Barry Ashpole Media Watch (#471)

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

Australia – Call for funds for a 20-bed refuge in Wollongong Central Business District

AUSTRALIA (New South Wales) | The Illawarra Mercury (Wollongong) – 15 July 2016 –  A month ago, John (not his real name) was given three months to live. Suffering end stage liver disease due to alcohol abuse and hepatitis C… the 44 year-old’s life expectancy was “measured in weeks, perhaps two to three months at most.” Yet on Monday, John was discharged from Wollongong Hospital; deemed ineligible for palliative care. He’d heard of the Wollongong Homeless Hub, so walked two kilometres from the hospital to Kenny Street service. He told workers he was scared he’d have no crisis accommodation after discharge; he was “afraid of dying on the streets”.

Specialist Publication – Palliative care: The other opioid issue

NATURE | Online – 13 July 2016 – Opioids have been a hot potato since the 1961 United Nations Single Convention on Narcotic Drugs. The U.S.-led war on drugs that followed resulted in widespread reluctance to prescribe and supply opioids for fear patients would become addicted or overdose, or drug cartels would divert opioids to the black market. [Jim] Cleary [oncologist and palliative care specialist at the University of Wisconsin-Madison] says countries such as the U.S. have an “unbalanced” opioid situation, and abuse in these countries has distorted policies elsewhere, restricting legitimate access. More than 5 billion people worldwide cannot get the medical opioids they need. That is a staggering amount of unnecessary agony. Cleary has been working with activists such as [pharmacologist Ravindra] Ghooi and [M.R.] Rajagopal [founder of Pallium India] advocating policies that recognize pain relief as a human right. Such work is slowly reshaping some national drug policies, but changing the status quo entails more than just arguing that patients have a right to opioids – campaigners must also help governments around the world to chart a course to the safe supply of these powerful painkillers.

New Zealand – A family requests that their grandmother, who does not speak English, is not informed of her terminal diagnosis

CLINICAL ETHICS | Online – 10 July 2016 – [This case study] focuses mostly on the issues of autonomy of patient and truth telling, but fails to highlight the most ethically salient feature of the case; the clinician did not talk to the patient. The case study notes that the patient spoke a dialect of Cantonese and felt that translation services might not have been readily available. This is unacceptable practice given the easy availability of professional telephone interpreters. In addition, it rendered the rest of the discussion academic as without a professional interpreter the clinician had no idea exactly what the family member who was interpreting was saying to their grandmother. This is an excellent case to discuss the ethics of the care of culturally and linguistically diverse people and the importance of interpreter use in patients with limited English proficiency. This case is also a good illustration of a limitation of clinical ethics committees. A common norm is that there is no patient involvement in the deliberations of the committee. Without any patient involvement, it is very difficult to understand the patient’s position (well illustrated in this case) and impossible to engage in dialogue to find an agreed management plan.

Specialist publications – Resource use and health care costs of chronic obstructive pulmonary disease patients at the end of life: A systematic review

JOURNAL OF PAIN & SYMPTOM MANAGEMENT | Online – 8 July 2016 – Patients with chronic obstructive pulmonary disease (COPD) in their final months of life potentially place a high burden upon health care systems. Concrete knowledge about resources used and costs incurred by those patients at the end of life is crucial for policymakers. Ten manuscripts fulfilled the [authors’] inclusion criteria. Three, five and two studies described European, North American and Asian health care settings, respectively. All … were published between 2006 and 2015. The authors’ observed variable resource use, an increased number of hospitalizations, intensive care unit stays, primary care consultations and medication prescriptions, as well as a lack of utilization of formal palliative care services… Specific cost items were not well described. The high use of health care resources in COPD patients in the final months of life suggests a focus on prolonging life and a tendency towards aggressive care.

Article highlighted to be of particular interest:

Law, perception, and cultural cognition near the end of life

WASHBURN LAW JOURNAL (Washburn University, Kansas), 2016;55(3)1-825. It does indeed happen all the time; facts and opinions are all jumbled together. Facts are portrayed as opinions and opinions are portrayed as facts. Some “facts,” it turns out, are opinions, or at least are functions of perspectives and values rather than what a scientist would consider to be “fact.” Facts and opinions are confused a great deal among the general public regarding scientific matters, perhaps because truly understanding science requires a degree of expertise many people do not have. Neuroscience – the science of the brain and the nervous system – is ripe for such confusion: confusion, which can cause great upheaval in medical settings. For example, “the most extraordinary end-of-life case ever” involved a family dispute over what most consider a neuroscientific fact – the diagnosis of a young woman as being in a vegetative state – that erupted into a nationwide spectacle. The case of Theresa Marie Schiavo [1990-2005] prompted twenty-four-hour-a-day news coverage, public protests, state and federal legislative action, and a papal pronouncement. The resulting “culture war” over whether to withdraw her life-sustaining treatment was a vivid reminder of how differently opposing sides of a dispute can view “facts.”

Published on: 5 August, 2016 | Last modified: 5 August, 2016