Journal of pain & palliative care pharmacotherapy
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In the past year, the American Academy of Hospice and Palliative Medicine (AAHPM) Board of Directors charged the Academy's Ethics Committee with updating our positions on a number of topics, and the board recently approved and published position statements on artificial hydration and nutrition, palliative sedation, and physician-assisted death, as well as statements on palliative care research, quality palliative care, and palliative care accreditation. AAHPM supports intense efforts to alleviate suffering and to reduce any perceived need for physician assisted death (PAD). The Board of Directors respects the beliefs and opinions of all members and does not suggest that physicians or healthcare providers be forced to deliver care they see as harmful or wrong. ⋯ Situations in which patients or their surrogates request physician assisted death (PAD) are particularly challenging for physicians and other healthcare providers because they raise significant clinical, ethical, and legal issues. Deep disagreement persists about the morality of PAD, and sincere, compassionate, and morally conscientious individuals stand on both sides of this debate. Rather than take a position of one side or the other, the Board's position of "studied neutrality" is intended to stimulate thinking and discussion about how best to respond to the urgent needs of the few dying patients who continue to suffer despite expert palliative care.
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Life expectancy in Japan is highest in the world. Cancer is the leading cause of mortality in Japan, accounting for about 30 percent of all deaths. Many Japanese cancer patients experience severe pain although they and their families hope to be pain free at the end of their lives. ⋯ Patients often do not participate in decision making about medical treatment because of remaining paternalism in the relationship between Japanese doctors and patients. Thus, cancer pain management in Japan is not as effective as it can be and not all Japanese cancer patients receive appropriate management for their cancer pain. To improve outcomes for Japanese patients, it is necessary for health professional and social work students and practicing professionals to receive contemporary education including an introduction to palliative care and ethics.
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J Pain Palliat Care Pharmacother · Jan 2007
The Declaration of Venice: palliative care research in developing countries.
In May 2006 at the Fourth Research Forum of the European Association for Palliative Care (EAPC) in Venice Italy, recognizing that the World Health Organization definition of palliative care calls for "impeccable assessment and treatment of physical symptoms and of psychological, social and spiritual problems," the EAPC and the International Association for Hospice and Palliative Care (IAPC) introduced a declaration to develop a global palliative care research initiative.
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The purpose and activities of the Pain & Policy Studies Group (PPSG) at the University of Wisconsin are discussed, especially in its role as the World Health Organization Collaborating Center for Policy and Communications in Cancer Care. Issues relating to the need for balanced opioid policy, the International Narcotics Control Board, opioid availability, overly restrictive national laws and regulations, and specific examples of improvements that have resulted from work of the PPSG are described.
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J Pain Palliat Care Pharmacother · Jan 2007
Patient perspectives on criminal prosecutions of pain management practitioners:lessons from the Fisher-Miller case.
The profound effect of the filing of criminal drug trafficking charges against health professionals on the patients are described. Two high profile cases in which a physician, Frank Fisher, and a pharmacist, Stephen Miller, were prosecuted for providing opioid analgesics for pain patients are described. The patients' personal perspectives on their being labeled as drug abusers for using prescribed analgesics that improved their quality of life and the way in which other health professionals and society related to them are described. In spite of the fact that the charges were dismissed, lasting harm to the professionals, their patients and society resulted from this prosecution.