International Association for Hospice and Palliative Care 

Subject: IAHPC Newsroom 2005; Volume 6, No 8, August

William Farr, PhD, MD

Liliana De Lima, MHA

Alou Design
Layout and Distribution

Dear Members and Colleagues:

The July issue of the IAHPC newsletter is now on our website here

To send an email to one of the IAHPC Newsletter team members,
visit the following page

Please click on the title of any article to view the full article.
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In this issue:

Message from the Chair and Executive Director -
Dr. Foley and Ms. De Lima

Tribute To Dame Cicely Saunders

Article of the Month - Carla Ripamonti, MD

Book Reviews - Roger Woodruff, MD

IAHPC Board Member’s Page Must Oncology be our Home?!

What's New

Webmaster's Corner - Anne Laidlaw

Editor's Notes - William Farr, PhD, MD

Until next month!

Kathleen Foley, MD
William Farr, PhD, MD

Message from the Chair
and Executive Director

Kathy Foley, MD
Liliana De Lima, MHA

Dear readers:

Most of you know by now that Dame Cicely Saunders died on July 14th, in Saint Christopher's Hospice, London. Dame Cicely Saunders was the founder of the modern hospice movement and the first person to call attention to the concept of “Total Pain” which includes the components of physical, spiritual, social and family pain.

Because of her work dedication and untiring energy, many dying patients around the world now have access to better care. The Board of Directors, members and officers of IAHPC express our deepest condolences to her friends, colleagues and her family members. A section of this Newsletter is dedicated to Dame Cicely as a tribute to her and her work. We are forever in her debt for paving the way for so many of us.

Last month we received a grant from the Open Society Institute (OSI) Foundation in Switzerland to support activities in developing countries for the World Hospice and Palliative Care Day (WHPCD) to be held on October 8th, 2005. Many thanks to the OSI Foundation for this grant and for enabling us to help celebrate this important date. The World Hospice and Palliative Care Day is a new unified day of action to celebrate and support hospice and palliative care around the world. It has been developed in association with Voices for Hospices and international and regional hospice and palliative care associations worldwide. On October 8th, many events and activities will take place worldwide and a collective global voice of individuals and associations will raise awareness and understanding of the need and importance of hospice and palliative care. Additional information about the day can be found in the WHPCD website at

We also wish to thank Mundipharma KK in Japan for their unconditional donation to IAHPC. We are very grateful for this donation and especially wish to thank Mr. Steven Eric Engen, President & Representative Director of Mundipharma, Japan. This grant will enable us to continue providing financial help to programs and individuals in developing countries who are committed to improving access and availability of palliative care in their settings.

We are proud to announce that the IAHPC website has won a Silver Award from the American Association of Webmasters in recognition for the work, effort and information in our site at  Congratulations to Anne Laidlaw, our Webmaster, for this well deserved recognition. Our website now has more than 2,500 pages of information and continues to grow. Take a look at our new International Directory and please check to see if your organization, or program, is listed and if the information we have is up to date. The International Directory has more than 800 entries and can be viewed at  If you want to include a listing in the directory, click on the Submit a Listing on the left, under Menu.

We continue to receive emails, faxes and letters thanking us for the donation of the Oxford Textbook of Palliative Medicine. We are glad that IAHPC has been able to help with this donation. Many of those who received the books have already placed them in hospital libraries and are using them to teach medical and nursing workers. We hope that all those who have benefited with this donation will put it to good use, by sharing it with colleagues, co workers, and students. This is a valuable publication that deserves to be used to the greatest extent. Many thanks again to one of our past presidents, Dr. Derek Doyle, for his help in securing this donation to the Clearing House Program by Oxford University Press. It will be a gift that will benefit many for years to come.

