NHS: Disclosing "Death Pathway" Use

The NHS's "Liverpool Care Pathway"--known to some in the press as the "death pathway"--is a palliative care pathway designed to reduce burdensome end-of-life medical interventions including, controversially, artificial nutrition and hydration. Tens of thousands of patients annually are put onto the pathway in the last days of their lives. But a new report claims that in a quarter of hospital trusts, one in three families are never informed that their loved one has been placed on the Liverpool Care Pathway. In one trust, fully half of families weren't informed. The good news is that doctors do discuss the issue with families in 94% of cases overall--a sharp improvement over the 2008-09 audit figure of 75%, even though twice as many patients are put on the protocol now than then.

Argentina: Toward "Dignified Death"?

Argentina's Lower House has passed, by a wide margin, a "dignified death" bill. The bill, which is still to be debated in the Senate, would permit patients with irreversible conditions or terminal illness to make informed refusal of lifesaving or life-sustaining medical interventions, including nutrition and hydration. Incompetent patients' wishes could be expressed by a defined set of eligible proxy decision makers (family members and partners). The bill would also relieve medical professionals of liability for following patients' wishes.