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pick a pathway, you're leaving

It must be these dark, post-festive days of the new year that set me thinking about the Liverpool Care Pathway for the Dying Patient.

The LCP, as it is known for short, is the guidebook for giving terminal cases a gentle nudge into eternity.

Patients for whom doctors consider nothing can be done are put on the pathway. Treatments and medication are discontinued. Clinicians are "prompted to consider whether clinically-assisted nutrition or hydration is needed and is in the person's best interests".

I worry when some doctors say patients are being put on the pathway unnecessarily. I worry when the NHS pays financial incentives to health trusts to get more patients on an accelerated road to death.

It is disconcerting to hear Jeremy Hunt, the Westminster Health Secretary, describe the Liverpool Care Pathway as "a fantastic step forward" in allowing death with dignity. The same Mr Hunt who as Culture Secretary thought it was a fantastic idea to hand control of almost all our TV to Rupert Murdoch.

The most shocking aspect (apart from hospital trusts getting bonuses for re-shuffling departures from this mortal coil) is that half the patients don't know they are on the pathway. Me, I would rather know if I was being pointed to the exit.

I will have to carry a card saying that in the event of imminent death I am not to be placed on the LPC. It will state my preference of going on a pathway which involves hydration (assisted if necessary) with the very best of red wines. With regular supplements of the finest brandies. Could the nurse peel me a grape ? And leave the oxygen mask off while I smoke a large Havana cigar?

In fact, the last few weeks have seemed to be a trial run of a pathway of death by indulgence. People have been trying to kill me all through the Christmas and New Year period. Truffles, Belgian chocolates, entire selection boxes all designed to trigger the Type 2 diabetes peripheral nephritis. Go on, have a drink and damage your liver. This large cheeseboard will only make you a teensy bit more obese.

PS: If you're looking for a pathway, avoid Shettleston. That's the one where on average you die 15 years younger than the folk who live in leafier and wealthier parts of the UK.

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