Until next month

Kathleen Foley, MD
Chair, Board of Directors

Liliana De Lima, MHA
Executive Director

Tribute To Dame Cicely Saunders

Cicely Saunder’s obituaries barely capture her extraordinary contributions as one of the most important social change agents of the twentieth century. Through her thoughtful and determined advocacy for the care of the dying, she has educated society and much more slowly, the health care profession, in the concepts of hospice and palliative care. She defined and shaped the discipline of symptom control and supportive therapy for the most vulnerable of our populations, the dying. By creating St. Christopher’s Hospice as a “place” to care for the dying, she modeled a health care system where personhood and dignity were preserved, pain managed and family centered care provided. In a medical culture where opioid drug therapy was indicated only for acute pain and tolerance and addiction risk was thought to limit long term use, Saunders showed the safety and efficacy of opioid drug therapy and its impact on improving the quality of life for patients suffering from moderate to severe pain. Her observations were ground breaking and opened the door to our current advances in pain management and the redefinition of tolerance and addiction risk. Her clinical work has transformed society’s perspective on the treatment of suffering.

Whether one is in Singapore, Hong-Kong, Japan, South Africa, India - in a developed country or a developing country - hospice care is strikingly the same despite broad cultural differences. An international perspective shows the universality of Cicely Saunders’ vision for improving the quality of life of the dying.

Saunders’ efforts have clearly influenced the American approach to the care of the dying. Approximately 2.5 million Americans die each year and over 20% currently receive hospice care in the last days of their lives. There are over 3200 hospice care programs and payment for care is supported through a Hospice Medicare Benefit. The standards, domains of care and emphasis on a patient and family centered approach are all modeled after Cicely Saunders’ philosophy and principles of care.

As IAHPC works to transform healthcare systems nationally and internationally into systems that acknowledge the care of the dying as a priority and reduce the patient, physician and institutional barriers that currently thwart the full integration of palliative care, Cicely Saunders’ vision and achievements serve to remind us that it is a reachable goal. Her writings, lectures and her role modeling care at St. Christopher’s will forever serve as our guiding light. We honor her willingness to be the public face for dignified dying and for her tireless, unselfish advocacy.

Kathleen Foley, Chair IAHPC


Cicely Saunders deserves to be listed among The Greats of Medicine. She saw a need and reacted to it. What made her different from the rest of us was that we too saw the need but did nothing about it. Thousands of doctors and nurses, social workers and others have now adopted what have come to be known as the principles of hospice care but it needed a Cicely Saunders to start the process, to highlight the need, to startle and challenge the world, and to make people like us uncomfortable until we tried to follow her pointing finger.

She deserves to be counted among The Greats because she kept her message simple.  Even the principles she managed to express simply, though many of us who have followed have made them more complicated and convoluted as we have strived to emulate not her teaching but that of our scientific peers and their sophistication..

She deserves to be named a Great because, more than most of us today, she knew that she had to speak for, to be an advocate for the patient, knew that winning politicians was vital, and knew that hospice-type care had to be "evidence-based", something that some have failed to associate with hospice and palliative care.

As she told many of us, she knew that hospice care was needed, not only in London where she worked but worldwide. Never did she envisage that its principles would spread so rapidly, never did she think they would be understood, adopted and adapted for such a kaleidoscope of cultures as has happened.   In a sense she was as surprised and as delighted as we have been. Never did she change her advice to those who came asking her how to prepare and get started - " Don't waste time. If you see there's a need, get on with it and get started.  You'll soon see how best to do it!" To some of us that is somewhat naive. If we had all agreed with that we in IAHPC would not be promoting our "Getting Started" section on our website. Nevertheless her advice had the effect of making people think what exactly they needed, making them act rather than prevaricate.  It was, after all, what she herself had done and done with such success and to such effect.

It may be that some will remember features of her personality that they would have liked to change, but few of us would be in this work today had it not been for her, or those whom she inspired, those who took her principles to the far corners of the earth. How seldom do most of us get the chance to meet one of The Greats.

Dr. Derek Doyle, Scotland
Former President of the College of the International Hospice Institute and College, IAHPC Board member


Dame Cicely was a tireless clinician, teacher and educator and her lectures and writings had an enormous impact on all of us working in Palliative Care. She provided us with a solid foundation, a sense of belonging and confidence as we started our journey into the care of terminally ill patients and their families.

The first generation of pioneers in our field have given us the gift of their wisdom and hard work and have empowered us to build clinical and academic programs we could not have dreamed of 20 years ago. As the first among these giants Dame Cicely also provided us with the example of her life and works and hopefully she will continue to inspire future generations of health care professionals who want to embrace Palliative Care.

