Patrick Pullicino



Evidence-based medicine is increasingly regarded as the gold standard of clinical care. The Liverpool Care Pathway (LCP) is a pre-specified care plan used for patients who are judged to be “in the last hours or days of life”. 29% of patients in NHS hospitals currently die on the LCP. The median time to death on the LCP is 33 hrs. A review of the literature reveals that there are no published criteria that can predict death within this time frame. The lack of an evidence-base for institution of the LCP makes it a form of assisted death rather than a care plan. The pathway is having major negative effects on patient outcomes. It is also likely negatively affecting doctor-patient relationships and having a negative effect on medical care, particularly of the elderly, in NHS hospitals.