International Association for Hospice & Palliative Care

International Association for Hospice & Palliative Care

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Promoting Hospice & Palliative Care Worldwide


2006; Volume 7, No 2, February



Many ways to help support palliative care.

Main Index:

IAHPC's Homepage

Message from the Chair & Executive Director:
Kathleen M. Foley, MD
Liliana De Lima, MHA

Article of the Month:
Dr. Ripamonti

IAHPC Traveling Scholars’ Reports

Regional News:
Greece, USA & India

Book Reviews:
Roger Woodruff, MD

IAHPC Board Member Retires

What's New?
Hot News


Webmaster's Corner:
Anne Laidlaw

Editor's Notes:
Dr. William Farr

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Regional News: Greece, USA and India



Collective Member of the European Association for Palliative Care (EAPC)
Member of the Task Force for Palliative Care of Central and Eastern Europe (ECEPT)
7 Χifiou Str., 11471, Athens , Greece



Our Society, on occasion of the World Palliative Care Day, contributed to the following events:

1. On the World Palliative Care day, a press conference was called where information was given to the press. The conference was greeted by his Excellency the Greek Minister of Health, Mr. Nikitas Kaklamanis, and a letter by the Executive Director of the International Association for Hospice and Palliative Care, Mrs. Liliana de Lima, was read. The response of the press was very satisfying.

2. A booklet for patients was distributed in hospitals informing them how and where they can ask for help, should they need it.

3. An informative open letter clarifying the purpose and the content of Palliative Care and asking for support was addressed to distinguished members of the Greek Society. So far, more than 140 personalities coming from the political, artistic, scientific and intellectual Greek society responded. Among them, Party leaders, Congressmen, the Rector and Vice Rectors of Athens University, the Dean of Medical School, Professors of various disciplines, writers, artists, journalists etc. have singed the letter. The project is still ongoing.

4. A TV spot and a radio message on palliative care was prepared and aired on national stations.

5. TV interviews of the president and members of the society were conducted with an immediate and massive response from the public.

6. The 7th PANHELLENIC CONGRESS ON REGIONAL ANAESTHESIA, PAIN THERAPY & PALLIATIVE CARE was conducted from 7-9 October 2005, near Athens. The congress was greeted by the dean of Athens Medical School and by political authorities. More than 450 people were registered. The scientific programme covered most disciplines of Pain and Palliative Care medicine. More than 40 distinguished Greek speakers and 4 invited internationally renowned speakers brought us up-to-date information on recent developments in pain management and palliative care. The past president of EAPC, Prof. S. Kaasa, the past President of EFIC and WIP, Professor D. Niv, the President elect of EFIC, Professor G. Varassi, and Board member of ESRA, Prof. P. Narchi presented very interesting topics on the field of palliative care, pain management and regional anaesthesia. In addition to the scientific programme, the well-organised social events gave the participants an opportunity to meet and exchange knowledge in a relaxed atmosphere.

7. An exhibition of photography entitled “Palliative Care” was organised using sensitive photos coming from the daily work in the Pain and Palliative Care Centre of Aretaieion University Hospital, Athens.

8. A notification and briefing for the celebration of the Day is organised on our web-site,, with links to all relevant foreign Internet sites (Greek version already available).

United States

Physician Credentialing in Hospice and Palliative Medicine in the US will change after 2006


Dale Lupu, Ph.D.
American Board of Hospice and Palliative Medicine
[email protected]

2006 Last Year for Physicians to Gain Board Certification in Hospice and Palliative Medicine through ABHPM

Silver Spring, MD, January 20, 2006 —The American Board of Hospice and Palliative Medicine (ABHPM) has opened registration for the 2006 certification examination for physicians, the last year that ABHPM will offer certifying examinations. The ABHPM will close its certifying program to new applicants after 2006, beginning a smooth transition to the next step in certification of this subspecialty. The American Board of Medical Specialties (ABMS) begins certification of Hospice and Palliative Medicine in 2008.

