Barry Ashpole Media Watch #490

Barry Ashpole Media Watch

Conversations with sick people have always been difficult. Read what not to say to a cancer patient! When is a patient sick, and when is a patient dying? Find out more in this issue of Media Watch! Also in this issue, read about the status of a public health approach to palliative care at New Zealand hospices. 

Articles from Asia Pacific Region:

What not to say to a cancer patient

THE NEW YORK TIMES | Online – 28 November 2016 – A diagnosis of cancer can tie the tongues of friends and family members or prompt them to utter inappropriate, albeit well-meaning, comments. Some who don’t know what to say simply avoid the cancer patient altogether, an act that can be more painful than if they said or did the wrong thing.

The status of a public health approach to palliative care at New Zealand hospices

PROGRESS IN PALLIATIVE CARE | Online – 1 December 2016 – There is growing international support for a public health approach to palliative care (PC); however, the status of the movement in the New Zealand context is unknown. Analysis of the quantitative results [of this mixed method study] confirmed that a public health approach to PC was a current priority at 60% of New Zealand hospices. However, both phases of the study demonstrated that community engagement, one of the chief out-workings of a public health approach to PC, was incompletely understood and practised. Furthermore, the qualitative results showed that, while this approach is supported, there are significant barriers to implementation, including paternalism, resource constraints, adequate evaluation, and incomplete understanding of key concepts, such as social networking and community engagement. This study is the first to explore the extent to which a public health approach to PC is supported by hospices in New Zealand. The unique new findings show that there is need for the model to be recognized in policy. Related to practice, if the model is to be implemented to maximum benefit, further conceptual clarity of the key tenets is needed. In addition, addressing the barriers to implementation identified by this study will need to be prioritized by hospice leadership.

Specialist Publications

The dying role: Its relevance to improved patient care

PSYCHIATRY, 2016;79(3):199-205. Society is failing to meet the obligation it has to its dying members. Persons with terminal illness suffer isolation and neglect in hospitals, receive overzealous treatment by physicians, and are kept in ignorance of their situation by families and medical personal. Evidence for these statements has come from observers of the medical care system and from dying patients themselves… In the nineteenth century it was common for persons to die in the familiar environs of their homes, surrounded by grieving families from whom they parted in a meaningful manner… Dying persons today no longer fill a well-defined social role. Instead, the distinction between the roles of sick and dying persons has been lost and, in the resulting confusion, the care of dying people has suffered. The purpose of this article is to clarify the distinction between the dying and sick roles, identify the signs of existing role confusion, suggest ways in which this confusion may be corrected, and show how re-establishment of the dying role can result in improved care for dying people. The important part physicians play in defining sick and dying roles is emphasized.

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