The Liverpool Care Pathway – #WeNeedToTalkAboutMidazolam

Midazolam. It should be the word that is on everyone’s lips. If it isn’t we can assure you it will be by the time we’ve finished exposing one of the greatest crimes against humanity ever committed. We have the evidence midazolam may have been used to prematurely end the lives of thousands upon thousands of people in the United Kingdom, who you were told died due to Covid-19. But there is also evidence emerging this hasn’t just happened in the United Kingdom, it is in fact a world-wide issue.

But before we can reveal the evidence we need you to understand what midazolam is. Which is why we released our article ‘We need to talk about midazolam…’ on the 3rd June, and that’s why today we want to talk to you about the Liverpool Care Pathway…

The Liverpool Care Pathway (LCP) was a scheme that we’re told intended to improve the quality of care in the final hours or days of a patient’s life. It’s alleged aim was to ensure a peaceful and comfortable death. The LCP was a guide to doctors, nurses and other health workers looking after someone who was dying on issues such as the appropriate time to remove tubes providing food and fluid, or when to stop medication.

The LCP was developed during the late 1990’s at the Royal Liverpool University Hospital, in conjunction with the Marie Curie Palliative Care Institute. Palliative care is medical treatment designed to make people with terminal illness feel as comfortable as possible – both physically and emotionally. It can be used to relieve symptoms but not cure a condition.

The LCP involved reviews of –

whether any further medications and tests (such as taking the patient’s temperature or blood pressure) would be helpful
how to keep the patient as comfortable as possible, for example, by adjusting their position in bed or providing regular mouth care (some illnesses or treatments can cause over- or underproduction of saliva)
whether artificial fluids should be given, when a patient has stopped being able to eat or drink
the patient’s spiritual or religious needs

However…

In 2013 an independent review was carried out by Baroness Neuberger, who recommended discontinuation of the Liverpool Care Pathway. Why was there a review? Because it was applied to patients without their families’ knowledge and when they still had a chance of recovery. Doctors in the NHS were withdrawing treatment, heavily sedating the patient, and removing the tubes which provided food and fluid in the last 24 hours of their life.

The Review and the media highlighted examples of extremely poor practice. Many cases revealed ineffective or absent communication between healthcare professionals and patients or relatives, resulting in appalling care when this happened. Even though the LCP repeatedly emphasised the importance of clear and open communication with the patient and family and within the multidisciplinary team.

Particular concern was raised in the Review about reports of patients being denied oral fluids, contrary to the legal requirement to provide basic care:

‘The offer of food and drink by mouth … must always be offered to patients who are able to swallow without serious risk of choking or aspiration.’⁴.

In fact, the LCP guidance was explicit that:

‘… the patient should be supported to take food and fluid by mouth for as long as tolerated.’⁶

The Review also identified reports of withdrawal of nutrition and hydration by drip or tube, without explanation or consultation.

According to newspaper reports, several families complained about use of the care pathway. Some relatives claimed that their loved ones were put on the pathway without their consent and some said it hastened death in relatives who were not dying imminently.

The review also found that use of the pathway was being encouraged for financial reasons, linked to targets. Almost two-thirds of NHS trusts using the LCP received “payouts” totaling millions of pounds for hitting targets related to its use.

There review also found examples of people who “survived” the Liverpool Care Pathway. A Daily Mail article described how Doctors at a hospital had removed all feeding tubes and drips and placed an 82-year-old grandmother on the Liverpool Care Pathway. Her children and grandchildren were told to say their last goodbyes.

But they said no. And after they defied hospital orders and gave Mrs Greenwood drops of water, her family helped her make a remarkable recovery.

The Liverpool Care Pathway was discontinued in 2014 following mounting criticism and a national review. Or so we are told.

One of the drugs of choice given to heavily sedate the patient and give them a “good death” was a drug called Midazolam.

Midazolam should be used with extreme caution in patients who have chronic renal failure, impaired hepatic function, or impaired cardiac function. It should also be used with extreme caution in obese patients, or elderly patients.

Midazolam induces significant depression of respiration.
UK regulators insist midazolam should only be administered in a hospital or doctor’s office under the supervision of a doctor or nurse to monitor the breathing of the patient in order to provide life saving treatment to the patient if breathing slows or stops.
Midazolam should be used with extreme caution in elderly patients.

Covid-19 is an alleged disease which can severely affect the respiratory system. Midazolam is a drug that severely suppresses the respiratory system.

Considering all of the above, how do you feel now that we’ve told you we have the evidence to show midazolam may have been used to prematurely end the lives of thousands upon thousands of people, and you were told that they died of Covid-19?

Please help to get #WeNeedToTalkAboutMidazolam trending on Twitter and share this article on all social media platforms.

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