Eduardo Bruera, M.D.
Professor & Chair
Department of Palliative Care & Rehabilitation Medicine (Unit 8)
UT M. D. Anderson Cancer Center
Houston, TX 77030
Past Chair of IAHPC


She walked among us for so many years; it is now difficult to think that Dame Cicely will not be traveling with us on the long road of making palliative care/hospice available everywhere. I started my professional career in the early days during the development of the discipline of hospice/palliative care. It was a time when there was a small scientific base on the subject of symptom management, but a time during which a significant amount of work was being done by Dame Cicely and the scholars working with her at St. Christopher’s. Soon we had a foundation upon which we could begin to function. Her message was clear, very understandable and transferable to those of us working in the US at the time.  Through the years she led us, actually “walked with us,” on a glorious journey down a path to a better understanding of the true needs of the dying and their families while providing us with a vastly improved approach of how to help those in great need of comfort. Many have followed in her footsteps, and have added to the knowledge base we have today. In 2002, the Cicely Saunders Foundation was formed. In the Mission Statement, Dame Cicely writes, “ … This Foundation sets out to make a major contribution in an area of universal need – researching and disseminating further evidence based knowledge in a field that has an impact and importance worldwide.” It is clear that we still have a long way to go to full fill her/our dreams. I am sure we will eventually get there.

On behalf of our team, and the millions of dying people who have been touched by and benefited from the implementation of her principles, we all say Thank You Dame Cicely for you dedication, foresight and courage!

We send our sincere condolences to her family, friends and colleagues at St. Christopher’s Hospice.

William Farr, PhD, MD, Vice Chair IAHPC


We would like to express our sincere condolences to the family, friends and all like-minded persons because of the loss of the well-known founder and pioneer of the modern hospice movement ­ Dame Cicely Saunders.

She was the best example for all palliative care professionals and the bright lighthouse for those countries, where palliative care makes merely its first steps in development.

Her progressive ideas as well as our good memories about her will always remain in our hearts and minds to continue improving quality of life of the dying people everywhere.

Natalia Carafizi
National Association of Palliative Care of Moldova,
Charity Foundation for Public Health "Angelus Moldova",
Hospice "Angelus"


Websites to read more:

Cicely Saunders Foundation URL:

The Foundation website has an audio interview of Dame Cicely by Professor Irene Higginson

St. Christopher’s Hospice

Article of the Month

Carla Ripamonti, MD

Predicting survival in terminal cancer patients:
clinical observation
or quality of life evaluation?

Author(s): Toscani R, Brunelli C, Miccinesi G et al.
Abstract:  Palliative Medicine 2005; 19: 220-7

This is a prospective cohort study carried out in 58 Italian Palliative Care (PC) Units with the aim to compare the prognostic power of patients’ quality of life (QoL) evaluations and of some clinical symptoms or problems evaluated by the physician and to assess whether their combined use could improve their predictive accuracy.

Of the 601 randomly selected terminal cancer patients, 574 were followed until death and received a prospective evaluation: clinical base evaluation, a weekly QoL assessment and a final evaluation regarding the last week of life by STAS (McCarthy and Higginson, Palliative Medicine 1991; 5: 215).

The clinical and QoL baseline data and the clinical condition during the week before death were analysed.

Performance impairments were measured by Katz’s Activities of Daily Living (ADL) (Katz and Akpom, Int J Health Serv 1976; 6: 493) and QoL by means of Therapy Impact Questionnaire (TIQ) (Tamburini et al. Ann Oncol 1992; 3: 565). TIQ is a multidimensional 36-item questionnaire filled in by the patient or proxy with respect to the previous week.

Two primary scales were derived from TIQ items: 1. physical symptoms index (PSI) (the physical well-being, fatigue, gastrointestinal symptoms); 2. the therapy impact index (TII) (functional, emotional, cognitive status, and the social interaction).

Physicians’ or nurses’ QoL evaluation was used in 28.6% of cases to replace missing data that was related to the worsening of the patient’s conditions.

