Consensus document : as part of an Erasmus+ project of the Bioethics Research Programme of the Medical School, on harmonisation of end of life care (EndCare)

Abstract

The End Care Project started with the realisation that end of life care is not homogenous notwithstanding that we have ample moral sources to harmonise it. End of life care has become medicalised. Many have come to expect nothing less than miraculous cures even when people suddenly approach an unexpected death. A consultant recently told me that when faced with a patient who was dying a discussion arose with one of his registrars who had come from the UK and who had suggested the Liverpool Care Pathway, which was intended to be nothing more than a Palliative Care pathway for the dying and accepted in the NICE guidelines. The consultant replied that in Malta Euthanasia is not accepted. One cannot blame him as the LCP turned out not to be applied with proper training and became a tick-box where all people who were put on the pathways suddenly had all treatment, hydration and nutrition stopped. This of course was a misapplication, as all know, of the pathway and led to the ‘One chance to get it right’ document. It was a learning experience. People were simply abandoned on a ‘pathway’ which was meant to provide them with proper end of life care as was done in Hospices throughout the UK. The pathway was developed for those people who did not have access to hospices. It turned out not to have been practiced as a pathway.