Medical assistance in dying for palliative patients in different countries of the world: lessons on euthanasia legalization
Inter Collegas,
Год журнала:
2024,
Номер
11(2)
Опубликована: Июнь 30, 2024
Background.
The
practice
of
countries
in
legalizing
euthanasia
is
useful
for
other
that
have
not
yet
allowed
Medical
Assistance
Dying
(MAiD).
Palliative
patients
these
varying
levels
access
to
medical
care,
including
adequate
analgesia.
care
many
does
meet
the
needs
palliative
patients,
and
systems
hospice
are
often
poorly
developed.
MAiD
can
be
an
alternative
suffering
at
end
life.
Aim.
Analysis
legal,
social
financial
aspects
legalization
different
world.
Materials
Methods.
method
system
analysis,
comparative
bibliosemantic
were
used
research.
Results
Conclusions.
path
begins
with
a
wide
public
debate.
Important
opinion
professionals,
who
usually
divided
into
two
camps:
those
deny
necessity
humanity
euthanasia,
as
well
advocate
their
seeking
satisfy
persistent
conscious
desire
exercise
"right
die".
Countries
take
paths
speeds
legalize
euthanasia.
difference
between
models
legalized
lies,
first
all,
its
permitted
type
(passive
or
active),
distribution
age
categories
hopeless
(in
particular,
children),
incapacitated
cognitive
disorders.
Active
such
European
Netherlands
(since
2001),
Belgium
2002),
Luxembourg
2009),
Spain
2010),
Switzerland
2011).
Since
years,
there
has
been
change
attitude
towards
medically
assisted
death
Court
Human
Rights,
which
previously
categorically
regarded
intentional
murder.
In
all
active
discussion
continues
regarding
rules
implementation.
A
common
feature
already
approval
procedure
by
least
third
professionals.
Keywords:
suicide,
suicide
tourism,
Quality
Death
Index,
critically
ill
right
life,
die.
Язык: Английский
The controllability of pain in palliative medicine as a factor in the medical and social impact on the patients’ quality of life at the end-of-life
Experimental and Clinical Medicine,
Год журнала:
2024,
Номер
93(1), С. 69 - 86
Опубликована: Март 31, 2024
Availability
and
adequacy
of
analgesia
is
one
the
factors
that
significantly
influence
quality
life
palliative
patients.
At
current
stage
development,
system
hospice
care
in
Ukraine
will
not
provide
clear
pain
relief
for
majority
We
conducted
a
study
PubMed
Google
Scholar’s
sources
legal
acts
at
list
content
management
patients,
which
should
be
considered
their
work
by
medical
social
workers
providing
care,
as
well
health
managers.
proposed
to
expand
scientific
discussion
about
types
corresponding
analgesia.
The
regulatory
documentation
on
protocol
treatment
chronic
patients
revealed
compliance
with
modern
protocols
rules
systems
developed
care.
However,
we
also
found
practical
implementation
existing
varies
direction
non-enforcement.
came
conclusion
need
use
narcotic
non-narcotic
relievers
Ukrainian
medicine,
strengthen
material
technical
base
hospices
eliminate
staff
shortage.
article
covers
number
issues
pathophysiology
pain.
determined
both
causes
its
perception,
can
evaluated
several
scales
points,
are
important
issue
perception
an
adequate
reaction
simplifies
diagnosis
appointment
treatment,
excessive
"stoic"
complicates
them.
noted
involves
drug
therapy,
hypnosis,
cognitive-behavioral
physical
exercises,
physiotherapeutic
procedures.
Keywords:
pain,
nociception,
pharmacotherapy,
analgesics,
analgesics.
Язык: Английский
Readiness for dialogue regarding euthanasia of palliative patients in Ukraine
Experimental and Clinical Medicine,
Год журнала:
2024,
Номер
93(2), С. 79 - 88
Опубликована: Июнь 30, 2024
The
aging
population
of
Ukraine
and
the
severity
serious
diseases
increase
number
palliative
patients,
who
at
end
their
lives
need
to
reduce
suffering
ensure
ability
die
with
dignity.
lack
resources
shortcomings
mechanisms
for
organization
analgesia,
etiopathogenetic
treatment
comorbid
diseases,
full
care
support
presence
in
list
that
are
not
amenable
effective
require
an
alternative
slow
dying
through
use
euthanasia,
which
is
legalized
many
countries
world,
but
Ukraine.
