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People Who Have Died on the Liverpool Care Pathway

Updated on October 23, 2012

The Liverpool Care Pathway is a hospital management guide to death and dying for the elderly.

It is a written care plan for the dying that has been drawn up by professionals and has to be followed to the letter.

Unfortunately, it does not target only dying people, but it does ensure death is the end result.

This has meant the swift deaths of thousands of elderly people in the UK since its introduction in 1996.

People who just happened to have taken a turn for the worse, and who ended up in an NHS hospital from their home or residential care home.

People who may have had a few more precious months or even years to live, until their untimely end.

While it almost certain that the majority of those deaths would have happened anyway, some old people do seem to have been euthanized, and it is these cases we will look at here.

Jean Tulloch with her son (inset)
Jean Tulloch with her son (inset) | Source

Jean Tulloch, 83

Jean Tulloch, aged 83, was admitted to the Western General Hospital in Edinburgh, Scotland, from her care home in the city, suffering from a kidney and urinary tract infection.

Within a week, the infections were cleared up, but the hospital contacted her son, Peter, who lived 400 miles away in London, to inform him that she was dying.

He immediately travelled up to Edinburgh to visit his mother, only to find far from death, being awake, conscious, smiling and trying to talk but with difficulty because she had sores in her mouth. She did, however, make hand gestures to communicate.

The doctors advised Mr Tulloch to go home and that he would be called if his mother deteriorated.

He decided to stay nearby, and paid a surprise visit the next day, only to find that his mother's IV drip of life sustaining fluids had been removed and that her mouth was dry as well as painful.

She was distressed, having been put in a side ward on her own, and had no means of sustenance. She had not been sedated and so was hungry and thirsty.

Medical notes revealed that Mrs Tulloch had been placed on the Liverpool Care Pathway (LCP) the day before, without the knowledge or consent of her son.

He strongly believes the hospital tried to kill his mother, safe in the knowledge that he had returned to England and so would not have known about it.

Fluids were re-instated to Mrs Tulloch, but she died 3 weeks later in the same hospital, a death which her son feels the hospital were partly responsible for, having deprived her of fluids for 24 hours.

Olive Goom
Olive Goom | Source

Olive Goom, 85

Olive Goom, aged 85, died alone with no-one at her bedside at the Chelsea and Westminster Hospital in London.

Her family were never informed that she had been put on the LCP.

Her niece had phoned the hospital to enquire how she was, and had been advised that her aunt was comfortable and that there was no need to visit.

This is despite the fact that she had already been put on the plan at this point, and death is usually expected with 33 hours, mainly due to the lack of sustenance.

Her niece, Marion Hebbourne, 68, made several visits entailing a 70 mile round trip from her home in High Wycombe to see her aunt, who had been admitted after falling and breaking her arm, and later developing a urinary tract infection.

Her final visit was to the mortuary, not even having been informed of Miss Goom's death until she arrived for a normal visit.

Mary Cooper
Mary Cooper | Source

Mary Cooper, 79

Diabetic Mary Cooper, aged 79, was admitted to the Queen Elizabeth Hospital in King's Lynn, Norfolk.

She had suffered from appetite loss caused by antibiotics she was prescribed for a foot infection.

This in turn had meant she was not eating properly, which caused her blood sugar to drop bringing about a hypoglycaemic attack.

Her condition was stabilized in hospital over a five week period, after which time her health declined.

One of her daughters maintained a bedside vigil throughout this period, so sick was her mother.

Doctors did discuss the possibility of putting her onto the Liverpool Care Pathway, but the process was never fully explained to them.

Her husband says the process was never explained to him, and that he would not have agreed had he known.

On being told that Mrs Cooper was dying (after the LCP had been started), her husband offered to take her home, to die in her own home surrounded by family, and was told he couldn't.

When the reason why he couldn't do that was further explained, that his wife was on the LCP, he asked for it to be stopped and this request was refused.

Mary Cooper died hours later in hospital surrounded by her family.

Carole Jones and her mother Maureen Rodd
Carole Jones and her mother Maureen Rodd

Maureen Rodd, 85

Maureen Rodd, aged 85, was admitted to Addenbrooke’s Hospital in Cambridge from her care home, after suffering a massive right-sided stroke.

According to her daughter, 64 year old nurse Carole Jones, Mrs Rodd had been in relatively good health previously, but with signs of early dementia. Her mobility had also been deteriorating in the previous few months.

This, and the fact that she had now suffered a stroke, seemed to be enough for the senior registrar to decide that her quality of life would not be good, and all treatment was withdrawn after just 2 days.

Carole was only told of this the day after. Even as a nurse, she had not heard of the Liverpool Care Pathway.

A doctor explained to her that her mother would probably die in 3-4 days after the withdrawal of fluids.

The LCP was started on the Wednesday, but it was 5 days later, on the following Monday evening before a diamorphine pump was started.

