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A Phased Plan for the Expansion of Hospice and Palliative Care

  • So Young Park (Department of Pulmonary, Allergy and Critical Care Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical Center)
  • Received : 2024.06.24
  • Accepted : 2024.07.17
  • Published : 2024.09.01

Abstract

Palliative care is a comprehensive approach aimed at improving the quality of life for patients and their families. The symptom burden and care needs of patients with end-stage, non-malignant diseases are similar to those experienced by patients with advanced cancer. Therefore, the World Health Organization (WHO) has recommended the expansion of palliative care to encompass a broad spectrum of diseases. However, in Korea, the adoption of palliative care for non-malignant conditions remains markedly low, presenting numerous challenges that differ from those associated with cancer. Key barriers to implementing hospice care for non-malignant diseases include the difficulty in predicting end-of-life and a general lack of awareness about hospice palliative care among healthcare providers, patients, and their families. Additionally, there is a risk that suggesting palliative care to patients with non-malignant diseases might be misinterpreted as an endorsement by healthcare providers to cease treatment or abandon the patient. This article explores strategies to broaden the scope of hospice and palliative care for patients with non-malignant diseases.

Keywords

Acknowledgement

This study was supported by a grant from the National R&D Program for Cancer Control, Ministry of Health & Welfare, Republic of Korea (RS -2023-CC140333).

References

  1. World Health Organization: Definition of palliative care [Internet]. Geneva: World Health Organization; 2022 [cited 2024 Jan 22]. Available from: http://www.who.int/cancer/palliative/definition/en/.
  2. WHO. Global atlas of palliative care. 2nd ed. London:Worldwide Palliative Care Alliance;c2020.
  3. Ministry of Health and Welfare. Enforcement Decree of the Act on Hospice and Palliative Care and Decisions on Life-Sustaining Treatment for Patients at the End of Life. Enforcement Date Feb 4 2018. Sejong: Korea Legislation Research Institute; c2019.
  4. Oh SN, Kim YA, Kim YJ, Shim HJ, Song EK, Kang JH, et al. The attitudes of physicians and the general public toward prognostic disclosure of different serious illnesses: a Korean nationwide study. J Korean Med Sci 2020;35:e401.
  5. Park SY. Palliative care approach and end-of-life care for patients with advanced COPD. OLD 2018;6:22-7.
  6. Rocker G, Horton R, Currow D, Goodridge D, Young J, Booth S. Palliation of dyspnea in advanced COPD: revisiting a role for opioids. Thorax 2009;64:910-5.
  7. Lunney JR, Lynn J, Foley DJ, Lipson S, Guralnik JM. Patterns of functional decline at the end of life. JAMA 2003;289:2387-92. https://doi.org/10.1001/jama.289.18.2387
  8. Assessing national capacity for the prevention and control of noncommunicable diseases: report of the 2019 global survey [Internet]. Geneva: World Health Organization; 2020 [cited 2024 Jan 22]. Available from: https://public.ebookcentral.proquest.com/choice/PublicFullRecord.aspx?p=31498649.
  9. van der Eerden M, Csikos A, Busa C, Hughes S, Radbruch L, Menten J, et al. Experiences of patients, family and professional caregivers with Integrated Palliative Care in Europe: protocol for an international, multicenter, prospective, mixed method study. BMC Palliat Care 2014;13:52.
  10. Radbruch L, Payne S. White Paper on standards and norms for hospice and palliative care in Europe: part 1: Recommendations from the European Association for Palliative Care. Eur J Palliat Care 2009;16:278-89.
  11. Temel JS, Greer JA, Muzikansky A, Gallagher ER, Admane S, Jackson VA, et al. Early palliative care for patients with metastatic non-smallcell lung cancer. N Engl J Med 2010;363:733-42. https://doi.org/10.1056/NEJMoa1000678
  12. Rocker GM, Simpson AC, Horton R. Palliative care in advanced lung disease: The challenge of integrating palliation into everyday care. Chest 2015;148:801-9.
  13. Croft M. Palliative care in end-stage COPD. Br J Gen Pract 2005;55:234.
  14. Harrison KL, Kotwal AA, Smith AK. Palliative care for patients with noncancer illnesses. JAMA 2020;324:1404-5. https://doi.org/10.1001/jama.2020.15075
  15. Doyle D, Woodruff R. The IAHPC Manual of palliative care [Internet]. 3rd ed. Houston, TX: IAHPC Press; 2013 [cited 2024 Jan 22]. Available from: https://hospicecare.com/what-we-do/publications/manual-of-palliative-care/.
  16. Hadler R, Aslakson RA. Advance care planning in 2024 and beyond-hoping for harmony amidst cacophony. JAMA Netw Open 2024;7:e2415408.
  17. Clark V. Death education in the United Kingdom. J Moral Educ1998;27:393-400. https://doi.org/10.1080/0305724980270308