An
anonymous
survey
relatives
(caregivers),
medical
social
workers,
volunteers,
priests
provide
services
scientists
research
issues
medicine
was
conducted
order
determine
attitude
towards
possibility
legalizing
euthanasia
desired
format
public
dialogue
about
such
legalization.
A
low
readiness
established
both
among
patients
relatives,
specialists
them
medical,
social,
spiritual
assistance.
Parents
children
diagnoses
(in
comparison
adult
guardians),
religious
(guardians)
atheists,
demonstrate
lowest
indicators
euthanasia.
In
activate
dignified
right
we
offer
a
scientific
analysis
foreign
practices
includes
needs
hospice
adults
these
Ukraine,
patient
satisfaction
treatment,
support,
presentation
results
studies.
Keywords:
care,
practices,
sociological
research.
Язык: Английский
Practical aspects of pain relief in palliative medicine
Inter Collegas,
Год журнала:
2024,
Номер
11(1), С. 57 - 72
Опубликована: Март 31, 2024
Background.
Treatment
of
chronic
pain
in
adults
and
children
is
regulated
by
the
national
standard
Ukraine,
which
recommends
adherence
to
choice
painkillers
accordance
with
WHO
three-step
protocol.
But
treatment
does
not
detail
use
according
nosological
units.
The
aim
work
was
determine
need
for
different
types
analgesia
palliative
patients
depending
on
main
diagnosis.
Materials
Methods.
System
analysis,
aggregation
bibliosemantic
methods
were
used.
list
diagnoses
determined
when
studying
forecasting
hospice
care
methodology
Ukrainian
Center
Social
Data
(2019),
improved
us
2021–2024.
Results
Conclusions.
conducted
research
made
it
possible
predominant
pain,
their
intensity
corresponding
groups
pharmaceutical
drugs
an
analgesic
effect
units
from
diseases
proposed
us.
Neuropathic
mainly
present
diabetes
(diabetic
polyneuropathy)
phenylketonuria.
Predominantly
nociceptive
cardiovascular
stages,
tuberculosis,
rheumatoid
arthritis,
cystic
fibrosis
hepatitis
children.
mixed
(nociceptive
neuropathic
at
same
time)
characteristic
HIV/AIDS,
epilepsy,
dementia,
multiple
sclerosis,
cirrhosis
liver,
obstructive
pulmonary
disease,
stage
kidney
disease
adults,
cerebral
palsy,
inflammatory
central
nervous
system
mucopolysaccharidoses
We
clarify
children,
define
necessary
non-steroidal
anti-inflammatory
drugs,
non-narcotic
analgesics,
weak
strong
opioids,
anticonvulsants,
antidepressants,
other
adjuvants
effect.
perspective
further
studies
dosage
calculate
level
reimbursement
under
"Affordable
Medicines"
program.
Keywords:
reimbursement.
Язык: Английский
Medical and social aspects of euthanasia of palliative patients in Ukraine, Switzerland, Canada, the USA and Israel
Medicine Today and Tomorrow,
Год журнала:
2024,
Номер
93(3)
Опубликована: Сен. 20, 2024
Medical
Assistance
in
Dying
(MAiD)
is
legally
used
such
countries
as
the
Netherlands,
Belgium,
Luxembourg,
Switzerland,
Colombia,
Canada,
Australia,
Spain,
Germany,
and
USA.
Portugal
New
Zealand
are
considering
legal
euthanasia
laws.
MAiD
performed
by
injecting
a
lethal
substance
into
terminally
ill
person
doctor
or
patient
himself.
Euthanasia
one
of
services
that
palliative
patients
need
last
months
days
their
lives.
The
availability
increases
country's
ranking
Quality
Death
Index
reduces
for
tourism.
Ukraine
needs
legalization
MAiD,
well
improvement
hospice
care
system
general.
research
was
conducted
using
methods
systematic
analysis,
comparative
method
bibliosemantic
with
search
literary
sources
acts
Google,
Google
Scholar
PubMed,
an
emphasis
on
Ukraine,
USA,
Canada
Israel.
During
it
concluded
Canadian
model
optimal
taking
account
experience
its
construction,
society's
perception
problems
related
to
application
legislative
norms
MAiD.
health
system,
practice
guided
social
work
models.
Legislators
respond
sensitively
thorough
scientific
court
decisions,
which
respect
state
institutions.
analyzed
results
USA
Israel
warn
researchers
legislators
against
possible
abuses
implementation
But
at
same
time,
they
attest
importance
accessible
procedure
patients,
should
be
available
realization
right
dignified
death
along
quality
medicine
life.
