David Falk is a palliative care physician working in Calgary, Alberta
Recently the president of one of the Quebec medical federations published a request to the public to give the medical profession some time to accept physician assisted death (or medical assistance in dying - MAiD) “because they do not like change.” I agree and disagree with him about this. Yes, physicians are slow to change without measured assurance that the change would be beneficial to their patients, but, when it comes to the matters of the heart, these changes may not be beneficial nor become mainstream. Suppression of visceral responses does lessen with repeat exposure, just as shoplifting becomes less traumatic the more often you do it, but whether continued suppression of the heart language is good is questionable. ...continue reading →
Over the past several decades, the economic interests of the pharmaceutical and medical technology industries have both pressured and tempted medicine to overextend itself. The traditional moral commitment of the medical profession to relieve suffering and to care for the dying has been gradually displaced by a futile and misguided attempt to solve humanity’s most profound existential problems through biotechnical means. Doctors now apply more and more powerful treatments towards the end of life and try to prevent diseases by seeking out and correcting more and more risk factors. All this has led to an epidemic of overdiagnosis ...continue reading →
Professor Scott A Murray is the St Columba’s Hospice Chair of Primary Palliative Care Research Group at The University of Edinburgh in Scotland, UK
We live in exciting times for palliative care in general and for palliative care in primary care and family medicine in particular. The World Health Assembly (WHO's resolution-making body) in May 2014 passed its first ever resolution about palliative care. It called for palliative care to be integrated into health care in all settings, especially in the community, and countries will be answerable to this resolution in May20161.
The opening ceremony of the 2015 Canadian Cardiovascular Congress began with a bang on Saturday October 24th, but by the end of the keynote address from Dr. Chris Simpson, past President of the Canadian Medical Association (CMA), some may have thought the opening ceremony ended with a whimper. The moderator used the term "depressing" to characterize Dr. Simpson's talk on "Seniors Care: The Paramount Health Care Issue of our Time."
All Dr. Simpson did was to point out some clear realities about the Canadian health care system to the attendees. For the first time in Canada history, there are more seniors than children. Despite the billions of dollars thrown at it, our health care system is ranked 11 out of 12 similar nations, just ahead of the United States. ...continue reading →
Geoffrey Mitchell is Professorof General Practice and Palliative care at the University of Queensland in Brisbane, Australia
The developed world is experiencing a dramatic shift in its demographics, with rapidly increasing proportions of older people. By 2050, many countries will have over 30% of their citizens aged 60 or over. With this comes a quantum increase in the proportion of people with chronic and complex diseases, and of deaths. Most people who die are old. Most people will die of conditions with a period where death can be anticipated, rather than by a sudden event. Dying over time also brings complex psychosocial and spiritual needs – as Samuel Johnson once said – impending death concentrates the mind wonderfully! ...continue reading →
Fred Burge is a Professor in the Department of Family Medicine at Dalhousie University, Nova Scotia.
Finally, a plenary session at NAPCRG on dying. For over twenty years I’ve come to this annual meeting as ‘the’ place to be nurtured as that oddest of breeds in medical research, a family doctor. Early in my academic life I thought I wanted to be a full time palliative care doctor. But over time I realized I loved long relationships with patients, sharing their experience with illness, helping them stay healthy and most compelling to me was being with them at life’s tough moments. What I call the transitions. New heart attacks, the diagnosis of multiple sclerosis, cancer diagnoses, depression, relationship challenges and so much more. Being a palliative care doc seemed only to work at the end of all of this. So, I moved back to being and loving family medicine. ...continue reading →