Singapore Statement

The Singapore Statement was issued at the 12th Asia Pacific Hospice Conference held in Singapore from 26th – 29th July.

Photo Credit: HPM Global

Singapore Statement

We participants of the 12th International Conference of the Asia Pacific Hospice Palliative Care Network on 28 July 2017 in Singapore,

  • finding that there is a huge burden of unrelieved suffering associated with life limiting illnesses in the region,
  • viewing with concern that less than 10% of those in need have access to pain relief and palliative care globally, and
  • aware of the World Health Assembly resolution of 2014[1] which calls on all member countries’ health systems to integrate evidence-based, cost effective and equitable palliative care services in the continuum of care, community and home based care and universal coverage schemes,

request member states in the region to ensure:

  • adequate funding and effective implementation of national palliative care strategies to implement palliative care in the region,
  • the inclusion of palliative care in non-communicable diseases control programs and in HIV and TB control programs,
  • inclusion of palliative care education in basic education for all health professionals, and
  • improving access to palliative care for children and young people.

[1] Reference: World Health Organisation. World Health Assembly WHA 67.19 Agenda Item 15.5. Strengthening of palliative care as a component of comprehensive care throughout the life course. Available at http://apps.who.int/gb/ebwha/pdf_files/WHA67/A67_R19-en.pdf

‘Happy Death Day’ – palliative care and death awareness exhibition held in Thailand

This article was originally from eHospice.

Some 3,300 participants, with another 30,000 people watching the exhibition online, attended the ‘Happy Death Day’ palliative care and death awareness exhibition. The exhibition consisted of various zones, consisted of a talk on how to prepare for death and a ‘Last Talk’ session where people diagnosed with terminal illnesses share their experiences, feelings, hopes and dreams. The second day saw participants reflecting on their lives while lying in a coffin at the exhibition and interacting with speakers, patients, carers and the healthcare team at the ‘Death Cafe’, a casual setting to promote conversations on palliative care or death-related issues.

Read the full article here.

 

An exhibition is an interactive way to promote awareness of hospice and palliative care during World Hospice and Palliative Care Day 2017Email us at aphn@aphn.org to let us know what activities you will be having to celebrate and support hospice and palliative care.

APHN statement on our stand against the deliberate ending of life

The Asia Pacific Hospice and Palliative Care Network promotes access to good-quality hospice and palliative care for all in the Asia Pacific region. We value every moment of life and do not support any action that has the intention of shortening a person’s life. Restoring dignity and enhancing quality of life is the basis of palliative care.

We do not support the deliberate ending of life and we view with concern moves in certain jurisdictions in the region to legalise physician-administered euthanasia and physician-assisted suicide.  Licensing doctors to administer or supply lethal drugs to seriously-ill patients has no place in the practice of health care.  Such moves devalue the dying and undermine society’s responsibility to protect its most vulnerable members.

Australia and New Zealand are acknowledged leaders in fostering palliative care development in the Asia Pacific region. In much of this region, pioneers are struggling to establish good end-of-life services in the face of little political and financial support. Eighty percent of the world’s dying has little or no access to morphine for pain relief.

The United Kingdom, Australia and New Zealand have been ranked as the top three countries worldwide in the 2015 Economist Quality of Death Index. The eyes of the world are on these nations and on how they discharge their responsibilities to dying people.

For those of us trying to improve end-of-life care, licensing doctors to provide or administer lethal drugs to patients poses serious risks of sabotaging efforts around the globe to convince governments that pain relief and good end-of-life care are basic human rights.

The Asia Pacific Hospice and Palliative Care Network appeals to you therefore to recognise your responsibilities on the world stage when considering any proposed legislation before you.

 

Yours faithfully

 

Associate Professor Cynthia Goh
Chair, Asia Pacific Hospice Palliative Care Network

_____________________________________________________________________________________________

Thank you everyone for your support. The comments section is closed. You may read the archived comments below.

Comments from the community:

“Thank you for highlighting the risk that legalising assisted dying risks sabotaging efforts to improve pain management, palliative care and end of life care in countries where there is a poor commitment to human rights.”

“The vast majority of patients can die comfortably with good palliative care. Resources are better utilised enhancing good palliative care, rather than developing morally and ethically grey services (Euthanasia and Physician Assisted Suicide) that may only benefit a very small minority. Society should evolve to compassionately care for dying patients, and not evolve towards using euthanasia as a convenient but cold alternative.”