Dysphagia for solids, severe dyspnea, delirium, dehydration, cachexia, hepatic and acute renal failure, oliguria, and Katz’s ADL were the clinical variables most closely associated with survival (hazard ratios (HRs) > 2.1). Only dyspnea, cachexia, oliguria and Katz’s ADL kept their strength once introduced in the Cox model. The TIQ scales most strongly associated with survival were physical well-being, fatigue, functional status and cognitive status (HRs  ranging from 1.42 to 1.71), but only fatigue showed a strong independent prognostic relevance (90% of selection). In the TIQ scales, PSI was strongly associated with survival with respect to TII (HR 1.71 vs HR 1.47).

This study shows that clinical variables are better predictors of survival than QoL in terminal cancer patients.

Why I chose this article

Many studies were carried out in order to evaluate prognostic factors of survival of cancer patients. The aim of some of these studies was to enable the study of these factors and enable identification of patients as possible candidates for MEDICARE.

As a matter of fact, in oncology and in a palliative care setting, prognostic indicators of survival are above all intended to improve patient care. They are also used to personalize and plan specific care strategies such as the best setting for the patient’s care (PC Unit, hospice, home care, nursing home), to facilitate most clinical, emotional, spiritual and ethical goals of PC and also to give patients the time to fulfil their commitments.

This is the first study comparing the prognostic power of clinical variables and other QoL indicators such as performance status, global health status, and cognitive impairment. The study shows that clinical variables are better predictors of survival than QoL in terminal cancer patients. In a future issue, I will present the following  article “Prognostic factors in advanced cancer patients. Evidence-based clinical recommendations” written by Maltoni M, Caraceni A, Brunelli C et al., in press in J Clinical Oncology.

Carla Ripamonti, MD
Member of the Board of Directors, IAHPC

Please visit the following link to read past
Articles Of The Month:

Book Reviews

Roger Woodruff, MD

A Practical Handbook

Brian S. Carter and Marcia Levetown (Eds)
Johns Hopkins University Press 2004
399 pp
ISBN 0-8018-8005-X
RRP $US29.95, £21.50.
More Info & Purchase

In her Foreword, Dr. Kathleen Foley describes this volume as a ‘brilliant clinical handbook’ that ‘is a compendium of educational material uniquely edited to facilitate health care professionals’ understanding of how to think about, talk with, and practice caring for, the seriously ill child with competency and compassion.’  I agree.

The book is divided into three main sections.  The first deals with societal and institutional issues, the second with the practicalities of making holistic pediatric palliative care work, and the last with special patient populations including genetic conditions, HIV infection, and cancer.

With the exception of the chapter on health care professionals’ stress and care giver suffering, each chapter is written by multiple members of the interdisciplinary team, providing real insight into the way holistic pediatric palliative care should work.  Numerous short case reports are effectively woven into the text.  Anyone involved with pediatric palliative care will benefit from reading this book.

Highly recommended.



Marianne La Porte Matzo and Deborah Witt Sherman (Eds)
Mosby, 2004
ISBN 0-323-01990-0
RRP $US59, £27.
More Info & Purchase

This book focuses on promoting quality of life of older adult patients who have progressive, incurable illnesses in a holistic but individualized manner. 

The book is divided into three main sections.  The first is about promoting quality of life in the dying process.  The second is about disease-related palliative care nursing and includes chapters on end-stage cardiac, hepatic, pulmonary and renal disease.  The final part deals with symptom management.

I found the text user-friendly.  Case studies are usefully used to illustrate the text.  Key studies from the literature are summarized in boxes labeled Evidence-Based Practice.  The liberal use of tables improves access to the information.

This book should be a core text for any undergraduate or postgraduate nursing course that deals with the palliative care of older adults with life limiting illnesses.



Ruth B. Purtilo and Henk A.M.J. ten Have (Eds)
Johns Hopkins University Press, 2004
368 pp
ISBN 0-8018-7870-5
RRP $US49.95, £35.50
More Info & Purchase

Dementia challenges all of the principles upon which Western medical ethics is based.  This thoughtful collection of essays by leading clinicians, ethicists, philosophers, and theologians from
North America and Europe was more than five years in the making.  First, the editors initiated a dialogue that lasted for at three years, following which each contributor’s essay was critiqued at a meeting in the Netherlands in 2001, after which the dialogue was continued for another two years before the final submissions were peer-reviewed.

