Barry Ashpole’s Media Watch (#479)

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:

When parents disagree with doctors on a child’s treatment, who should have the final say?

AUSTRALIA (Western Australia) | The Conversation – 7 September 2016 – As the recent case of six year-old boy Oshin Kiszko highlights, some disagreements between doctors and parents can’t be resolved by further information and discussion. Oshin has brain cancer. His doctors believe he should receive treatment aimed at curing his disease, while Oshin’s parents believe the potential benefits of treatment don’t justify side-effects and other negative outcomes for their son, such as the possibility of long-term health issues. They want Oshin to receive only palliative care to ensure his comfort in the remaining months of his life. In March, Western Australia’s Family Court mandated Oshin be given chemotherapy. The most recent judgement, after another two court cases, supports a palliative pathway for Oshin as his chance of a cure has decreased. Oshin’s case is unique.1 Not all disagreements between doctors and parents reach court. Many are resolved in the hospital and many do not involve life-threatening conditions. In our recent research project, we investigated types of conflicts that can arise between doctors and parents in a pediatric hospital and the ethics of these situations. We developed an approach called the “zone of parental discretion” to assist doctors in deciding whether a parental choice should be overridden.2 This is a tool that holds it is ethical for doctors to accept a treatment option parents want, providing it is good enough, rather than insisting on the best possible treatment.

Hospice proposal illustrates failure to plan for palliative care

NEW ZEALAND | The Dominion Post (Wellington) – 7 September 2016 – Mary Potter Hospice’s plan for an apartment block in central Newtown graphically illustrates the challenge of looking after New Zealanders at the end of their lives. Residents question the need for a large multi-level building that will change their neighbourhood, but it’s a response to the changing landscape of palliative care(PC), which is failing in the face of growing demand. Hospices do an incredible job providing care about 11,500 people each year in their final stage of life. As people live longer, demand for PC is growing – and is increasingly being provided in other facilities. This year, around 10,500 people will die in an aged home. A Ministry of Health study says that figure is expected to almost double in 20 years, people will die in aged residential care than hospices, hospitals and private homes combined. Despite this trend, aged care facilities simply aren’t set up to provide the sort of wrap-around intensive care New Zealanders expect at the end of their life – in fact, aged care facilities currently receive no funding specifically for PC at all, despite its resource-intensive nature. The volume of PC the aged care facilities are now required to provide has led to some labelling members of the New Zealand Aged Care Association as “de facto hospices,” but without the resourcing or the recognition. This is largely due to policy failing to keep up with the changing nature of aged care. Rest homes aren’t seen as providers of PC, but the reality is soon most of us will die in one.

Article highlighted to be of particular interest:

Writing a “last letter” when you’re healthy

THE NEW YORK TIMES | Online – 7 September 2016 – Over the last 15 years, as a geriatrics and palliative care doctor, I have had candid conversations with patients near the end of their lives. The most common emotion they express is regret: regret that they never took the time to mend broken friendships and relationships; regret that they never told their friends and family how much they care; regret that they are going to be remembered by their children as hypercritical mothers or exacting, authoritarian fathers. And that’s why I came up with a project to encourage people to write a last letter to their loved ones. It can be done when someone is ill, but it’s realyl worth doing when one is still healthy, before it’s too late.

What it feels like to die

THE ATLANTIC | Online – 9 September 2016 – James Hallenbeck, a palliative care specialist at Stanford University, often compares dying to black holes. “We can see the effect of black holes, but it is extremely difficult, if not possible, to look inside them. The exert an increasingly strong gravitational pull the closer one gets to them. As one passes the ‘event horizon’, apparently the laws of physics begin to change. “What does dying feel like? Despite a growing body of research about death, the actual, physical experience of dying – the last few days or moments – remains shrouded in mystery. Medicine is just beginning to peek beyond the horizon.

Published on: 12 October, 2016 | Last modified: 12 October, 2016