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A curriculum of palliative medicine for medical students in Japan
The first draft
January 2003
Working Party
KATO, Tsuneo. M.D. (Chairman)
Director of Hospital
Kato & Namiki-dori Hospital
BAN, Nobutaro, M.D.
Professor
Department of General Medicine
Nagoya University Hospital
MATOBA, Kazuko, M.D.
Geriatric Health Service Facility 'TAIYO'
MA:TOBA, Motohiro, M.D., Ph.D.
Assistant Professor
Department of Anesthesiology,
School of Medicine, Kitasato University
SAITO, Shinya, M.D.
Lecturer
Department of Gastroenterological Surgery and Surgical Oncology
Okayama University Graduate School of Medicine and Dentistry
Rev. SAITO, Takeshi
Chaplain
Diabetic Center
Tokyo Women's Medical college
Chaplain
Palliative Care Unit
Miyazaki City & County Medical Society Hospital
SATO. Hidetoshi, M.D., Ph.D.
Director, Assistant Professor
Office of Palliative Care
Dept. of Anesthesiology & Critical Care Medicine
Saga Medical School
YOSHIDA, Motofumi, MD, PhD (Medical Science)
Associate Professor
Center for Education Research in Medicine and Dentistry (CERMeD)
Tokyo Medical and Dental University
Index
1. The concept of palliative care (medicine)
2. Symptom control
1) Pain control
2) Other symptom control
3. Psycho-social issues
4. Ethical issues in palliative care (medicine)
5. Service delivery
6. Team approach
7. Communication
8. Cooperation with other disciplines
9. Caring families
10. Spirituality
11. Home care
12. Complementary therapies
13. Caring support-team members
1 The concept of palliative care (medicine)
Once a student has completed the course, he or she should be able to:
1) Attitude
a) Respect human's life as well as inevitable dying process
b) Offer to a patient psycho-social and spiritual care as well as physical care
c) Support a distressing family after a patient's death as well as a patient is under treatment
d) Hold palliative care philosophy to all patients who are suffering from non malignant diseases as well as cancer patients
e) Hold palliative care philosophy to all patients regardless to their clinicals stages.
2) Skill
a) Apply the basic communication skills
b) Describe the meaning and feeling of both one's own and family's death
3) Knowledge
a) Describe following definitions
1. Palliative care
2. Hospice and hospice care
3. Terminal care
b) Describe the history and the reality of palliative care in Japan
c) Describe for euthanasia with dignity
d) Describe for death with dignity
2 Symptom control
1 Pain control
1) Attitude
a) Listen to and accept a patient's complaints as he or she states
b) Try to relieve a patient's pain at first
3) Understand a patient's pain from physical, emotional, psycho-social, and spiritual aspects
2) Skill
a) Assess a patient's pain after taking a case history and physical observations
b) Describe an assessment plainly
c) Record an assessment's outcome
3) Knowledge
a) Explain the etiology of pains
b) Describe WHO's cancer pain relief guidelines
1. 5 protocols for using analgesics
2. Non opioid analgesics
3. Opioids
4. Adjuvant analgesics
c) Describe available opioids, and their subscription, chnical effects, side-effects (nausea and vomiting, constipation, drowsiness etc.)
d) Describe the treatments to opioids' side-effects
2 The other symptom control
1) Attitude
a) Describe the goal of a patient's symptom control
b) Consider a patient may have symptoms hesitate to say
c) Understand that symptom prevention is the important step for control
d) Keep in mind that medical interventions may have clinical limitation
e) Consider team approach to a patient and his or her family
2) Skill
a) Take a patient's case history and physical symptom assessment
b) Describe the assessment plainly
c) Record the assessment's outcome
3) Knowledge
a) Specify symptoms' diagnosis and treatment
b) Describe symptoms which may or may not improve by clinical interventions
c) Describe the clinical dying process
d) Describe symptoms have emotional, psycho-social and spiritual causes as well as physical etiology
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