Maureen, meanwhile, was conscious part of the time, even to the extent of telling the ward sister on the Monday not to wash her hair, as her normal hair-washing day was Wednesday (it was).

I can only assume her daughter was in shock when she apparently meekly accepted what was happening. She was even told by the ward nurses not to put a damp cloth to her mother's mouth in case she sucked some moisture off it, as this would prolong her life.

Maureen took 12 days to die.

This case is the most shocking of all so far, as she was obviously nowhere near death when the LCP was started.

A stroke is not the end for many people, and given time she may have recovered enough to have some sort of life.

Doctors are not God and shouldn't play with the lives of others, even if they did need the bed.

Professor Patrick Pullicino
Professor Patrick Pullicino | Source

Patients on the Liverpool Care Pathway are supposed to be 2 to 3 days away from a natural death before this plan is commenced.

They should display two of the following:

  1. Being bedbound
  2. Semi-comatose
  3. Only able to take sips of fluids
  4. No longer able to take tablets

This effectively means that someone who cannot take tablets orally but is able to sip fluids, but is otherwise alert and can get up (mobile) can be put on the plan.

The wording of the care plan makes it clear that fluids by tube, either naso-gastric or venous, should be stopped. There is no mention of stopping oral fluids, which should be offered if the patient is awake.

Some hospitals actively discourage sips of water by mouth, and this is wrong, and unnecessarily cruel.

Care TEAMS are supposed to decide who gets put on the LCP, not individual doctors.

It would seem that some doctors are taking it upon themselves, and nurses are saying nothing about it.

Families are supposed to be part of the decision-making process, but are frequently the last to know.

Top doctor speaks out against the Liverpool Care Pathway

In a speech given at the Royal Society of Medicine in London, Professor Patrick Pullicino said that the Liverpool Care Pathway had become the Liverpool Death Pathway.

The Professor, a consultant neurologist for East Kent Hospitals and Professor of Clinical Neurosciences at the University of Kent, said that too often doctors are using the pathway to kill off elderly patients for either economic factors, or because they are 'difficult to manage'.

A massive 29% of all NHS deaths in the UK per annum are of people on the LCP. This translates to 130,000 people.

Professor Pullicino states that it is impossible to say if someone is 2 or 3 days away from death, but once put on the LCP, they are!

He says it takes an average of 33 hours for someone on the Pathway to die.

He cited a case in his own hospital where he returned from a weekend off to find that a junior relief doctor had put one of his elderly patients on the Pathway.

The patient was a 71 year old man who he had been treating for pneumonia and epilepsy.

He immediately ordered the morphine syringe be removed, and normal care re-started.

The man recovered, went home and lived for a further 18 months, only dying when admitted to another hospital where the LCP was commenced a second time, this time killing him within 4 hours.

The Professor is not alone in voicing his reservations.

Three years ago Peter Millard, emeritus professor of geriatrics at the University of London, and Dr Peter Hargreaves, palliative care consultant at St Luke’s cancer centre in Guildford, Surrey, warned of the possibility of ‘backdoor euthanasia’ being practised to detriment of vulnerable patients.

Meanwhile, other health professionals are full of praise for the Liverpool Care Pathway, which was developed in the Liverpool area of England in the late 1990s and recommended to hospitals in 2004 by a body called the National Institute for Health and Clinical Excellence (NICE).

When used correctly, it ensures dying patients a smooth passage from this world to the next.

Sometimes patients even recover while on it, and they are then supposed to be taken off it and normal treatment resumed.

This didn't happen to poor Maureen Rodd, who died hungry and thirsty, if not alone. Nor to Olive Goom, Jean Tulloch or Mary Cooper and goodness knows who else.


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    • IzzyM profile imageAUTHOR


      5 years ago from UK

      As if they are ever going to let us know the death rates! The best we can all do is make people aware what is going on. I wonder how many people have died and their families have been unaware they were put to sleep? You can print yourself out a card (or one for your parents) saying you do NOT want to be 'treated' with the Liverpool Care Pathway. These pen-pushers will respect anything put in writing like that.

    • CASE1WORKER profile image


      5 years ago from UNITED KINGDOM

      Speechless- what on earth are we doing? where are the people sayingt "no" to this. My mum was in Eastbourne General last year and they were superb, but after reading this I realise we cant rely on hospitals- It would be interesting to see death rates from hospitals that operate this and those that dont

    • IzzyM profile imageAUTHOR


      5 years ago from UK

      I have linked all the sources for these news stories, 2uesday, and they were covered by other mainstream news outlets too. They are accurate as far as I can see.

      Yes stroke victims can be completely helpless for a few days before their sensibilities return. Some aren't getting that chance. This is horrendous. We need to know what is going on.