“It is a matter of urgency to stop this move to legalize Euthanasia, whatever else it may be called, PAS or MAID etc.”

“As a specialist physician in Palliative Care for 34 years I have assisted more than 30,000 people at the end of their lives. I have never killed anyone and find the idea abhorrent.”

“Human rights is the right to live till the end”

“We need palliative care not euthanasia”

“I support the APHN statement against Physician assisted suicide and Euthanasia”

“Respecting life is to allow the person to live to the end with holistic support”

“They say assisted dying doesn’t hurt palliative care. Sign up to show you disagree.”

“I fully support the APHN stance on resisting any law change on assisted dying”

“No to Euthanasia and Physician Assisted Suicide! We are committed to the defense of human life from womb to tomb. There is a time to live and a time to die. Let us not artificially prolong nor shorten life or the dying process. It’s all about respect, stewardship, and accountability.”

“To take care of Elders and Sick people is Asian tradition. We should generate multidimensional & creative ways to reduce the sufferings at the end-of-life, not PAS/Euthanasia.”

“End of life care/ care of terminally ill is NOT physician assisted suicide.”

“There can be no guaranteed legal protection for those that are vulnerable against coercion if euthanasia is legalised. The focus needs to be on equitable and good palliative care for all.”

“I wholeheartedly support the invaluable skill and support that is given to patients from our own Palliative Care team. I would also welcome more frontline education given to medical staff to enable more “to get on board with timely and compassionate” patient referrals to the Palliative team. I would also support more funding to enable more frontline staff to be trained and encouraged to “grow” Palliative services in our mainstream hospitals. Thank you”

“Better understanding of palliative care by both health professionals and the community is needed to overcome the myths of euthanasia and the slippery slope of legal quagmire if euthanasia was to be legalised in Victoria.”

“The Chinese word for euthanasia is 安乐死, which literally means “happy death”. However, “happy death” is not the same as “Happy. Death”

“Doctors never kill. Even at the last moment of life has its own values.”

“Palliative care provides comfort for patient till the end of their life, it does not provide comfort to end their life.”

“We need to find better ways to care for human beings that are suffering instead of silencing the sufferer through actions of euthanasia or to provide the means for assisted dying to occur. Fund better care options for the chronically ill and dying – not legislate against the living that are already vulnerable and need care”

Palliative Care Workshop on Suffering and Hope

Workshop On Suffering & Hope: 4 – 6 August 2017

This three (3) day workshop, in collaboration with the Asia Pacific Hospice Palliative Care Network, addresses how to deal with issues of suffering as many may not know how to give hope when all curative treatment becomes futile. It is most suitable for doctors, senior clinicians, nurses, psychologists, counsellors and especially those involved in making crucial decisions when the transitions from cure, to prolonging survival and palliation becomes the aim of holistic patient-centred care.

Please find here, the workshop program and registration form for those who are interested to attend. Registration submission can be made either online at our website: www.hospismalaysia.org or, emailed to: education@hospismalaysia.org or faxed to: 603 9133 3941. For further enquiries, please contact Wai Mun or Ira at telephone: 03 9133 3936 extension 267.

How to uphold patient dignity at the end of life

This article is from Palliative Matters.

According to Dr Harvey Max Chochinov, international expert in dignity and palliative care, dignity is not just a concept associated with managing bodily functions but also a dying person’s perception of how they are seen by others. For people who are dying, they feel a loss of dignity when focus on their illness or disease leaves them with the sense they have been defined generically as a patient and all they have.

The research also shows significantly higher rates of depression, anxiety and feelings of hopelessness in people experiencing a loss of dignity and healthcare workers have a responsibility in understanding the impact of their interactions with patients.

Read the full article here.

 

 

 

 

Rosalie Shaw Travelling Scholarship for Asia Pacific Hospice Conference 2017

Rosalie Shaw Travelling Scholarship

Dear APHN members

Greetings to you all!

APHN is pleased to invite applications for the APHN Rosalie Shaw Travelling Scholarship for the Asia Pacific Hospice Conference in 2017. This scholarship was created in honour of our former Executive Director, Dr Rosalie Shaw, to enable APHN members from resource limited countries to attend the Asia Pacific Conference. The successful applicant will receive support of up to SGD 2,200 to fund the conference registration, travel and accommodation.

