the protocol as vague and easily abused. “There is no quality control or accountability and there are no penalties,” he wrote. He concluded that “It is impossible to control such a programme with any respectable level of professionalism or care for the person involved”. 

The letter comes in the wake of three years of intense media scrutiny and public debate. The LCP – a palliative care protocol for dying patients in British hospitals – has been variously labelled ‘compassionate’, ‘poorly implemented’, ‘agenda driven’ and ‘euthanasia-lite’. The protocol has been adopted by over 85% of National Health Service Trusts in England.

Dr Breen’s letter was written in response to a BMJ study on the attitudes of specialists towards the LCP. Out of the 563 respondents, 98% did not think that pressure on beds or other resources had influenced decisions to use the pathway for end of life care. But 57% of respondents thought that negative media coverage had led to a decline in the use of the LCP. 

Xavier Symons
Creative commons
end-of-life care
Liverpool Care Pathway