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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 News and Current Palliative Care Events RSSHospice and palliative medicine specialty strives to prepare physicians for aging baby boomers
The American Academy of Hospice and Palliative Medicine announces two important medical education courses in hospice and palliative medicine and a significantly revised book series in keeping with the Academy's ongoing commitment to prevent and relieve pain and suffering during serious illness.
Survey compares views of trauma professionals, the public on dying from injuries
Most trauma professionals and members of the general public say they would prefer palliative care following a severe injury if physicians determined aggressive critical care would not save their lives, according to a report in the August issue of Archives of Surgery, one of the JAMA/Archives journals.
New research group offers hope to asbestosis sufferers
The Asbestos Research Group, offering hope to sufferers of asbestos-related diseases, was launched at The Wesley Research Institute today.
Acupuncture reduces pain and dysfunction in head and neck cancer patients after neck dissection
New data from a randomized, controlled trial found that acupuncture provided significant reductions in pain, dysfunction, and dry mouth in head and neck cancer patients after neck dissection.
New disaster preparedness strategy announced
In an unprecedented initiative, US and Canadian experts have developed a comprehensive framework to optimize and manage critical care resources during times of pandemic outbreaks or other mass critical care disasters.
Combining liver cancer treatments doubles survival rates, UVA researchers find
By combining the use of stents and photodynamic therapy, also called SpyGlass, physicians at the University of Virginia have been able to significantly increase survival rates for patients suffering from advanced cholangiocarcinoma, cancer of the liver bile duct.
Beyond the terminal: Palliative care
Palliative care was once reserved for patients when all curative options had been exhausted and death was imminent, but now it is considered an integral part of the care that should be available to patients with serious respiratory disorders and critical illnesses.
Study finds improvement in the care of children with cancer at the end of life
Expanded use of palliative care services is associated with enhanced communications between families and caregivers, improved symptoms management, and better quality of life for children dying from cancer, according to study by researchers at Dana-Farber Cancer Institute and Children's Hospital Boston.
Hope among patients with ALS may take a variety of forms
Sustaining hope in the face of a chronic, debilitating illness such as amyotrophic lateral sclerosis (ALS) should be a goal of palliative care and can take many forms, representing a continuum from focusing on the self to concern for others.
Combined stenting and photodynamic therapy improves survival in late stage liver cancer patients
A combined therapeutic approach of stenting and photodynamic therapy may improve survival rates for patients suffering from advanced liver bile duct cancer, according to a study published this month in Clinical Gastroenterology and Hepatology, the official journal of the American Gastroenterological Association (AGA) Institute.
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