The book is divided into six sections, which cover the clinical, philosophical, theological, ethical, organisational, and research aspects of dementia.  Some of the contributions have more questions than answers, although I was pleased to note that the contributor from The Netherlands who wrote the chapter on Alzheimer disease and euthanasia concluded that ‘euthanasia cannot be convincingly ethically justified in the treatment of persons with Alzheimer disease.’

This book will be useful and thought-provoking to anyone involved in the fields of dementia care, palliative care and bioethics.


Hospice/Palliative Care Training for Physicians

Porter Storey and Carol F. Knight
MaryAnn Liebert, 2003
8 booklets averaging 116 pp
Available from here

Individual Booklets $US45 ($US55 outside USA)
Set of 8 Books with CD ROM $US199 ($US224 outside USA)

This is the second edition of the American Academy of Hospice and Palliative Medicine’s (AAHPM) UNIPAC Self-Study Program in hospice and palliative care.  The booklets are well set out and follow the recommended format of self-instructional learning including a statement of the learning objectives, a pre-test, reading material, clinical situations for demonstrating knowledge application, a post-test, and references.

There are eight booklets in the series.

1.    The Hospice/Palliative Medicine Approach to End-of-Life Care
2.    Alleviating Psychological and Spiritual Pain in the Terminally Ill
3.    Assessment and Treatment of Pain in the Terminally Ill
4.    Management of Selected Non-Pain Symptoms in the Terminally Ill
5.    Caring for the Terminally Ill – Communication and the Physician’s Role on the Interdisciplinary Team
6.    Ethical and Legal Decision Making When Caring for the Terminally Ill
7.    The Hospice/Palliative Medicine Approach to Caring for Patients with HIV/AIDS
8.    The Hospice/Palliative Care Approach to Caring for Pediatric Patients.

I found these booklets enjoyable and user friendly.  The correct answers for the pre-tests and the questions asked in the clinical vignettes are given, but not those for the post-tests.  Provision of these answers would improve the booklets’ appeal outside
USA, whilst still allowing American Physicians to submit their answers (and money) to AAHPM for CME points.

These booklets are a valuable educational resource for anyone wishing to learn about palliative care or to refresh their knowledge.  They will be particularly valuable to anybody involved in teaching palliative care.

Roger Woodruff
Medical Oncologist and Director of Palliative Care,
Austin Health, Melbourne, Australia
(July 2005)

IAHPC Board Member’s Page

Must Oncology be our Home?!

Mohammad Zafir Al-Shahri, MBChB, FFCM, ABHPM
Consultant in palliative care medicine in King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia and is an IAHPC Board Member
Read Bio

Apart from some pioneering medical efforts aiming at better symptom control (pain in particular), the concept of palliative care may owe more to the nursing profession than to medicine. This is not to negate the crucial role of physicians and other professionals in the development and delivery of palliative care. Physicians whose discipline of practice is solely or mainly palliative care come from a variety of specialty backgrounds. Of these, family medicine, internal medicine, anesthesiology and oncology are only a few. Being still an evolving health discipline, no clear demarcation lines have yet been drawn to identify various territories related to palliative care medicine.

The question of what should be the parent specialty for palliative care medicine is valid and perhaps timely, given the increasing number of postgraduate training programs in this field. The other related and equally important question is: where should palliative care medicine be located on the organizational charts of academic and health care institutions. This question may be of a lesser significance in some West European and North American countries were palliative care is more established and recognized. However, the same question may be of greater relevance in other countries where the discipline is still struggling hard to gain recognition and support from professional colleagues and health policy makers. In developing countries, where the tendency of the management styles are too central, a higher level on an organizational chart is likely to imply better access to resources and fewer obstacles in the way of growth and development.

Traditionally, palliative care medicine is often organizationally patronized by oncology with the assumption that most of the referrals to palliative care come from oncologists. This assumption may not be very accurate. Clients of palliative care are often, but not always, cancer patients. Also, cancer patients may be treated at times by surgeons and other non-oncologists. A survey in our setting showed that more than half of the referrals to palliative care were initiated by non-oncologists, though cancer was by far the most prevalent diagnosis. Furthermore, other disciplines may have more valid arguments for claiming the right to be the home for palliative care medicine. Family medicine, for instance, with its holistic nature and focus on both the patient and family as the unit of care, may be a good example. It is my viewpoint that considering palliative care medicine to be by default a subdivision of oncology may lead to hindrance rather than facilitation for the development of the former discipline. This may be especially true in developing countries where palliative care has a long way to go in order to meet the massive unmet needs.

