Tag Archives: EOL

Scott MurrayProfessor 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.

Ten years ago Professor Geoff Mitchell, a speaker in today's NAPCRG 2015 plenary session, and I decided on his patio, one warm evening in Brisbane, Australia, that it was high time to re-emphasise the potential of palliative care in the community. That night the International Primary Palliative Care Network was born. ...continue reading

Moine_photoSébastien Moine est médecin généraliste en Saint Just en Chaussée, France, et doctorant en santé publique (Université Paris 13) | Sébastien Moine is a GP in Saint Just en Chaussée, France and a PhD candidate in public health (Université Paris 13)

 

[English version follows below]

« Nous sommes très heureux que vous veniez travailler avec nous ! C’est vrai, nous avons peu de médecins généralistes dans notre hôpital. Il est toujours bon de développer de nouvelles relations. » Je ne sais pas pourquoi, mais je sens qu’elle va rajouter quelque chose. J’acquiesce avec un sourire, sans dire un mot. C’est mon dernier entretien d’embauche avec la directrice adjointe des affaires médicales. ...continue reading

Caprio (CHS- 2012)Anthony J. Caprio, MD, CMD serves as the medical director and an Associate Professor for the Division of Aging, in the Department of Family Medicine for the Carolinas Healthcare System, Charlotte, North Carolina

 

The Institute of Medicine (IOM), a non-profit institution which provides objective analysis and recommendations to address problems related to medical care in the United States, issued the 2014 report Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life. The IOM report proposed changes to U.S. policy and payment systems to increase access to palliative care services, improve quality of care, and improve patient and family satisfaction with care at the end of life.

The release of the IOM report was regarded by many U.S. healthcare professionals as a significant step forward in identifying gaps in the delivery of care for seriously ill and terminally ill patients. Specific recommendations were outlined as a “call to action” to improve end-of-life care. Hospice and palliative care physicians, in particular, rallied behind the report. ...continue reading

Dees_MMarianne Dees is a family physician and academic researcher at Radboud University Medical Centre in the Netherlands

 

Let's take a look at appropriate end of life care.

The case of Mr. Jones

Mr. Jones, aged 88, was referred to the hospital for the fourth time that year with dyspnoea. He was diagnosed with pneumonia. His medical history mentioned myocardial infarction, chronic heart failure, and a pacemaker. Two years earlier he had made a written will with a non-resuscitation and non-intensive care statement. The next day he became progressively dyspnoeic and developed kidney failure. He was transferred to the ICU ...continue reading

Geoff photo sitting reducedGeoffrey Mitchell is Professor of 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

DFM_Burge_IMG_0633Fred 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

5 Comments

Kirsten_headshot

Kirsten Patrick is Deputy Editor at CMAJ

 

Today is a momentous day for physicians in Canada. No matter what your opinion about whether or not physician assisted dying is morally right, it will be a human right henceforth under certain circumstances.

We have aired a broad spectrum of views on this forum in the lead up to the Supreme Court of Canada’s unanimous decision on Carter vs. the Attorney General, released this morning. Even CMAJ’s editors are divided in their personal opinions. We have discussed our personal views in many an editorial meeting, and CMAJ’s Editor-In-Chief, John Fletcher, put me on the spot to declare my position publicly when we were recording the podcast for the November 18th issue of the journal.

Many Canadian physicians will feel unhappy about the decision, perhaps even angry ...continue reading