Board certification confers recognition that a physician is an expert in hospice and palliative medicine and has met stringent requirements appropriate for a subspecialist in the field. The ABHPM’s current eligibility requirements are significant: to sit for the certifying examination, applicants must have received prior major specialty certification, practiced at least two years following residency, worked for at least two years as a member of a hospice or palliative care interdisciplinary team, and have directly participated in the active care of at least fifty terminally ill patients in the preceding three years. Alternatively, applicants must have completed specialty fellowship training in palliative medicine. This training must be at least one year in length and meet established voluntary standards for such a program. Applicants meeting these eligibility requirements are permitted to sit for the half-day board examination. Candidates who pass the exam are certified for an eight-year period.

Once the ABMS process starts, everyone, including current ABHPM diplomates, must apply for initial certification. Because of the ABHPM’s rigorous certification requirements, its certification will likely be considered as part of the qualifying evidence to sit for the new ABMS exam.

Hospice and palliative medicine is the medical discipline specializing in the relief of symptoms and the alleviation of suffering throughout the course of a life-threatening illness. Hospice and palliative medicine physicians, working with an integrated team of other professionals, help the patient and family face the prospect of death with assurance that comfort will be a priority, values and decisions will be respected, spiritual and psychosocial needs will be addressed, and practical support will be on hand. Physicians who specialize in hospice and palliative medicine typically work with a hospice program or a hospital based palliative care program.

  • The American Board of Hospice and Palliative Medicine was formed in 1995 to establish and measure the level of knowledge, attitudes and skills required for certification of physicians in this field. ABHPM conducts its certification examinations each November at multiple sites through the United States. A current list of certified physicians may be viewed on the Board's website at

Information on the American Board of Hospice and Palliative Medicine, more detail on the transition to ABMS certification, and applications for the November 2006 examination are available on the website or by calling 301/439-8001. Early bird applications deadline are due April 1, 2006. The regular application deadline is May 1, 2006

“Relief of Pain and Suffering a Growing Priority in U.S Hospitals, Reports a Study in Journal of Palliative Medicine

From Vicki Cohn, Mary Ann Liebert, Inc.,

New Rochelle, NY, January 6, 2006— The number of palliative care programs that provide expert care to relieve pain and suffering and improve quality of life increased 67% in U.S. hospitals between 2000 and 2003, according to a study published in the December issue (Volume 8, Number 6) of Journal of Palliative Medicine, a peer-reviewed publication of Mary Ann Liebert, Inc., and the official journal of the American Academy of Hospice and Palliative Medicine. The paper is available free online at

Data gathered from annual surveys by the American Hospital Association revealed that the number of palliative care programs in hospitals across the U.S. grew from 632 (15% of hospitals) to 1,027 (25% of hospitals) during the three-year period.

As palliative care programs grow in number, accompanied by a corresponding increase in the numbers of certified palliative medicine physicians and nurses, seriously ill and dying patients at more hospitals across the country will have access to experts specially trained in advanced strategies for relieving pain and suffering.

In a paper entitled, “The Growth of Palliative Care Programs in United States Hospitals,” co-authors R. Sean Morrison, MD, Catherine Maroney-Galin, MA, MPH, Peter D. Kralovec, and Diane E. Meier, MD, present data that show that although growth in palliative care programs has occurred throughout the nation’s hospitals, larger hospitals, academic medical centers, not-for-profit hospitals such as those run by religious organizations, and VA hospitals are significantly more likely to develop a program as compared to other hospitals.

‘This data should create a sigh of relief among the public and a demand for implementation in the remaining 3,000 hospitals in the country. A new standard of care is being established,’ says Charles F. von Gunten, M.D., Ph.D., Editor-in-Chief of Journal of Palliative Medicine.

This important trend represents the translation of existing knowledge into practice. Numerous national news reports and commentaries have highlighted the need for better pain and symptom control and attention to the emotional, practical, and spiritual needs of patients with the most serious life-threatening illnesses. With palliative care services, there is a mechanism to implement this new knowledge to improve patient care and comfort. Existing palliative care programs in hospitals have been well received; patients report better symptom control, more satisfaction with their treatment, and better utilization of resources.”