IAHPC What's New?

Correspondence from an IAHPC Traveling Scholar

Dear Liliana De Lima,

I recently completed the Certificate Course in Pain and Palliative Medicine at the Amrita Institute of Medical Sciences, Cochin. Thanks to IAHPC's sponsorship, it was possible for me to attend the course. The training was very comprehensive. It has given me the confidence to take total care of patients. I plan to practice palliative care regularly. I have now joined with Dr.Mallika Tiruvadanan and I am working along with her in The Lakshmi Pain and Palliative Care Trust, Chennai. I wish to thank you once again for making it possible for me to train in Palliative care.

Warm Regards,
Dr. Subathra Muthukumaran


Free Online Course for Nurses and Carers has today launched its fourth, free online course for nurses and carers. The 'Introduction to Palliative Care Nursing' course is a practical learning resource that allows learners to study at a time that suits them. The course has been developed by Bob Becker. Bob holds a full-time, Senior Lecturer in Palliative Care, joint teaching appointment between Staffordshire University Faculty of Health and Science and the Severn Hospice in Shropshire, England.

The intention of the Introduction to Palliative Care Nursing course is to highlight and examine the diversity and the challenges inherent in the nurse's contribution to palliative care. After providing a general introduction to palliative care nursing, the course offers a series of self-assessment exercises to help a nurse reflect upon their own competence in the area, and to draw up an action plan for self-development.

New and existing registered learners can enrol on the course via the website at:

Since the launch of our first course, the response to the site from nurses across the world has been tremendous and has enabled to begin to develop a range of new courses. All of these courses are being written by experienced cancer nurses who have volunteered their knowledge and experience for the benefit of their colleagues worldwide.

Courses currently under development include:

- Cancer of the Stomach
- Cancer of the Lung
- Pain and Symptom Management
- Stoma Care
- Management of Skin-Tunnelled Central Venous Catheters
- Hypercalcaemia in Malignant Disease
- Introduction to Childhood Cancer


Recent Articles

Improving the Use of Hospice Services in Nursing Homes A Randomized Controlled Trial
David Casarett, et al.
JAMA. 2005; 294, 211-217. View the abstract here


Research in End-of-Life Care

The recent issue of Academic Medicine 2005; 80, (7) , July contains several articles on end-of-life care. Go to here


First Annual World Hospice and Palliative Care Day

The first annual World Hospice and Palliative Care Day will take place on October 8, 2005.

To make this a successful event that raises public awareness and knowledge about palliative care around the world Open Society’s (OSI’s) International Palliative Care Initiative has made eighteen $1,000 grants to hospice and palliative organizations and associations in 16 countries in Central and Eastern Europe, the former Soviet Union, Mongolia and Africa.

The funds will support a wide range of palliative care advocacy initiatives including: palliative care education programs for health care professionals and public education materials in Albania, Armenia, Hungary, Bulgaria, Lithuania, Poland, Romania, Tanzania and Zimbabwe; developing donation boxes placed in the community to support local hospices in Moldova; television program on hospice and palliative care in Mongolia; photography and art exhibits on palliative care in Armenia, Hungary and Slovenia; national news conferences on end of life care in Hungary, Poland and Slovenia; fundraising events like “Voices for Hospice” concerts to support local hospice and palliative care programs in the Czech Republic, Slovakia, South Africa and Tanzania; and a fundraising walk/run marathon in Kenya. A $10,000 grant was given to the International Association for Hospice and Palliative Care to support a wide range of hospice organizations in developing countries to design effective world hospice palliative care day initiatives.


From the Pain & Policy Studies Group

University of Wisconsin Comprehensive Cancer Center

World Health Organization Collaborating Center for Policy and Communications in Cancer Care

"Promoting pain relief by improving public policy and communications"

WHO Guidelines now available in 11 languages

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 *Bulgarian, German, Lithuanian, Polish, and Ukrainian* as well as English, French, Italian, Romanian, Russian, and Spanish. 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 11 languages, can be found here at this link

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.
For more information, please contact Karen Ryan at [email protected].

