Controversial ‘death pathway’ into the equivalent of euthanasia of the elderly, British doctor charges

By Dave Andrusko

Editor’s note. There is still time to register for the National Right to Life convention June 28-30 and to reserve a hotel room at the Hyatt Regency Crystal City in  Arlington, Virginia. Just go to

Professor Patrick Pullicino

In a speech to the Royal Society of Medicine in London, Professor Patrick Pullicino charged that doctors have turned the use of a controversial ‘death pathway’ into the equivalent of euthanasia of the elderly, the Daily Mail reported.  National Health Service (NHS) doctors are doing so, he said, because these elderly patients are difficult to manage or to free up beds.

About 29% (130,000) of the deaths of people each year who are in the hospital or under the care of the National Health Service are people who were on what is known as the Liverpool Care Pathway (LCP).

According to the Daily Mail’s Steve Doughty, the LCP is “a method of looking after terminally ill patients that is used in hospitals across the country” but supposedly not to come into force unless “doctors believe it is impossible for a patient to recover and death is imminent.”   But “Predicting death in a time frame of three to four days, or even at any other specific time, is not possible scientifically,” Prof. Pullicino told the Royal Society of Medicine.

The LCP can include withdrawal of treatment, “including the provision of water and nourishment by tube,” from which on average the patient dies in 33 hours.

Prof. Pullicino, a consultant neurologist for East Kent Hospitals and Professor of Clinical Neurosciences at the University of Kent, said that often clear evidence is lacking for initiating the LCP. “Professor Pullicino claimed that far too often elderly patients who could live longer are placed on the LCP and it had now become an ‘assisted death pathway rather than a care pathway’,”  Doughty reported. Prof. Pullicino cited “’pressure on beds and difficulty with nursing confused or difficult-to-manage elderly patients’ as factors.”

In the speech, Prof. Pullicino explained how the LCP determination become a self-fulfilling prophecy. The personal views of the physician as to the patient’s quality of life is central to placing the patient on the LCP in the first place.

He added, “If we accept the Liverpool Care Pathway we accept that euthanasia is part of the standard way of dying as it is now associated with 29 per cent of NHS deaths.”

Prof. Pullicino used anecdotes from his own experience to back up his assertion that it is likely that many elderly patients who could live substantially longer are being killed by the LCP.

For instance, he talked about a 71-year-old who was admitted to hospital suffering from pneumonia and epilepsy. The man was put on the LCP by a covering doctor on a weekend shift.

“Prof. Pullicino said he had returned to work after a weekend to find the patient unresponsive and his family upset because they had not agreed to place him on the LCP,” Doughty reported. “‘I removed the patient from the LCP despite significant resistance,’ Prof. Pullicino said. ‘His seizures came under control after four weeks.’”