    • 2uesday profile image


      5 years ago

      I will return to read this again Izzy, you will no doubt guess that it makes me feel concerned. Good for you for drawing attention to the subject.

      I am aware that people who will recover/survive a stroke may have difficulty in swallowing tablets or sipping fluids in the first few days.

    • IzzyM profile imageAUTHOR


      5 years ago from UK

      Absolutely John! I never imagined a day would come when our NHS would treat people like this. It can be stopped by raising public awareness, that I am sure of. It's not just the UK, I think I read somewhere that New Zealand were starting to follow it. Need to research further to see who else. It could end up affecting all of us the world over if not stopped now.

    • aguasilver profile image

      John Harper 

      5 years ago from Malaga, Spain

      Disgraceful, and a shocking reflection on what should be a caring service.

      Both my parents are dead, but I would never allow this to happen if they were still alive.

      My father died from asbestosis, and I remember the trouble I had getting him sent home for the last ten days of his life.

      Thanks for writing this, I've FB'd and voted up and all that, this needs to be known by anyone thinking of dying naturally.

      How can the nurses and doctors do this and sleep?

      Well of course they are so hard pushed I guess they collapse and sleep whenever they can, but this is obviously a deliberate kill policy to save cash and beds.

      Shame on the Health Service Managers for allowing this euthanasia to happen.


    • IzzyM profile imageAUTHOR


      5 years ago from UK

      Totally agree with you Cynthia! I think the members of the public who agree with this are also not aware of what is happening, and still live in some cloud cuckoo land where the LCP is applied (as it was intended) to the dying only. I'm sure it is being used correctly in many hospitals or hospices but not all, obviously. It is frightening to think we have DOCTORS willingly taking someone's life. Why were their psychotic tendencies not weeded out during their training? Same goes for nurses who are complicit in this too.

      You are right. One day they too will be old and I bet they don't want to die in such a way. I am working on another hub on how to opt out of such a scheme.

    • CMHypno profile image


      5 years ago from Other Side of the Sun

      Unfortunately Izzy this is all part of a trend in our country to downgrade the value of the lives of the elderly. The elderly are now viewed by many as just so much dead weight that takes resources away from more 'deserving' and 'valuable' younger people. There is no sense of gratitude to older people for having worked hard to bring up the younger generation and no awareness that the elderly have a lot to give in terms of wisdom and experience.

      The trouble is that all of the doctors and health care workers who are complicit in these little schemes and members of the public who agree with it, will one day be old themselves. Do they really want to face a future where they will be starved and dehydrated to death in a dingy side ward somewhere? We all deserve to die in comfort and dignity, and not be helped along the way because someone somewhere regards us a 'nuisance' and an unecessary burden,

    • IzzyM profile imageAUTHOR


      5 years ago from UK

      Thanks for the votes :)

      It is obvious that the guidelines are not been adhered to, and it is fast becoming a form of legal murder, at least in some parts of the country. At the moment this is a UK problem, but soon it will be worldwide if we don't do something to stop it now. I am ashamed to be British at this point.

    • writer20 profile image

      Joyce Haragsim 

      5 years ago from Southern Nevada

      Izzy, I am so sorry to hear about this poor people dying with permission from the families, it's discussing. I hope something will be done about this.

      Voted your great Hub Awesome and up.

    • lindalou1963 profile image


      5 years ago from Texas

      Best of luck!!

    • IzzyM profile imageAUTHOR


      5 years ago from UK

      Thanks :)

      We'll be fine, because I am terrier when I get my teeth into something LOL, but something needs to be done about all those other old folk whose lives are being lost needlessly. I hope by writing about it, I can help raise awareness. That's a just a start of course...

    • lindalou1963 profile image


      5 years ago from Texas

      I just listened to that... I had no idea!! And I wish you the best of luck with your parents. I'll keep you all in my prayers.

    • IzzyM profile imageAUTHOR


      5 years ago from UK

      I am. My Dad is 84 and my mum is 80. Neither is in good health, but no way would I allow them out of my sight after learning about this. Old folk deserve to die with dignity when their time has come, and not before it. Have these so-called health professionals not got parents they can compare their patients to, and treat accordingly? BTW, I am hearing rumours that the US is going to bring in something similar -

    • lindalou1963 profile image


      5 years ago from Texas

      I don't blame you one bit. Are you in the UK?

    • IzzyM profile imageAUTHOR


      5 years ago from UK

      I totally agree with you Linda. I only learned about this in the past few days and I am fuming! As an ex-healthcare professional, this is disgusting and from all accounts, the LCP is being sorely misused in some quarters. As a full-time carer for my own elderly parents, I will make damned sure nothing like this happens to them.

    • lindalou1963 profile image


      5 years ago from Texas

      From my point of view, this is basically murder. Unless someone has a living will, the doctors are supposed to SAVE lives not TAKE lives. Here in the states, we put people in prison for doing what these people are doing.


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