Journal of Pain & Palliative Care Pharmacotherapy. 2014;28:335. Copyright © 2014 Informa Healthcare USA, Inc. ISSN: 1536-0288 print / 1536-0539 online DOI: 10.3109/15360288.2014.972492
EDITORIAL
Dying in America and the World In September 2014, the Institute of Medicine (IOM), widely regarded as the preeminent health care policy body in the United States, published a report entitled Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life.1 In May 2014, the World Health Assembly passed a resolution entitled Strengthening of Palliative Care as a Component of Comprehensive Care throughout the Life Course.2 These two documents define the need for policy makers and clinicians world-wide to focus far more on quality end-of-life care. The World Health Assembly (WHA) is the governing body of the World Health Organization (WHO). As such, the WHA is a premier policy recommending body for health ministries worldwide. The resolution passed by the WHA recognizes that end-of-life care is not limited to patients with cancer as the earliest forms of palliative care often were perceived, but also must address other life-limiting conditions such as HIV, end-stage renal failure, advanced cardiovascular diseases and multi-drug-resistant tuberculosis. The resolution calls on health ministries to include palliative care in their policies and budgeting, and to recognize that many low to middle income persons with life-limiting illnesses do not receive care until their disease is far advanced. This issue of the journal contains an important commentary by De Lima and Radbruch entitled Palliative Care in the Global Health Agenda. As Executive Director and Chairman of the Board of Directors of the International Association for Hospice and Palliative Care (IAHPC), these authors provide context to and include the full WHA resolution. The IOM report documents that there is now a substantial body of evidence showing that improved end-of-life care is now possible. Adopting such care would not only enhance the quality of life through the end of life, the IOM posits, but may also help point us in the direction of a more sustainable health care system. The report goes on to emphasize the pressing need to improve end-of-life care. Identified factors which impede this occurring are barrier sin
access to care that disadvantages certain groups, a mismatch between the serviced patients and families need and the services they can obtain, inadequate numbers of palliative care knowledge among other clinicians who care for individuals with serious advanced illness, and a fragmented care delivery system spurred by perverse financial incentives that contributes to the lack of service coordination across programs and sustainable growth in costs. The report goes on to describe opportunities for improvement; the delivery of person-centered, family oriented end-of-life care; clinician-patient communication and advance care planning; and public education and engagement. It is now nearly 50 years since Cicely Saunders defined modern palliative care and created St. Christopher’s Hospice in London, England3 and Florence Wald brought hospice care to the United States.4 These two landmark reports suggest that palliative care may finally be receiving the priority and attention that it so sorely needs and deserves. Clearly the time has come for clinicians and policy makers worldwide to make quality palliative care a priority. Declaration of interest: The author reports no conflicts of interest. The author alone is responsible for the content and writing of the article.
Arthur G. Lipman
REFERENCES [1] Institute of Medicine. Dying in America: Improving quality and Honoring Individual Preferences Near the End of Life, Washington, DC, National Academies Press, 2014. [2] De Lima L, Radbruch L. Palliative care in the global health agenda. J Pain Palliat Care Pharmacother. 2014;28(4): this issue. [3] Lipman AG. Remembering dame cicely saunders. J Pain Palliative Care Pharmacother. 2006;20(1):31–32. [4] Lipman AG. Hospice care in the United States: A conversation with Florence S. Wald JAMA. 1999;281(18):1683– 1685.
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Copyright of Journal of Pain & Palliative Care Pharmacotherapy is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
EDITORIAL
Dying in America and the World In September 2014, the Institute of Medicine (IOM), widely regarded as the preeminent health care policy body in the United States, published a report entitled Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life.1 In May 2014, the World Health Assembly passed a resolution entitled Strengthening of Palliative Care as a Component of Comprehensive Care throughout the Life Course.2 These two documents define the need for policy makers and clinicians world-wide to focus far more on quality end-of-life care. The World Health Assembly (WHA) is the governing body of the World Health Organization (WHO). As such, the WHA is a premier policy recommending body for health ministries worldwide. The resolution passed by the WHA recognizes that end-of-life care is not limited to patients with cancer as the earliest forms of palliative care often were perceived, but also must address other life-limiting conditions such as HIV, end-stage renal failure, advanced cardiovascular diseases and multi-drug-resistant tuberculosis. The resolution calls on health ministries to include palliative care in their policies and budgeting, and to recognize that many low to middle income persons with life-limiting illnesses do not receive care until their disease is far advanced. This issue of the journal contains an important commentary by De Lima and Radbruch entitled Palliative Care in the Global Health Agenda. As Executive Director and Chairman of the Board of Directors of the International Association for Hospice and Palliative Care (IAHPC), these authors provide context to and include the full WHA resolution. The IOM report documents that there is now a substantial body of evidence showing that improved end-of-life care is now possible. Adopting such care would not only enhance the quality of life through the end of life, the IOM posits, but may also help point us in the direction of a more sustainable health care system. The report goes on to emphasize the pressing need to improve end-of-life care. Identified factors which impede this occurring are barrier sin
access to care that disadvantages certain groups, a mismatch between the serviced patients and families need and the services they can obtain, inadequate numbers of palliative care knowledge among other clinicians who care for individuals with serious advanced illness, and a fragmented care delivery system spurred by perverse financial incentives that contributes to the lack of service coordination across programs and sustainable growth in costs. The report goes on to describe opportunities for improvement; the delivery of person-centered, family oriented end-of-life care; clinician-patient communication and advance care planning; and public education and engagement. It is now nearly 50 years since Cicely Saunders defined modern palliative care and created St. Christopher’s Hospice in London, England3 and Florence Wald brought hospice care to the United States.4 These two landmark reports suggest that palliative care may finally be receiving the priority and attention that it so sorely needs and deserves. Clearly the time has come for clinicians and policy makers worldwide to make quality palliative care a priority. Declaration of interest: The author reports no conflicts of interest. The author alone is responsible for the content and writing of the article.
Arthur G. Lipman
REFERENCES [1] Institute of Medicine. Dying in America: Improving quality and Honoring Individual Preferences Near the End of Life, Washington, DC, National Academies Press, 2014. [2] De Lima L, Radbruch L. Palliative care in the global health agenda. J Pain Palliat Care Pharmacother. 2014;28(4): this issue. [3] Lipman AG. Remembering dame cicely saunders. J Pain Palliative Care Pharmacother. 2006;20(1):31–32. [4] Lipman AG. Hospice care in the United States: A conversation with Florence S. Wald JAMA. 1999;281(18):1683– 1685.
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Copyright of Journal of Pain & Palliative Care Pharmacotherapy is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