Eligibility Criteria

  • Must be a current individual member of APHN
  • Nomination supported by 2 other APHN members
  • Display leadership qualities and works in a palliative care service
  • Contribution to palliative care development in your country of work or residence
  • Must submit an abstract for the APHC
  • Must submit a report on the benefits of attendance within 3 months after attending APHC
  • Has not received any grants from APHN for the past 5 years

Preference will be given to members who have not received sponsorship of any kind for attending regional and international palliative care conferences.

Applications must be submitted online here by the application deadline 31 January 2017.

The successful applicant will be notified by email. The disbursement of monies by the APHN Secretariat will be on a reimbursement basis on receipt of original receipts and/or invoices.

People with Alzheimer’s need more palliative care support

From Palliative Care Australia Press Release

Dementia and Alzheimer’s disease are the second leading causes of death in Australia, but patients often miss out on palliative care as they aren’t recognised as having a terminal condition.

Dementia is different from other terminal conditions because of the long, unpredictable course of the disease, difficult issues around capacity for decision making, difficulties in communication and lack of community understanding of the disease as a life limiting illness which requires palliative care.

Because of complications such as these, people with dementia may be unaware of, or denied access to, palliative care services.

Read the full release here.

Presentations available for download from 5th International African Palliative Care Conference

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Download the presentations from the 5th International African Palliative Care Conference, hosted in Kampala, Uganda from 16-19 August today! It is FREE!

The conference programme is available here, with access to corresponding presenter Powerpoints and video presentations, outlined below:

From ehospice

 

Communication – Paediatric Longitudinal Assessment of Needs (PLAN)

content%202%20-%20jul%20forum1From Lien Collaborative for Palliative Care Newsletter

The Paediatric Longitudinal Assessment of Needs (PLAN) framework, designed and used by the team to facilitate interdisciplinary communication during meetings, was presented at the monthly SHC-LCPC multidisciplinary forum. Mr Desmond Tan, a medical social worker, and Ms Li Kejia Lily, a registered nurse, both are part of the multidisciplinary team at home based Star PALS (Paediatric Advanced Life Support) programme at HCA.

There were five dimensions the team needed to assess.

  1. Physical and nursing care where diet and symptoms needed to be managed.
  2.  Practical and financial aspects such as the equipment loans and financial assistance.
  3. Spirituality for existential issues.
  4. Family and social aspects such as getting community and bereavement support.
  5. Handling grief, including negative emotions

Read the full article here.

Barry Ashpole’s Media Watch (#484)

Barry Ashpole Media Watch

The latest issue of Media Watch, compiled and annotated by Barry R. Ashpole (Ontario, Canada) can now be downloaded here. More reports can be found at IPCRC.NET

Articles from Asia Pacific Region:

Fresh call for improved palliative care in residential aged care

AUSTRALIA | Australian Ageing Agenda – 21 October 2016 – New data released this week showed that among 231,500 residents with completed Aged Care Funding Instrument (ACFI) appraisals in 2014-15, 9,144 residents, had indicated the need for palliative care. Odette Waanders, CEO of Palliative Care Victoria, found the gap between the need for palliative care among the residents and the recognition and response for it is of extreme concern. Qualitative research would be valuable to identify factors for the variability in facilities and for improvement in standards, said Ms Waanders. However, Professor Deborah Parker, director of the New South Wales Centre for Evidence Based Health Care, said it was important to distinguish that ACFI is a resource allocation instrument, not taken to represent the number of residents who require aged care facilities. https://goo.gl/hFcV6C

 Ministry considers program to share end-of-life wishes of elderly with ER doctors, paramedics

 JAPAN | The Japan Times (Tokyo) – 17 October 2016 – There is an increase in elderly terminally ill patients, and doctors have to try to revive them following collapse despite the patients’ wishes, they are unsure. The Health, Labor and Welfare Ministry will back a system that allows nurses, paramedics and doctors who provide home care for elderly patients to share information and makes a record of their end-of-life wishes. “Some fire department officials perform CPR regardless of the patients’ will. We need a guideline,” said Seishiro Marukawa, who heads the panel deciding on the guidelines. He also added that it’s best to respect the will of the patient and rely on their personal doctor rather than ER doctors and paramedics. “Many family members ask us to do everything we can,” Ryota Konishi who heads the emergency room at a hospital in Kawasaki said. “But if they have been bedridden for a long time and have no prospect for recovery, we aren’t sure if life support is the best option.”