From the Pain & Policy Studies Group
University of Wisconsin Comprehensive Cancer Center
World Health Organization Collaborating Center

406 Science Drive, Suite 202
Madison , WI 53711-1068
ph.: 608.263.7662
fax: 608.263.0259

Dear International Colleagues,

This is to inform you that the 2000 World Health Organization guidelines, “Achieving Balance in National Opioids Control Policy” are now available via our public access website in Mongolian, Serbian, and Turkish as well as Bulgarian, English, French, German, Italian, Lithuanian, Polish, Romanian, Russian, Spanish, and Ukrainian. As you may know, WHO designed these guidelines for governments and healthcare professionals to assess national opioids control policies and their administration to determine if they contain the provisions, administrative procedures and cooperation that are necessary to ensure availability of opioid analgesics for pain relief and palliative care. These guidelines are an essential tool in our ongoing work in Eastern Europe to improve patient access to pain medications.

The WHO guidelines, now available in all 14 languages, can be found at

We are grateful to the Open Society Institute for its ongoing support of work in Eastern and Central Europe and the Former Soviet Union countries and to Dr. Odontuya Davaasuren for providing the Mongolian translation. For more information, please contact Karen Ryan at [email protected]

From the Hastings Center

“Dear Colleague:

In the decade since the SUPPORT study was released in 1995, major philanthropic and government organizations have worked to improve end-of-life care by improving direct care, changing federal and state laws and regulations, and taking legal action. To some extent, things have improved, but problems remain. Reaction to highly publicized cases, such as that of Terri Schiavo, points to the kinds of disagreements and misunderstandings that lead to personal anguish and public controversy.  Issues we thought were settled in 1976 or 1990 are not truly resolved. 

Last spring, as the Schiavo case went through the courts (and Congress), The Hastings Center invited 10 experts to write about changes that have occurred in care of the dying, and where change has yet to be effected. This group includes some of the most influential thinkers who have helped to shape the ethical and legal framework on end-of-life care in the past two decades. They represent a variety of disciplines, and approach end-of-life issues from distinct perspectives and particular experiences. These thought-provoking essays ask us to consider what we believe to be true about end-of-life care, to consider what is actually true, and to envision innovative and improved approaches to concerns such as personal autonomy, advance directives, disability rights, the role of law in end-of-life care, and cultural and personal attitudes toward death and dying.

I invite you to download the full text of the report, Improving End-of-Life Care: Why Has It Been So Difficult?, by visiting The Hastings Center Web site at

Individual copies may be ordered by emailing [email protected]

or writing to:
Publications Department, The Hastings Center,
21 Malcolm Gordon Road,
Garrison, New York, 10524
Also, we encourage you to post the announcement that follows this note to your organization's listserv and on your Web site.

As you read, please consider what you or your organization might do to improve care of the dying:  Can you work toward changes in public policy? Has your organization engaged the disability rights community to resolve their concerns about forgoing treatment? Are the courts the best way to resolve end-of-life issues-and if not, how should we?  We welcome your thoughts and insights about this supplement and look forward to hearing from you.

Thomas H. Murray, President
Bruce Jennings, Senior Research Scholar”


Harmala Gupta, President, CanSupport and Cancer Care India, received the prestigious “Outstanding Contribution to Social Welfare” award instituted by the PHD Chamber of Commerce and Industry. Dr. A.P.J. Kalam, President of India, presented the award at a glittering ceremony held at Vigyan Bhawan, New Delhi, on 21st December 2005.

Outstanding Contribution to Social Welfare


News from Kerala ( India )

Northern and mid Kerala now have an extensive network of community owned palliative care initiatives. This network of home care services, outpatient clinics and inpatient services called Neighbourhood Network in Palliative Care now covers a population of more than 12 million. The sixty first initiative in the network was inaugurated on 30 th January 2006 in Kadalundi, a village in Northern Kerala. The new initiative, being developed by ‘Navadhara’ a collective of lower and lower middle class people in the village, is expected to cover an area of 12 square KM with a population of more than 40,000. Inauguration of the palliative care centre by a popular singer was a major event in the village, demonstrating the spirit of community ownership. The function was attended by an audience of more than 5,000, about one eighth of the whole population of the village!


Mr Hamsa, a patient
The man in the wheelchair
(front and center)
is Mr Hamsa, a patient.

Provided by Dr. Suresh Kumar.

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