Draft Reply Letter to the Daily Telegraph
(Disclaimer: thoughts still in progress and may not be suitably worded to get my meaning across yet!)
SIR - As a junior doctor who has worked on many wards where the Liverpool Care Pathway has been utilised to bring dignity to those in the last days of their lives, I am shocked by its misrepresentation by a fringe group of doctors in your paper (letters, July 9).
Whilst there may be no sure way of diagnosing imminent death, there are many cases where it becomes clear that medical science has no genuine life-prolonging treatment to offer. In these cases, are we to attempt futile, painful and traumatic procedures and artificial feeding knowing the chances of success are near non-exisitent? Or are we to come to the careful conclusion that rather than 'playing God', we should accept the inevitable and focus on holding our patients' hands through a key and final stage in their lives.
The aim of the carefully titrated mix of medications in the Liverpool Care Pathway is not to deprive anyone of their consciousness but to attempt to avoid pain, agitation, nausea and breathlessness which nobody should have to suffer in the last days of their lives. It is a basic humanitarian act.
Having seen many 'natural deaths' as these colleagues of mine call them, I know that to leave many of these patients suffering in their last hours of need would be a massive dereliction of duty. Their letter is offensive to anyone who has worked with immanently dying patients, to any patient who has made the informed decision to try and approach their last days of life without unbearable discomfort and to any anguished relative who has had to participate in the difficult decision-making process at the end of a life.
Dr Payam Torabi
Junior Doctor, London
