Palliative care and human rights in patient care: an Armenia case study

Luca, Gabriela B. de; Zopunyan, Violeta; Burke-Shyne, Naomi; Papikyan, Anahit; Amiryan, Davit

doi:10.1186/s40985-017-0062-7

Cited by 8 publications

(11 citation statements)

References 5 publications

(4 reference statements)

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“…The limited knowledge on the existence and aims of Palliative Care matched the little availability and development of Palliative Care services, (9,12). Characteristic appearances of caring at home, uninformed patients, importance of the family and limited accessibility ( nancial barriers) of Palliative Care corresponded with former research, (9,11,13). Varying understanding of Spiritual Care ("Spiritual care equals religion") and Social Care might indicate a lack of availability and knowledge.…”

Section: Discussionsupporting

confidence: 58%

“…As a result, hospitals often provide long-term care. Within the hospital setting, patients often remain uninformed about their medical condition and information is directed to the family instead, (11).…”

Section: Introductionmentioning

confidence: 99%

“…NCDs, especially cardiovascular diseases and cancer, are the primary cause of death in Armenia. Approximately 60-70% of Armenia's end-of-life patients would bene t from Palliative Care, (9,11). However, Palliative Care is a fairly new medical eld in Armenia with limited implementation: formation of a Palliative Care task force, integration of few Palliative Care teams and adoption of a "long-term sustainable national strategy for Palliative Care for 2017-2019", (9,12).…”

Section: Introductionmentioning

confidence: 99%

“…Besides challenging availability/accessibility of Palliative Care, lack of Palliative Care education and uninformed patients, remaining challenges include an uninformed public, widespread opiophobia and restrictive regulations on access to narcotics, limiting clinical availability: annually, only 3% of all patients in need, receive morphine, (9,(11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

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Improvable Education in Palliative Care A Qualitative Research About Palliative Care Education From the Perspective of Young Physicians

Hagedorn

Tadevosyan

Mason

et al. 2021

Preprint

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Background Due to i.e. demographic changes, an aging society and the increasing prevalence of non-communicable diseases, Palliative Care has become a relevant topic worldwide. The need for Palliative Care in Armenia is faced with inadequate care. (Undergraduate) education marks a major barrier to provide sufficient care and remains deficient. This research aimed to assess the current status of Palliative Care (undergraduate education) in Armenia and identify issues that need to be addressed. Methods Twenty Armenian first-year residents with different specializations were questioned in July – September 2016 regarding understanding/knowledge, experiences, self-perception of competence and expectations of Palliative Care and Palliative Care (undergraduate) education. These semi-structured interviews resulted in complete transcripts which were analyzed in a summarizing Qualitative Content Analysis subsequently. Results According to the interviews, Armenia’s health care system lacked sufficient Palliative Care and Palliative Care (undergraduate) education. Some topics, included in different subjects, only partially provided a clear understanding of typical Palliative Care patients/symptoms, approaches of incurable patients and missing training on breaking bad news. Challenges included emotional difficulties, communication of diagnosis/prognosis, uninformed patients and feared consequences for patients, families and physicians. Self-confidence in treating incurable patients varied. Stated wishes included increasing availability and accessibility of Palliative Care and extension of education in all levels (undergraduate, postgraduate, specialization). Conclusions Missing education resulted in misconceptions and ignorance of common Palliative Care concepts, expandable confidence in such situations and widely individual, varying, non-standardized approaches towards incurable patients. Palliative Care education needs to be implemented and expanded in Armenia. This research may set a base for further exploration in this field. It can be assumed that these specific results are also applicable to Palliative Care Education in other countries of the Caucasus region and beyond.