Please also visit their web site at URL:


10th Biennial Symposium on Minorities, the Medically Underserved & Cancer: Committed to Eliminating Disparities

April 19-23, 2006
Omni Shoreham Hotel Washington, DC

Abstract Deadline: October 31, 2005
Scholarship Deadline: November 30, 2005

Hotel reservations, scholarship and abstract information may be obtained online after September 15, 2005 at . . .
Download PDF flyer now at . . .
(New window will open)


The 3rd Pan-Pacific Nursing Conference & the 5th Hong Kong Nursing Symposium on Cancer Care

Date: 11-12 November 2005
Venue: Sheraton Hong Kong Hotel & Towers

Email: [email protected]


Hospice and Palliative Care Study Seminar in Britain
sponsored by the Hospice Education Institute

London, England,
March 26-April 7, 2006

Three Unity Square
PO Box 98
Machiasport Maine 04655


The Art and Science of Cancer Medicine
Sponsored by Hospis Malaysia & Malaysian Oncological Society

Kuala Lumpur, Malaysia
Sept 23 - 25, 2005

For information and registration please contact:
Malaysian Oncological Society Secretariat: [email protected]


Building Palliative Care Programs in Hospitals: Tools and Strategies for Success
Sponsored by the Center to Advance Palliative Care (CAPC)

October 17-19, 2005
Westin Horton Plaza San Diego, USA

For registration and information:
1255 Fifth Ave, Suite C-2
New York, NY 10029
Ph (212) 201-2680
Fax (212) 426-1369
Email: [email protected]


16th Annual Provincial Conference on Palliative and End-of-Life Care
Sponsored By: Humber/Ontario Palliative Care Association

Taking Place: Toronto
Marriott Eaton Centre Hotel, Toronto, Ontario, Canada
Date Of Event: April 23-25, 2006

Event Description: This annual conference attracts over 500 participants, including physicians, nurses, case managers, social workers,program managers and coordinators, and other practitioners interested in end-of-life care.

Contact Information: To receive program information, or to have your name added to our distribution lists email [email protected] or call 416-674-2472
Event Website:


Palliative Care in Heart Failure: Moving Forward Together
Sponsored by the National Council for Palliative Care

5th December 2005
Centennial Centre, Birmingham

To downlaod an information and registration flyer:

For additional information contact
Sofia Rahman, Events Coordinator at
[email protected]


Fourth International Palliative Care in the 21st Century Conference
Sponsored by Columbia University College of Physicians and Surgeons and The

Professional Education Center of The Jewish Home & Hospital Lifecare System
Thursday, September 8, 2005
Columbia University, New York

Please visit here to read more about this event, download the PDF brochure and the program agenda, or register online.
For further information please contact:
Naim Gribaa
Email: [email protected]

The Jewish Home & Hospital Lifecare System
120 West 106 Street
New York, NY 10025
Tel: 212-870-4762 Fax: 212-870-4611


Suffering and Hope: An interdisciplinary conference on the ideas underlying the medical specialty of palliative and hospice care
Sponsored by the Center for Thomistic Studies at the University of St. Thomas

November 10 -13, 2005 Houston, USA

For registration, call for papers, and updates:
Or send an email to: [email protected]


European Conference on Palliative Care
Sponsored by the Secretary General of the Council of Europe

October 20-25, 2005
Belgrade, Serbia

For information and registration:

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Editor’s Notes

William Farr, PhD, MD (USA)

Wilbur E. Flannery, MD died

Wilbur E. Flannery, MD was a great supporter of our organization starting from its inception when it was the International Hospice Institute (IHI). Dr. Flannery was elected as the second president of the Academy of Hospice Physicians in 1990. The Academy was then part of the IHI and later went on to become an independent organization called the American Academy of Hospice and Palliative Medicine. He died at the age of 96 at home in New Castle, Pennsylvania on March 13, 2004. He was a good friend and a great supporter of our organizations. I am sorry that I am just now hearing of this sad news.