 

Palliative care: The other opioid issue

From Nature

The ‘war on drugs’ has left many in developing nations with no access to strong painkillers. More than 5 billion people worldwide cannot get the medical opioids that they need. That is a staggering amount of unnecessary agony. – WE CAN DO SOMETHING ABOUT THIS!

Jim Cleary, an oncologist and palliative-care specialist at the University of Wisconsin–Madison – “Patients with pain have been unwitting victims of the war on drugs,” he says. The US-led war on drugs that followed resulted in widespread reluctance to prescribe and supply opioids for fear that patients would become addicted or overdose, or that drug cartels would divert opioids to the black market. Cleary says that countries such as the United States have an “unbalanced” opioid situation, and that abuse in these countries has distorted policies elsewhere, restricting legitimate access.

“It’s about the government and society at large accepting that while we have a responsibility to prevent abuse and diversion of opiates, we also have a responsibility to people in pain,” says former anaesthesiologist M. R. Rajagopal, who is a founder of palliative-care charity Pallium India in Thiruvananthapuram. Read more about the issue here.

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Please also check out “Life Asked Death” developing palliative care in Asia, a film on the Lien Collaborative Project by Lien Foundation and the APHN to find out what we are doing in other parts of Asia to relieve pain and suffering.

Barry Ashpole’s Media Watch (#483)

Barry Ashpole Media Watch

The latest issue of Media Watch, compiled and annotated by Barry R. Ashpole (Ontario, Canada) can now be downloaded here. More reports can be found at IPCRC.NET

Articles from Asia Pacific Region:

More Chinese committed to end-of-life care

CHINA | New China (Beijing) – 8 October 2016 – Currently, only a small proportion of patients can access hospice care, as the waiting list comes mainly from nursing homes and community health centers. It is China’s top priority to train more social workers and carers as experienced hospice workers are scarce.  There are 200 million Chinese who are over 60, with more than 40 million critically ill. Most of them are disabled, blind, or suffering from conditions like Alzheimer’s and aphasia, says Li Zan, director general of Changsha Shifangyuan. Tang Zhuozhuo, the oldest volunteer there, feels grateful to every person she accompanied as they helped her overcome her fear of death. At the Carnation Geriatric Hospital in Changsha, social worker Sangye Tashi describes his job as to love and accompany. He also finds it more worthy by helping these people pass away peacefully than singing for fans. https://goo.gl/fGsDOl

Article highlighted to be of particular interest:

Palliative care: Keeping hope alive for the terminally ill

AFRICA (Rwanda) | The New Times (Kigali) – 10 October 2016 – Every year, desperate family members abandon their loved ones in hospitals hoping for help, after being financially and psychologically drained. Concerns of lack of trained palliative care professionals, regulation of the use of painkillers and ignorance among caregivers at family level, among others are a big issue. Grace Kankindi, palliative care nurse, warns that despite regular supply of morphine, lack of support affects patients’ well being and stifles their recovery. https://goo.gl/gCEK7K

The AAP Resilience in the Face of Grief and Loss Curriculum

PEDIATRICS | Online – 10 October 2016 – In order to help pediatric health providers turn anxiety and grief into professional experiences, a curriculum on resilience and adaptation has been designed.  It addresses the intellectual and emotional characteristics they need to provide high-quality, compassionate care while also addressing active and intentional ways to maintain personal wellness and resilience. https://goo.gl/AUgmS9

Quality of life can be worth more than extending life at all costs

U.K. (Scotland) | The Scotsman (Edinburgh) – 7 October 2016 – It is vital to ensure that care and support is built around the needs of the patients and their wishes towards the end of their lives. Often, this is when medical interventions of little or no benefit may be given, contrasting to their wishes. Therefore, it is important to have better communication between patients, families and healthcare providers to plan for the future. When healthcare professionals see what matters to their patients, beyond the medications to be used, then will there be a shift from extending life to improving quality of life. https://goo.gl/jB2nfb