Our Observatory is following the palliative care issue as an urgent global ethical matter to be resolved, both in developed countries and in the rest of the world (read HERE). In this sense, the Lancet constituted a special Commission in palliative care (see Lancet report “Alleviating the access abyss in palliative care and pain relief—an imperative of universal health coverage”). In a more recent article, the Lancet’s Special Commission criticized the WHO guide to maintain essential health service during coronavirus pandemic, “WHO has issued guidance on how to maintain essential health services during the pandemic, highlighting immunization, maternal care, emergency care, and chronic diseases among others, but there was no mention of palliative care. This was an oversight. Indeed, palliative care ought to be an explicit part of national and international response plans for COVID-19. Practical steps can be taken: ensure access to drugs (such as opioids) and protective equipment, consider greater use of telemedicine and video, discuss advance care plans, provide better training and preparation across the health workforce, and embrace the role of lay carers and the wider community.” read more HERE.
Now an article published in the Washigton Post (September 7, 2020) analyzes a recent study about the general public’s perception of palliative care among more than 5000 older Americans.
The article says “[The study] revealed that over 70 percent of participants did not even know what palliative care was […] Of those who are aware of palliative care, the same study shows almost two-thirds think it is the same as hospice, which is a service delivered at home or in a facility for someone with an expected survival of no more than six months.”
But, according to the author, not only the general public has a palliative care wrong understanding, “Most physicians are likely to call palliative care specialists primarily when death is imminent — many worries that calling in a palliative-care consultation will increase anxiety and fear among patients. Diane Meier, a palliative care specialist who directs the Center to Advance Palliative Care, said “doctors are the group most fearful of death. We are people who like to achieve control over the uncontrollable. For our profession, in particular, it is existentially threatening. Any acknowledgment that life is finite, that we don’t live forever, is like saying there is no God.”
The article continues “Yet palliative care not only has been shown to repeatedly improve quality of life in patients with conditions such as cancer and heart failure but also has been shown in some studies to help people live longer, perhaps through avoidance of potentially ineffective treatments, procedures and hospitalizations.”
Palliative care specialists needed
The article concluded, “In providing care to the sickest patients in the hospital, many of whom survived, palliative care specialists needed to provide crucial supportive care not just to patients and their loved ones, but also the doctors struggling to take care of them.
The pandemic has given palliative care doctors more work than ever before and has added a new charge to palliative care, Anthony Back a palliative care physician and professor at the University of Washington in Seattle, said, to fulfill our most human desire — to acknowledge the moment.”