To read more about Dr. Flannery's long and very exceptional career, go to the The Ceveland Clinic Foundation's Alumi Connection Newsletter  2004; 24 (2), page 24 CLICK HERE


Clearing House Program

Those of us at IAHPC wish to thank the many individuals, companies and organizations from around the world who have donated books and journals for distribution to those in great need of these materials. Please continue to help your fellow hospice/palliative care workers by donating to our Clearing House Program.

Details are available in our website at:

Displayed below are some of the notes we have received from recipients of the donations to the Clearing House Program.

Dear Liliana,

I apologize for not communicating with you sooner due to my overwhelmed administrative responsibilities in the hospital and a hectic schedule with my patients. However, I wanted to express my deepest gratitude for your kindness and consideration.

Four weeks ago I received the courtesy copy of the Second Edition of the Oxford Textbook of Palliative Medicine as part of your Clearing House Program, which I consider the most comprehensive edition of studies in palliative medicine and palliative care and a valuable learning tool. I can not thank you enough for facilitating this extraordinary edition to us, which, as you are aware, it is not available in my country.

My medical assistants and nurse practitioner are very impressed with it and wanted me to extend their gratitude to you as well. Because of your kindness, they are also benefiting by improving their professional growth in the field of palliative medicine which will be reflected in the quality of services to our patients.

If I can contribute in any way to the association or to the developing of hospices in Latin America, please do not hesitate to contact me.

Respectfully yours,
Fernando A. Calderon-Higginson, M.D.
Head, Service of Clinical Oncology
Department of Medicine
Naval Medical Centre
Lima – PERU


Dear Liliana

I would like to say a very BIG THANK YOU to you for all the wonderful books and material that I have received from you, it is much appreciated!!!! Thank you again for your support and assistance in ensuring that Palliative Care and Hospice Care continue to develop and in our country.

Kind regards,
Carin Marcus
Social worker
Hospice Wits South Africa


Dear Liliana,

I would like to thank you personally and on behalf of “Contigo” for sending the Second Edition of the Oxford Textbook of Palliative Medicine, which is being consulted daily and has come a tremendous help in our work, allowing us to have a deeper and broader knowledge of palliative and hospice care.


Dr. María Pruvost
Contigo Palliative Care Program
Cordoba, Argentina


Thank you very much for sending us the Oxford Textbook of Palliative Medicine. I saw a copy of this book at the St. Christopher's Hospice in London and I had wanted to buy a copy, but it was beyond my means.  I praise God that you have chosen us as one of your recipients and I hope that when you clear house again that you will again consider our hospice here in the Philippines.  Again, thank youv very much and may the Lord greatly bless your work!

Yours truly,
Dr. Annabelle de Guzman, FPAFP,MHA


Dear Liliana,

We are very grateful to the IAHPC, because last week we received the Second Edition of Oxford Textbook .This will be very useful to us.Last year your service increase the number of beds(110 now),and all of books that you send help our work so much.

Thank you again!!
Dr Maria Marta Vallejos
Pades-Hospital Privado de Comunidad
Mar del Plata-Argentina


The Art and Science of Cancer Medicine
Sponsored by Hospis Malaysia & Malaysian Oncological Society

Kuala Lumpur, Malaysia
Sept 23 - 25, 2005

For information and registration please contact:
Malaysian Oncological Society Secretariat: [email protected]


Dear Liliana De Lima, MHA

We are extremely grateful for the last gift you sent to us. The Oxford Textbook of Palliative Care is definitely a treasure. We had seen it last year in London, when visiting the Dep. of Palliative Care and Policy of King's College, and felt how valuable it would be to us. Be assured that the copy you sent will be at the library we are organising to serve the comunity and people interested in Palliative and Bereavement Care.

Yours sincerely,
Joao Paulo C Solano, MD
Federal University of Sao Paulo


Dear Liliana de Lima,

On the behalf of the ECEPT Board and myself I would like to thank you very much for providing our organisation with this very important resource.

Sincerely yours,
Professor Jacek Luczak


William Farr, PhD, MD
Newsletter Editor

Letters to the editor may be submitted at the following page

****Thanks to all contributors to this issue.****

Ways To Help The IAHPC

© 2005 IAHPC Press

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