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Section: Discussionsupporting

confidence: 58%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Improvable Education in Palliative Care A Qualitative Research About Palliative Care Education From the Perspective of Young Physicians

Hagedorn

Tadevosyan

Mason

et al. 2021

Preprint

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“…Gabriela Barros de Luca, Violeta Zopunyan (a former HRPC Legal Fellow), Naomi Burke-Shyne, Anahit Papikyan, and Davit Amiryan, staff of the Open Society Foundations and the Center for Rights Development in Armenia, further apply the HRPC framework to the sphere of palliative care, examining the rights of both patients and providers. Through a case study in Armenia, they delve into the role of advocacy in creating an enabling environment for palliative care and HRPC more broadly [ 17 ].…”

mentioning

confidence: 99%

Human rights in patient care: a special collection

Ezer

Overall

2020

Public Health Rev

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This piece introduces the special Public Health Reviews collection on human rights in patient care (HRPC). Work on HRPC dates back to 2007 and an Open Society Foundations initiative in collaboration with partners in Eastern Europe and Central Asia. We found that for marginalized groups, health care settings often were places of coercion, punishment, and/or violence rather than of treatment or care. At the same time, health care providers often did not know of their legal obligations and how to incorporate human rights norms in their work. They themselves faced a lack of independence, unsafe working conditions, and sanctions for providing evidence-based care. Laws existed that could potentially address violations, but they were rarely enforced, and most people did not know what they were. HRPC brings human rights principles to health care delivery and addresses the rights of both patients and health care providers. It seeks to translate laws and procedures protecting rights into practical terms, linking national, regional, and international frameworks. The special collection explores various aspects of HRPC, including state responsibility in private health facilities, reproductive health, palliative care, and intersections with public health. It further explores dimensions relevant to particular populations, including Roma, people who use drugs, and transgender persons.

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Access to palliative and supportive care in the Philippines: A call to action

Corpuz

2023

Pall Supp Care

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Palliative and supportive care need is increasing in the Philippines due to rising mortality rate and noncommunicable diseases in addition to the COVID-19 pandemic (Corpuz 2023). The Philippines' palliative care is expected to rise due to increased prevalence of chronic diseases, increasing awareness, an aging population, government support, and technological advancements (Corpuz 2023). In the absence of a professional palliative care team, the immediate family serves as the caregiver of the dying patient. Culture, religions/traditions, and beliefs play an important role in every Filipino's life and death (Nambayan and Lu 2015). In far-flung areas like barrios or sitios, access to palliative care has been hindered by several factors such as the unavailability of pain medications and other treatments, expensive palliative care in hospitals, lack of proper guidelines, lack of government priority on palliative care, and a socio-cultural belief system that considers palliative and supportive care as nonessential (Poudel et al. 2019). This essay aims to contribute to literature on the need to integrate palliative care and supportive care in hospitals and hospices in the Philippine context.Palliative and supportive focus on the quality of life of patients and that of their families who are facing challenges associated with life-threatening illness, whether physical, psychological, social, or spiritual (Breitbart 2019; WHO 2020). Before the COVID-19 pandemic struck the world, Sleeman et al. ( 2019) report the first worldwide projection of future global burden of serious health-related suffering: "By 2060, an estimated 48 million people (47% of all deaths globally) will die each year with serious health-related suffering, and 83% of these deaths will occur in low-income and middle-income countries. " The World Health Organization (WHO 2020) estimated that 56.8 million people, including 25.7 million in the last year of life, are in need of palliative care.Access to such care is a fundamental human right, yet disparities in access persist globally, particularly in resource-limited settings (Breitbart 2008). In the context of palliative care, these rights extend beyond the right to health and include patient rights to freedom from torture, cruel and inhuman treatment, nondiscrimination and equality, bodily integrity, privacy and confidentiality, information, and right to a remedy (Barros de Luca et al. 2017). The Philippines, an archipelago in Southeast Asia, is home to over 110 million people and faces unique challenges in delivering palliative and supportive care services across its diverse population. Ho et al. ( 2023) found that a limited palliative care workforce, high out-of-pocket health-care costs, and low opioid availability all hinder access to palliative care in the Philippines. In addition, religious fatalism, strong family-ties, and physician reluctance to refer to palliative care providers represent contributory sociocultural factors. Breitbart (2019) opines that there is a need for novel interventions in pall...

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Palliative care and human rights in patient care: an Armenia case study

Cited by 8 publications

References 5 publications

Improvable Education in Palliative Care A Qualitative Research About Palliative Care Education From the Perspective of Young Physicians

Improvable Education in Palliative Care A Qualitative Research About Palliative Care Education From the Perspective of Young Physicians

Human rights in patient care: a special collection

Access to palliative and supportive care in the Philippines: A call to action

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