Appropriate and inappropriate care in the last phase of life: an explorative study among patients and relatives

BMC Health Services Research 2016 16:655
Authors: Eva Elizabeth Bolt, H Roeline Willemijn Pasman, Dick Willems, Bregje Dorien Onwuteaka-Philipsen
“Many people are in need of care in the last phase of life. However, the care they receive is not always appropriate. For instance, people can receive overly aggressive treatment or can have limited access to palliative care. The term appropriate care is often used by policy makers, while it is unclear what care recipients consider as appropriate care. This study aims to identify what care patients and relatives perceive as appropriate and as inappropriate in the last phase of life, for patients suffering from different conditions.”
Find article here.

Belgian euthanasia model splits Aussie experts

MJA Insight, Issue 37, 26 September 2016
Author: Sarah Colyer
“GPs in Belgium are becoming increasingly confident about referring patients for euthanasia, new research suggests, as in September 2016 the country approved the first death of a child under its laws. The latest study has divided Australian experts amid renewed clamour for a national vote on the issue. Opponents claim that the findings provide fresh evidence of a slippery slope of widening justification for euthanasia, and of the ineffectiveness of safeguards to avoid abuse of the legislation. Supporters, by contrast, emphasise that the overall rate of deaths is still very low, and say that euthanasia is finding a natural place in palliative care.”
Find article here.

Palliative care on World Health Assembly agenda

PCA statement, online 23 May 2016
“Palliative Care Australia (PCA) CEO Liz Callaghan looks forward to the review of the palliative care resolution at the sixty-ninth World Health Assembly which starts today in Geneva, Switzerland. “Two years ago a palliative care resolution was passed unanimously at the World Health Assembly to ask governments around the world to make palliative care a priority for their health systems.” “This week is Australia’s 20th National Palliative Care Week, and in the lead up to the Federal election we are calling on political parties to make palliative care a National Health Priority,” Ms Callaghan said.”
Find statement and election policy here.

Perceptions of palliative care among patients with advanced cancer and their caregivers

CMAJ April 18, 2016 First published April 18, 2016, doi: 10.1503/cmaj.151171
Authors: Camilla Zimmermann, Nadia Swami, Monika Krzyzanowska, Natasha Leighl, Anne Rydall, Gary Rodin, Ian Tannock, Breffni Hannon
“Background: Early palliative care is increasingly recommended but seldom practised. We sought to examine perceptions of palliative care among patients with advanced cancer and their caregivers. …Interpretation: There is a strong stigma attached to palliative care, which may persist even after positive experiences with an early palliative care intervention. Education of the public, patients and health care providers is paramount if early integration of palliative care is to be successful.”
Find abstract here.

End of life care still not living up to public and doctors’ expectations

BMJ 2016;353:i2188
Author: Scott A Murray
“As a society and as a medical profession we are apparently failing most people who die. Another report again calls for UK governments to prioritise and improve end of life care, particularly for those with non-cancer related illnesses.1 This latest detailed BMA report rates specialist palliative care for people with cancer as “excellent,” while stating that palliative care for other conditions can be “poor” and “could frequently do much better.” High quality care is not being delivered consistently.”
Find editorial here.

Facing Death

Q&A, ABC television, broadcast 9 November 2015
“Tonight, we’re focusing on death and the dilemmas we all must face. Here to answer your questions: writer and doctor Karen Hitchcock, who believes we should be helping the elderly to live well; journalist and broadcaster Andrew Denton, who used the Wheeler Centre’s Di Gribble Argument to make the case for voluntary assisted dying; Ana Lamaro who is living with advanced cancer and hoping for a conscious and peaceful death; Ralph McConaghy, the head of the palliative care unit at Brisbane’s Wesley Hospital; and Victorian doctor Rodney Syme who, for 25 years, has been helping terminally ill patients who want to end their lives. Please welcome our panel.”
Find program here.

Australians’ use of palliative care services double over the last decade

AIHW, online 23 September 2015
“A new web report from the Australian Institute of Health and Welfare (AIHW) shows that palliative care-related hospitalisations have risen by over 50% in the last decade. Palliative care aims to improve the quality of life of patients and their families facing a life-threatening illness, through the prevention and relief of suffering.”
Find release here and report here.

Palliative Care and End of Life Decisions

Med Law Rev (2015) doi: 10.1093/medlaw/fwv035 First published online: August 27, 2015
Reviewer: Loane Skene
“Debates about end-of-life treatment are constant and often heated as sensitive decisions have to be made about the care to be provided to a growing population of ageing patients, some suffering untreatable pain or distress. …Smith’s beautifully presented book [Palliative Care and End of Life Decisions, New York Palgrave Pivot, 2013] is a valuable contribution to legal studies in this area because it presents a strong and coherent argument for the use of ‘terminal sedation’ for patients at the end of their lives, where they are suffering unbearable pain or distress that cannot be treated (pp. 48–50). Smith analyses legal and ethical principles to explain how the prospect of terminal sedation can be aligned with them to overcome potential legal objections.”
Find extract here.

Chemo may worsen quality of life for end stage cancer patients

WebMD, 23 July 2015
Author: Robert Preidt
“Chemotherapy may worsen quality of life for some cancer patients who are nearing death, a new study finds. The research included more than 300 patients with advanced cancer who had about four months to live. The hope is that palliative chemotherapy will ease symptoms and extend survival. But that wasn’t the case for those patients who started the study with good ability to care for themselves. In fact, for people who could still work and perform day-to-day tasks, chemotherapy was associated with a worsened quality of life, the study found.”
Find article here.