Dr Rosalie Shaw:"There is also a danger that those who practise palliative care can become insular. Others can also teach palliative care practitioners...Hospice care is a philosophy care and should be part of the training of all health care professionals."
Mrs Nellie Fung: "Palliative care should be part of the undergraduate medical program so that doctors realise that they cannot cure everyone."
Dr Cynthia Goh: "In Adelaide, Australia, palliative care is introduced in every year of the medical course,"
Dr Sunaryadi Tejawinata: "The teaching of palliative care to family doctors is very important."
Dr Kashiwagi: "There are now four Chairs of Palliative Care in the United Kingdom, five in Australia. Japan will also have a Department of Palliative Care. This will help bridge the gap between cure and care."
Mrs Ellen Nightingale: "Nurses do not have a Specialist College system. However, palliative care interest groups for nurses have been established in Australia."
Dr Smales: "Nurses are concerned about recognition of their skills. In USA there are now examinations which give accreditation."
Dr Kashiwagi: "Hospice has been weak on the scientific side, that is in research. A balance is needed."
Mrs Ellen Nightingale: "How can we measure 'care'?"
Dr Cynthia Goh: "We can now measure quality of life,"
DRUG AVAILABILITY
Dr Devaraj: "Many doctors do not want to use morphine."
Joy Brann: "There is an ethical dilemma. In the region, many do not have access to health care because of a deficiency of resources. How can we justify the use of resources for palliative care when others do not have basic health care? Furthermore, many countries do not have oral morphine available but those who have money can obtain expensive preparations of morphine such as slow release tablets."
Dr Sunaryadi Tejawinata: "In the Indonesian population of 200 million people there is an incidence of 180 cancer cases in 100,000. This means that there are 200,000 new cases of cancer each year with more than 50% of these being at an advanced stage."
Dr Hong: "In Korea, MST (slow release morphine) 10 mg and 30 mg tablets are available but no regular release morphine sulphate because the government is afraid that an increase in the amount of opiates available will result in an increased number of addicts. One patient needed 1300mg of morphine per day to control pain. This would mean taking 40 MST tablets a day and so the cost is prohibitive."
