Media Watch

2014; Volume 15, No 3, March

An Annotated List of Recent Articles about Palliative Care in the News Media and the Literature

Media Watch is intended as an advocacy and research tool. The weekly report, published by Barry R. Ashpole, a Canadian communications consultant and educator, monitors the literature and the lay press on issues specific to the quality of end-of-life care. It is international in scope and distribution. Each month, this section of the IAHPC will publish an abstract or summary of an article or report of special interest noted in a recent issue of Media Watch (see below).

Prognosis terminal: Truth-telling in the context of end-of-life care
Cambridge Quarterly of Healthcare Ethics, 2014; 23 (2):209-219. Recent contributions to the medical literature have raised yet again the issue of whether the term "terminal" is an intelligible one and whether there is a consensus view of its meaning that is sufficient to justify or even require its use in discussing end-of-life care and treatment options with patients. Following a review of the history and development of informed consent, persistent problems with the communication of prognosis and the breaking of bad news are analyzed. The author argues that candid, but compassionate, communication between physicians and patients about prognosis is essential to informed decisions about both disease-directed (curative) and palliative therapies.
More info.

"Please describe from your point of view a typical case of an error in palliative care": Qualitative data from an exploratory cross-sectional survey study among palliative care professionals.
Journal of Palliative Medicine | Online – 4 February 2014 – Patient safety is a concern in medicine, and the prevention of medical errors remains a challenge. The definition and understanding of an error is particularly difficult in palliative care, with scarce empirical evidence about the nature and causes of medical errors in that discipline. This study explored incidents palliative care professionals perceive as typical errors in their practice, and descriptions of such events. Seven potential areas for errors were identified: drug treatment, palliative sedation, communication, care organization, treatment plan, end-of-life care, and history taking. Six categories emerged as causes of errors: miscommunication, system failure, dysfunctional attitudes, lack of knowledge, wrong use of technology and misjudgment.
More info.

Palliative care: International perspective
HUMAN RIGHTS WATCH | World Report 2014 – 23 January 2014 – World Report 2014 is the organization´s 24th annual review and summarizes key human rights issues in more than 90 countries and territories worldwide, drawing on events from the end of 2012 through November 2013. The report highlights palliative care in several countries:

Guatemala: Palliative care is limited in Guatemala, even though more than 10,000 people die of cancer or HIV/AIDS each year, many in severe pain. Although the introduction of immediate release morphine in 2012 was a positive development, the country maintains some of the most restrictive regulations on opioid medications in the world, effectively denying access to essential pain medicines to thousands of patients each year (p. 252 of World Report 2014).
Mexico: Tens of thousands of patients face major and often insurmountable obstacles in accessing end-of-life care, even though Mexican law grants them a right to such care. Health insurance schemes do not yet adequately address the health needs of incurable patients; drug control regulations unnecessarily restrict access to morphine, an essential medication for severe pain; and training in palliative care for healthcare workers remains insufficient (p. 270 of World Report 2014).
Armenia: Armenia´s complicated and time-consuming prescription and procurement procedures for opioid medications obstruct the delivery of adequate palliative care, condemning most terminally ill patients to unnecessary suffering. Although morphine is a safe, effective, and inexpensive way to improve the lives of terminally ill people, Armenia´s current consumption levels of morphine and alternative strong opioid medicines are insufficient to provide care to all terminally ill cancer patients, leaving many without adequate pain relief during the last stages of their illness (p.409 of World Report 2014).
Russia: Restrictive government policies and limited availability of pain treatment persists and severely hinders the delivery of palliative care. Each year, tens of thousands of dying cancer patients are denied their right to adequate pain relief. In May 2013, a doctor in Krasnoyarsk and another woman were found guilty and fined on charges of illegal trafficking of controlled substances, after they helped a man in the final stages of cancer and in debilitating pain obtain opioid pain medicines. In September, an appeals court sent the case for retrial. [see report elsewhere in the newsletter].
The court hearing the retrial excluded a lead defense lawyer from the case. A May 2013 government decree somewhat eased patients ‘access to narcotic pain medications. However, implementation is problematic (p. 478 of World Report 2014).
Ukraine: The government took important steps to improve access to palliative care, but has yet to implement new regulations or expand access to opiate substitution treatment for drug users (p.511 of World Report 2014).

World Report 2014.

The current and back issues of the weekly report can be accessed here.

Previous Page | News Index | Next Page

This newsletter, including (but not limited to) all written material, images, photos are protected under international copyright laws and are property of the IAHPC. You may share the IAHPC newsletter preserving the original design, the IAHPC logo, and the link to the IAHPC website, but you are not allowed to reproduce, modify, or republish any material without prior written permission from the IAHPC.