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Debating Issues Around Death and Dying in General Settings
  1. Jo Hockley, Consultant Nurse
  1. St Christopher’s Hospice, and Consultant Editor, End of Life Care. Email: j.hockley@stchristophers.org.uk

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Over the last few weeks there has been a stream of letters in UK national newspapers debating different aspects of care associated with people who are dying. In particular, there has been a critique of the Liverpool Care Pathway for the Dying Patient (LCP) documentation (Ellershaw and Wilkinson, 2003), hydration at the end of life and ‘do not attempt resuscitation’ orders. For many in health care, being faced with death and dying is frightening. In the generalist setting, death is not a daily occurrence and, unlike in specialist palliative care, many aspects of management do not appear straightforward. Perhaps what lies behind some of the letters is fear — fear of getting it wrong, fear of hastening death, and fear of taking responsibility for decisions in relation to dying.

In the UK, a strong hospice movement exists. Hospices, however, were never meant to be the sole providers of care for people who are dying. The majority of the …

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