Most palliative physicians want no role in assisted death

CMAJ, online 23 February 2015
Author: Laura Eggertson
“Dying Canadians should not assume palliative care doctors will assist them if they choose to end their lives, because the majority of those currently practising don’t want that role, says the president of the Canadian Society of Palliative Care Physicians.”
Find article here.

Don’t forget health when you talk about human rights

The Lancet, Volume 385, No. 9967, p481, 7 February 2015
Editorial: “Last week, Human Rights Watch (HRW) released World Report 2015, their 25th annual global review documenting human rights practices in more than 90 countries and territories in 2014. …this 656-page report is a grim read in a year marked by extensive conflict and extreme violence. But when one delves deeper, there is a hidden story that often does not make the headlines. That story is the health dimension of human rights. Viewed through the lens of health, the report contains several compelling and disturbing themes.”
Find editorial here.

Advance care planning in palliative care: a national survey of health professionals and service managers

Australian Health Review, published online 22 January 2015
Authors: Marcus Sellars, William Silvester, Malcolm Masso and Claire E. Johnson
“ACP is increasingly recognised as an important part of care of people in hospital and community settings. However, currently there is no empirical evidence about the national uptake and quality of ACP in palliative care settings specifically.”
Find abstract here. See also ‘Palliative care health professionals’ experiences of caring for patients with advance care directives‘.

End-of-life care: how terminally ill kids and their parents can plan for a better death

The Conversation, online 5 November 2014
Author: Nikola Stepanov
“Advance care planning and advance health directives are useful tools to help manage the care of adults with palliative illness. …The scenario is different for children with a palliative illness, as most have never had legal capacity and are reliant on parents (or others) to make health-care decisions for them. But this doesn’t mean that children and adolescents shouldn’t have a say in their future care, or have their choices acknowledged and recorded.”
Find article here.

Dying at home is not more expensive, Nuffield report finds

BMJ 2014;349:g5902
Author: Jacqui Wise
“Enabling people to die in their own home does not necessarily cost more than if they were cared for in hospital, research from the Nuffield Trust has found. The report, Exploring the Cost of Care at the End of Life,1 constructed a number of models to examine how people were using services at the end of their lives. It found that the overall care costs for patients using the Marie Curie home based palliative care nursing service were likely to be around £500 a person lower than other types of end of life care.”
Find extract here.

Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life

Institute of Medicine, released 17 Sept 2014
“A substantial body of evidence shows that broad improvements to end-of-life care are within reach. In Dying in America, a consensus report from the Institute of Medicine (IOM), a committee of experts finds that improving the quality and availability of medical and social services for patients and their families could not only enhance quality of life through the end of life, but may also contribute to a more sustainable care system.”
Find report here.

US health system is not meeting patients’ needs at end of life, says expert committee

BMJ 2014;349:g5739
Author: Michael McCarthy
“The US health system needs to undergo major changes if it is to meet the needs of patients nearing the end of life, a new report from the US Institute of Medicine has said. The report1 was written by a 21 member expert committee convened by the institute. It found that, although the fields of palliative and hospice care had become established in the United States, access to good end of life care remained limited by the small number of palliative care specialists, a lack of primary and specialty care providers who were proficient in basic palliative care, and a health system whose incentives promoted medical interventions ahead of compassionate end of life care.”
Find extract here.

More French Paradoxes

Bioethics Forum, the Hastings center, 8 August 2014
Author: Susan Gilbert
“Death is hard to deal with anywhere, but France has some contradictory ways of providing end-of-life care, as two recent articles discuss. On the lighter side, Agence France-Presse reports on a novel service that one French hospital will launch next month to improve the quality of life of terminally ill patients: a wine bar in the palliative care center, which will also stock champagne, whisky, and beer. The hope is that it will “cheer up the difficult day-to-day existence of patients,” the head of palliative care told the news service. On the darker side, France is grappling with what to do when patients can no longer benefit from wine, champagne, or more medical forms of palliative care. While France has resisted proposals to legalize physician-assisted suicide or euthanasia, doctors nonetheless resort to these practices regularly–thus far without legal consequences, according to a recent article in the New York Times, which has received surprisingly little attention on social media but prompted conversation here at The Hastings Center.”
Find article here.

Palliative care: more than one chance to get it right

The Lancet, Volume 384, Issue 9938, Page 103, 12 July 2014
“In today’s Lancet are the first two papers in the Every Newborn Series, campaigning to ensure that every baby has a healthy start in life through improved quality of care at birth. Equally important, and an area that often receives much less attention, is improvements in quality of care for people who are dying. This week sees the phasing out in the UK of the Liverpool Care Pathway (LCP), a set of guidelines developed in the 1990s intended to ensure comfort and dignity for patients at the end of their life, but one that has been widely criticised by the UK media and some patients and their relatives for failing to provide appropriate care.”
Find editorial here.