Barry Ashpole’s Media Watch (#473)

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 – Tasmania’s health system under pressure as federal funding dries up

AUSTRALIA (Tasmania) | ABC News (Hobart) – 28 July 2016 – There are concerns gaps are being left in Tasmania’s health system after a large Commonwealth cash injection dried up at the end of June. The [2012] $325 million Tasmanian Health Assistance Package included money for palliative care … but the money ran out on 30 June. Palliative Care Tasmania was one of the services funded by the package. It offered support and training on end-of-life care to more than 13,000 Tasmanians in the past 18 months. General manager Colleen Johnstone said Tasmania’s ageing population and high rate of complex chronic diseases meant end-of-life planning was particularly important in the island state. http://goo.gl/IFw9c9

Singapore – Taking care of cancer patients “more stressful than in West”

SINGAPORE | The Straits Times – 25 July 2016 – Caregivers of cancer patients … [in Singapore] … feel more burdened and stressed compared with their counterparts in the West, a study has found. And bucking the trend highlighted by previous such studies, male caregivers were found to have poorer qualities of life than their female counterparts. The two-year study of 258 caregivers in Singapore involved the answering of 35 questions on their physical and emotional state, as well as on things such as the level of social support they received. When the results were compared with those of similar studies overseas, Singaporean caregivers were found to fare worse than those in Britain, Canada and the U.S., but better than those from Iran and Korea. Associate Professor Rathi Mahendran of the Yong Loo Lin School of Medicine at the National University of Singapore, who co-led the study, said cancer patients in the West might rely less on their family, hence their family members are not taxed as much. In Canada, a family care- giver can take up to eight weeks of unpaid but job-protected leave per calendar year for each specified family member. http://goo.gl/M4HeIS

Singapore – Singaporean caregivers’ experiences of placing a relative into long term care

CLINICAL GERONTOLOGIST, 2016;39(3):167-189. Caregivers [i.e., study participants] were found to place significant emphasis on cultural values, specifically on filial piety. This impacted their care- giving role prior to placement, when making the decision to place their relative into a nursing home and in their continued involvement after placement. Despite the changing role, the placement experi- ence was fraught with persisting difficulties involving maintaining the relationship with the resident and developing a new relationship with the nursing home. http://goo.gl/u5BTql

Article highlighted to be of particular interest:

Dying well with reduced agency: A scoping review and thematic synthesis of the decision-making process in dementia, traumatic brain injury and frailty

BMC MEDICAL ETHICS | Online – 27 July 2016 – Three major themes arose from the review: First, the process of end-of-life decision-making took place in the context of the rhetoric of shared decision-making that included families and clinicians, but not, directly, the patients themselves. Patient wishes were sometimes overruled by doctors or families, which raises concerns about the fragility of the patient’s autonomy within this process. Nevertheless, patients lacking capacity influenced the decisions of others through a variety of passive and active means, and this dynamic is little studied in the papers reviewed here. Secondly, academic, public and professional discourse that presumed equivalence between minimal medical intervention in the dying process and a “good death” vied with counterfactual requests and behaviours when faced with death in reality. Poor understanding of death may drive this paradox, not just among the public, but among policy makers and healthcare professionals, suggesting that corrective intervention to increase understanding is a major challenge. Finally, the authors noted the tension between the increasingly international adoption of antecedent end-of-life decision-making and the difficulties in progressing this approach in countries where it is well established. While containing some interventions to promote antecedent end-of-life decision-making, the studies also documented widespread barriers to their use. Not least of these was the variety of personal perspectives on death, which suggests that parallel approaches require development. Together these three themes indicate a number of directions for future research in this area, which are likely to be broadly applicable to other conditions that result in reduced agency. Above all, this review emphasises the limits of current concepts and approaches to end-of-life decision-making, and the need for fresh approaches. http://goo.gl/lZFjtl