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Palliative care and legal euthanasia can be mutually beneficial
April 18, 2008Analysis: Development of palliative care and legalization of euthanasia: Antagonism or synergy?
Supporters of legalising euthanasia and those who wish to develop better palliative care services can help each other, according to a study published today on bmj.com.
The traditional view that palliative care and euthanasia are two alternative and antagonistic causes is not necessarily the case, say researchers.
Jan Berheim and colleagues from the End-of-Life Care Research Group of the Vrije Universiteit Brussel, reviewed historical, regulatory and epidemiological evidence from Belgium, which was the second country to legalise euthanasia in 2002, and has some of the best developed provisions for palliative care, third only to Iceland and the UK.
The authors show that the movement for the legalisation of euthanasia promoted the development of palliative care and the existence of adequate palliative care made the legalisation of euthanasia ethically and politically acceptable.
According to the authors one of the reasons for the overall lack of acrimony in the Belgian debate was that the two movements developed side by side with shared workers. As the societal debate about euthanasia grew, so did the provisions for palliative care.
They found no evidence that legalising euthanasia resulted in harm to vulnerable patients or disabled people, or that it impeded the development of palliative care in Belgium-concerns voiced by The European Association for Palliative Care. In fact, ethically disputable practices, such as clandestine physician-assisted dying, actually decreased in the run up to the euthanasia law being enacted.
People advocating euthanasia law in Belgium supported palliative care and did not present euthanasia as an alternative but as a possible complement, an option at the end of the palliative care pathway, with the patient's preferences coming first.
The euthanasia law passed in Belgium stated that patients asking for euthanasia had to be informed of the possibilities of palliative care and it was passed at the same time as another Act which ensured people's right to palliative care in every hospital, nursing home and at home, while doubling its public funding.
The process of legalisation of euthanasia was ethically, professionally, politically and financially linked to the development of palliative care, says the study.
The authors conclude: "The societal debates made clear that most values of palliative care workers and advocates of euthanasia are shared. If Belgium's experience applies elsewhere, advocates of the legalisation of euthanasia have every reason to promote palliative care, and activists for palliative care need not oppose the legalisation of euthanasia."
BMJ-British Medical Journal
Jan Berheim and colleagues from the End-of-Life Care Research Group of the Vrije Universiteit Brussel, reviewed historical, regulatory and epidemiological evidence from Belgium, which was the second country to legalise euthanasia in 2002, and has some of the best developed provisions for palliative care, third only to Iceland and the UK.
The authors show that the movement for the legalisation of euthanasia promoted the development of palliative care and the existence of adequate palliative care made the legalisation of euthanasia ethically and politically acceptable.
According to the authors one of the reasons for the overall lack of acrimony in the Belgian debate was that the two movements developed side by side with shared workers. As the societal debate about euthanasia grew, so did the provisions for palliative care.
They found no evidence that legalising euthanasia resulted in harm to vulnerable patients or disabled people, or that it impeded the development of palliative care in Belgium-concerns voiced by The European Association for Palliative Care. In fact, ethically disputable practices, such as clandestine physician-assisted dying, actually decreased in the run up to the euthanasia law being enacted.
People advocating euthanasia law in Belgium supported palliative care and did not present euthanasia as an alternative but as a possible complement, an option at the end of the palliative care pathway, with the patient's preferences coming first.
The euthanasia law passed in Belgium stated that patients asking for euthanasia had to be informed of the possibilities of palliative care and it was passed at the same time as another Act which ensured people's right to palliative care in every hospital, nursing home and at home, while doubling its public funding.
The process of legalisation of euthanasia was ethically, professionally, politically and financially linked to the development of palliative care, says the study.
The authors conclude: "The societal debates made clear that most values of palliative care workers and advocates of euthanasia are shared. If Belgium's experience applies elsewhere, advocates of the legalisation of euthanasia have every reason to promote palliative care, and activists for palliative care need not oppose the legalisation of euthanasia."
BMJ-British Medical Journal
Palliative Care Current Events and Palliative Care News RSSHospices not deactivating defibrillators in patients
Researchers from Mount Sinai School of Medicine have found that patients admitted to hospice care who have an implantable cardioverter defibrillator (ICD) are rarely having their ICDs deactivated and are receiving electrical shocks from these devices near the end of life.
Inadequate access to opioid-based pain relief is a human rights issue for cancer patients
Many cancer patients in Europe are being denied access to adequate pain relief because of over-zealous regulations restricting the availability and accessibility of opioid-based drugs such as morphine.
Home palliative sedation checklist may ease concerns
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Pain management failing as fears of prescription drug abuse rise
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AK2 inhibitor demonstrates effective, durable control of myelofibrosis
A first-in-its class oral medication provides significant and durable relief for patients with a rare, debilitating and lethal bone marrow disorder called myelofibrosis, researchers at The University of Texas M. D. Anderson Cancer Center reported today at the 51st Annual Meeting of the American Society of Hematology.
Dying from dementia
A growing number of older adults are dying from dementia. In an editorial in the October 15, 2009 issue of the New England Journal of Medicine, Greg Sachs, M.D., professor of medicine and director of the Division of General Internal Medicine and Geriatrics at the Indiana University School of Medicine and a Regenstrief Institute investigator, notes that end-of-life care for most older adults with dementia has not changed in decades and urges that these individuals be provided far greater access to palliative care, the management of pain and other symptoms.
Calculate benefit before dialysis for frail elders
Kidney specialists should weigh the potential quality of life for frail elders with end-stage renal disease (ESRD) in opting for dialysis over more conservative therapies, a nephrologist and a palliative care specialist suggest in an editorial in the New England Journal of Medicine.
Instanyl sets new standard in management of breakthrough cancer pain
New data presented today further demonstrate the efficacy of Instanyl in management of breakthrough cancer pain. The data which were presented at the 6th congress of the European Federation of Chapters of the International Association for the Study of Pain (EFIC) are from a multinational, crossover trial comparing Instanyl with oral transmucosal fentanyl citrate (OTFC) for the treatment of breakthrough pain in patients with cancer.
Expanded insurance benefits break down barriers to hospice care, according to new study
Patients with advanced illnesses more than doubled their use of hospice care when a major national health plan made hospice care more readily accessible, according to the results of a comparative study published in Journal of Palliative Medicine.
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