BAOJ Palliative medicine | Online – Accessed 15 December 2016 – Hospice palliative care started in Taiwan in 1990. Foundations of Christian, Catholic and Buddhist background and associations with medical, nursing and various social backgrounds joined in promotion of this modern humanistic medical care. Government organizations, especially the Ministry of Health & Welfare and the National Health Insurance (NHI) added policy momentum. Total subsidies for hospice care were provided by NHI. Hospice Palliative Care Act (a Natural Death Act) was enacted in 2000 and Patient Self-Determination Act passed in 2016. Clinical Buddhist Chaplaincy training program was started in 1998 and exported to Japan in 2013. A Taiwan Coma Scale was proposed for shortening of terminal suffering. Up to present, Taiwan has 57 hospice wards for the population of 23 millions. 93 hospitals provide hospice home care, 141 hospitals providing hospice combined care, and 155 hospitals providing community hospice care, covering almost all cities and counties.
N.B. Taiwan was ranked 6th of 80 countries surveyed in ‘2015 Quality of Death Index: Ranking Palliative Care Across the World,’ The Economist Intelligence Unit, October 2015. [Noted in Media Watch, 12 October 2015, #431 (p.6)].
Bulgarian Journal of Public Health, 2016: 8 (2): 31-42. Like most member states of the European Union, Bulgaria is facing a serious challenge posed by an ageing population that increases the need for services for long-term care and, therefore, an increase in public expenditure for these services. Exactly this similar niche “strives to fill a relatively new (not only for Bulgaria) and unexplored sufficiently by the science social phenomenon and institution, such as a hospice.” Life needs approve hospice as a necessary part of the social organism, regardless of the reluctance/desire of one or another person, an institution representing the state. The challenges faced by providers of such care, especially in small towns such as Bobov Dol, are not few at all.
N.B. Link is to complete issue of the journal. Scroll down to ‘Hospice care challenges in small towns.’ Article published in Bulgarian and English.
Cancers | Online – 13 December 2016 – Evidence and information is an integral part of the processes enabling clinical and service delivery within health. It is used by health professionals in clinical practice and in developing their professional knowledge, by policy makers in decision making, and is sought by health consumers to help them manage their health needs and assess their options. Increasingly, this evidence and information is being disseminated and sought through online channels. The internet is fundamentally changing how health information is being distributed and accessed. Clinicians, patients, community members, and decision makers have an unprecedented capacity to find online information about palliative care (PC) and end-of-life care. However, it is clear that not all individuals have the skills to be able to find and assess the quality of the resources they need. There are also many issues in creating online resources that are current, relevant and authoritative for use by health professionals and by health consumers. This paper explores the processes and structures used in creating a major national PC knowledge resource, the CareSearch website, to meet the needs of health professionals and of patients and their families and carers.
Indian Journal of Gerontology, 2016; 30 (4): 452-462. Contrary to the commonly held belief that death is hidden from public view, obituary announcements remain the most dominant channels of presentation in the mass media. Obituaries as part of the mourning process truly present life in death. They go beyond a simple announcement of death to include information about the socio-economic status of the deceased and/or his survivors. Obituary announcements represent an alternative data source on a people’s perceptions of life, death and dying, and derive their meanings from the socio-cultural codes of traditions, beliefs, religions and such other practices. Their presentations cover achievements from birth till death, the inevitability of death and the beliefs about the continuity of life after death. However, the practice of not to speak ill of the dead (which is prevalent in many cultures) presents a major limitation to the effective utilization of the data source in cultural analysis. This is evident in this study as no single obituary announcement detailed any wrong doing of the deceased. Nevertheless the authors’ findings have helped to understand that obituaries can be a useful tool for tracking societal norms and values in the face of rapid societal transformation.
N.B. Link is to complete issue of the journal. Scroll down to ‘Understanding the life course through newspaper obituaries’ beginning p.452.
Korean Journal of Hospice & Palliative Care, 2016; 19 (4): 283-291. Over the past decade, hospice and palliative care (PC) in Japan has progressed rapidly under the national policies supported by the Cancer Control Act. The numbers of PC units/inpatient hospices, hospital PC teams, and clinics with a home hospice function have been steadily increasing. The increasing numbers of physicians, nurses, and pharmacists have been certified as specialists in PC by national associations. Collaborative efforts have been made to standardize and disseminate educational programs and training opportunities in undergraduate, postgraduate, and continuing medical education. Research activities in Japan have markedly contributed to the growing body of evidence, especially in the fields of terminal delirium, terminal dehydration, palliative sedation, care for dying patients, prognostication, communication, psycho-oncology, and regional PC programs. This review focuses on major PC settings, specialty, national associations, education, and research in palliative care in Japan.
Medical Anthropology | Online – 15 November 2016 –The highly charged debate about the moral status of assisted suicide features regularly in the news media in medically advanced countries. In the U.K., the debate has been dominated in recent years by a new mode of death: assisted suicide in Switzerland, so-called “suicide tourism.” Drawing on in-depth interviews with people who were actively planning on “going to Switzerland,” alongside participant-observation at a do-it-yourself self-deliverance workshop, the author discusses how participants arrived at their decision to seek professionalized assistance. In doing so, she explores the constituent elements of people’s suffering, examining how participants justified, rationalized, or sought authentication from a doctor for their decision to die in light of their own belief system and aesthetic preferences for a good death.
Theoretical Medicine & Bioethics | Online – 3 December 2016 – This article traces the way autonomy has become a recognised value in health care in France. In a country that based its social fundamentals on the very idea of solidarity for many years, autonomy has long been considered a foreign ‘Anglo-American principle.’ Taking the example of the end-of-life (EOL) debate, the article shows, however, how the use of the French term “accompagnement” allowed autonomy to be redefined and to be associated with the concept of solidarity. Exploring the arguments used over the past 25 years in professional guidelines, parliamentary reports, ethics committee reports, and legal texts, the authors describe the shift that took place in public and legal discourses on EOL care. The analysis demonstrates how the scope of autonomy has been limited by other social values, such as the protection of the dying person, in order to become an accepted social value in its own right. The example of the French EOL debate shows that depending on how the concept of autonomy is adapted and applied in a specific context, it can be compatible with the idea of solidarity. Such compatibility has been challenged previously in the international bioethics debate. By demonstrating the possibility of combining autonomy and solidarity, this article makes an important contribution to the international bioethics debate and to the dialogue between countries that are often perceived as significantly different.
Media Watch is intended as an advocacy, education 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 Newsletter will publish an abstract or summary of an article or report of special interest noted in recent issues of Media Watch (see below).
Read the current and back issues of the weekly report.
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