Indian Journal of Palliative Care, 2014;20(3):171-181. A review of country reports, observational studies and key surveys demonstrates that end-of-life care (EOLC) in India is delivered ineffectively, with a majority of the Indian population dying with no access to palliative care at end of life and essential medications for pain and symptom control. Limited awareness of EOLC among public and health care providers, lack of EOLC education, absent EOLC policy and ambiguous legal standpoint are some of the major barriers in effective EOLC delivery. Access to receive good palliative and EOLC is a human right. All patients are entitled to a dignified death. This position paper is an effort to achieve this goal by developing a nationwide uniform EOLC policy, creating an appropriate environment for its provision and encouraging the participation of all the stake holders such that a common goal is attained. The position paper is envisaged to support and facilitate those health care providers who aim to make a difference in lives of the patients who are dying.
Palliative Medicine | Online – 25 July 2014 – U.K. respondents reported a continuum of practice from the provision of low doses of sedatives to control terminal restlessness to rarely encountered deep sedation. In contrast, Belgian respondents predominantly described the use of deep sedation, emphasizing the importance of responding to the patient's request. Dutch respondents emphasized making an official medical decision informed by the patient's wish and establishing that a refractory symptom was present. Respondents employed rationales that showed different stances towards four key issues: the preservation of consciousness, concerns about the potential hastening of death, whether they perceived continuous sedation until death as an "alternative" to euthanasia and whether they sought to follow guidelines or frameworks for practice.
Rambam Maimonides Medical Journal, 2014;5(3):e0018. The twentieth century witnessed profound changes in medical education. All these changes, however, took place within the existing framework... The present paper suggests that we are approaching a singularity point, where we shall have to change the paradigm and be prepared for an entirely new genre of medical education. This is based upon analysis of existing and envisaged trends: first, in technology, such as availability of information and sophisticated simulations; second, in medical practice, such as far-reaching interventions in life and death that create an array of new moral dilemmas, as well as a change in patient mix in hospitals and a growing need of team work; third, in the societal attitude toward higher education. The structure of the future medical school is delineated in a rough sketch, and so are the roles of the future medical teacher. It is concluded that we are presently not prepared for the approaching changes, neither from practical nor from attitudinal points of view, and that it is now high time for both awareness of and preparation for these changes.
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).