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The Liverpool Care Pathway for the Dying Patient (LCP) is a UK care pathway (excluding Wales) covering palliative care options for patients in the final days or hours of life. It was developed to help doctors and nurses provide quality end-of-life care. The Liverpool Care Pathway was developed by Royal Liverpool University Hospital and Liverpool's Marie Curie Hospice in the late 1990s for the care of terminally ill cancer patients. Since then the scope of the LCP has been extended to include all patients deemed dying. While initial reception was positive, it was heavily criticised in the media in 2009 and 2012. In July 2013, the Department of Health released a statement which stated the use of the LCP should be "phased out over the next 6-12 months and replaced with an individual approach to end of life care for each patient".〔(Press release Overhaul of End of Life Care system ) - Department of Health, 15 July 2013.〕 However, The Telegraph reported that the program was just rebranded and that its supposed replacement would "perpetuate many of its worst practices, allowing patients to suffer days of dehyration, or to be sedated, leaving them unable to even ask for food or drink."〔() - The Telegraph; Liverpool Care Pathway being 'rebranded' not axed, 1 December 2014〕 ==Aims== The pathway was developed to aid members of a multi-disciplinary team in matters relating to continuing medical treatment, discontinuation of treatment and comfort measures during the last days and hours of a patient's life. The Liverpool Care Pathway is organized into sections ensuring that evaluation and care is continuous and consistent. It was not intended to replace the skill and expertise of health professionals. In the first stage of the pathway a multi-professional team caring for the patient is supposed to agree that all reversible causes for the patient's conditions have been considered and that the patient is in fact "dying". The assessment then makes suggestions for what palliative care options to consider and whether non-essential treatments and medications should be discontinued.〔 In practice, the implementation of this guideline was found to be lacking. Many decisions are taken in ward settings without the oversight of an experienced doctor of medicine. In almost half of the cases neither patients nor family were informed or consulted that it was decided to place the patient on the LCP. The programme suggests the provision of treatments to manage pain, agitation, respiratory tract secretions, nausea and vomiting, or shortness of breath (dyspnoea) that the patient may experience.〔(Care for the dying patient ) ''Marie Curie Palliative Care Institute'', Liverpool Care Pathway for the Dying Patient (LCP).〕 The care was not designed to be a one-way street to death. However in 2012 controversy arose indicating that in most cases it was, and even patients that might have survived longer otherwise died because of the LCP.〔 In a response to negative media reports, Clare Henry and Professor Mike Richards issued a statement on behalf of the NHS End of Life Care Team, claiming that the pathway was reversible, and stating that "approximately 3% of patients initially put on the pathway are removed from the pathway when reassessed" - although no source was cited for this figure.〔("Liverpool Care Pathway: response to media reporting" ), NHS National End-of-life care programme, 15 October 2009.〕 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Liverpool Care Pathway for the Dying Patient」の詳細全文を読む スポンサード リンク
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