Joy Brann: "Representatives of this Network may be able to help other countries by lobbying for changes in drug regulations."
THE DEFINITION OF PALLIATIVE CARE
Dr Devaraj: "Palliative care is only one aspect of cancer control. In developing countries, facilities for basic cancer curative treatment are not yet fully developed. Many hospice programs have developed within Cancer Societies where cancer control is the main goal. There is concern that cancer cure may lag behind if scarce resources go to palliative care programs. In countries where there is still basic health needs such as for good water supplies, we must teach doctors and nurses to practise palliative care in their own work."
Mrs Nellie Fung: "Medication is only one aspect of palliative care. Caring counselling does not cost money and should be available from the time of diagnosis."
Mrs Ellen Nightingale: "But to tell bad news sensitively takes time, Health care is costed on tasks, not on time spent talking. Therefore, nurses feel frustrated because there is not sufficient time for counselling."
Dr Kashiwagi: "But hospice care can save money compared with care in hospital wards. Less money is spent with good results, Furthermore, with good listening skills, doctors and nurses do not have to spend so much time with patients because communication is more effective."
Dr Co-Shi Chantal Chao: "In Taiwan a study showed that although the nurse : patient ratio was higher in hospice (1 nurse : 1 patient) than in an oncology ward where chemotherapy and radiotherapy was given to the terminally ill (1 nurse : 3 patients), the hospice was cheaper."
Dr Cynthia Goh: "The only comparative cost study which has been published in the journal Palliative Medicine is the Barcelona Study."
EUTHANASIA
Dr Hong: "The Network needs to take a pro-active stand against euthanasia in view of the fact that a euthanasia law has been passed in two states in USA (under appeal at present) and in the Northern Territory in Australia. Three people have so far died with physician-assisted suicide in Australia since the euthanasia law was passed last year.
Dr Cynthia Goh: "In the past, palliative care has been seen to be the answer to calls for euthanasia. But now some palliative care physicians are pro-euthanasia."
Dr Maruya: "These patients are requesting euthanasia not because they are dying or because of physical pain. Instead they have deep existential fear."
Mrs Nellie Fung: "Does the physician have the right over life and death?"
Dr Sunaryadi Tejawinata: "In Indonesia, palliative care is seen to be passive euthanasia. There is a need to educate doctors about the goals of palliative care and clarification of the definition of euthanasia."