Keywords:
care,
reform,
Dying,
Index,
life,
die.
Язык: Английский
Justification of the model of optimized system of providing palliative and hospice care to the population of Ukraine
Inter Collegas,
Год журнала:
2024,
Номер
11(3)
Опубликована: Сен. 30, 2024
Background.
National
systems
of
Palliative
and
Hospice
Care
(PHC)
are
an
important
part
holistic
public
health
care.
According
to
ratings
(modified
Wright
М.,
Lynch
T.
Clark
D.
country
rating
system,
2008/2011;
Quality
Death
Index,
2015),
the
PHC
system
Ukraine
is
such
that
it
does
not
have
signs
systemic
organization
at
state
level,
provides
low
coverage
treatment
care
palliative
patients
(approximately
30%
need)
quality
(especially
analgesia)
predominantly
majority
(nearly
80%)
covered
patients.
Aim.
To
substantiate
model
optimized
on
basis
generalized
experience
countries
with
developed
results
own
scientific
research;
evaluate
model.
Materials
methods.
System
analysis
comparative
methods
were
used
in
study.
model,
a
sociological
method
was
used:
survey
specialists
carried
out.
The
evaluated
quartile
scale
(Q1–Q4).
Results
conclusions.
A
providing
population
developed,
which
outlines
subjects
objects
management,
goal,
strategy,
tactics,
functions
improved
management
directions,
methods,
measures,
resources,
regulation.
Scientific,
legal,
economic
administrative
solutions
proposed
improve
existing
order
organization.
parameters
reasonableness
consistency,
recognized
by
experts
as
high-quality
(the
assessment
within
Q4[75–100]%).
By
predictability,
correlativeness
resistance
changes,
well
according
general
assessment,
Q3[50–75]%).
evaluation
allows
us
propose
for
use
conditions
long-term
reform
uncertainty
wartime.
Keywords:
reform,
qualimetry,
expert
assessment.
Язык: Английский
Organizational and legal measures to prepare the system of palliative and hospice care of Ukraine for the widespread use of medical cannabis
Medicine Today and Tomorrow,
Год журнала:
2024,
Номер
unknown, С. 56 - 74
Опубликована: Янв. 1, 2024
In
Ukraine,
the
procedure
for
legalization
of
medical
cannabis,
which
is
needed
approximately
6
million
patients
with
cancer
in
palliative
stages,
multiple
sclerosis,
epilepsy,
lateral
amniotic
fibromyalgia,
arthritis,
HIV/AIDS,
glaucoma,
post-traumatic
stress
disorder,
Alzheimer's,
Parkinson's
disease,
Tourette,
Lennox-Gastaut,
Dravet
syndromes,
irritable
bowel,
back
pain,
chronic
pain
due
to
spinal
cord
injuries,
diabetic
neuropathy,
postherpetic
neuralgia,
being
completed.
Cannabis
necessary
such
overcome
spasticity,
nausea,
vomiting,
anorexia,
increased
eye
pressure.
It
can
be
a
supplement
treatment
other
pharmaceuticals
or
an
alternative
them.
On
eve
entry
into
force
relevant
law,
it
determine
main
directions
rapid
development
by-laws
(clinical
protocols,
instructions,
etc.)
start
wide
use
cannabis
clinical
practice,
particular
medicine.
Using
methods
systematic
analysis
and
bibliosemantic,
study
scientific
literary
sources
Google
Scholar
PubMed
was
conducted
properties
social
risks
its
use,
side
effects,
increase
illegal
recreational
herbal
cannabis.
The
experience
countries
where
has
already
been
legalized
(USA,
Canada,
Australia,
Denmark,
Germany,
Israel,
Switzerland)
studied.
list
normative
legal
acts
Ukraine
that
regulate
defined:
27
evidence-based
guidelines;
standards
protocols
care.
Possible
scenarios
are
identified
measures
proposed
adoption
final
decriminalization
determination
forecasting
need
patients,
creation
conditions
cultivation
Ukrainian
manufacture
domestic
pharmaceuticals,
reimbursement
their
cost
patients.
Keywords:
narcotic
painkillers,
marijuana,
PTSD,
anorexia.
Язык: Английский
Medical and social aspects of euthanasia of palliative patients in the Netherlands, Belgium and Germany
Experimental and Clinical Medicine,
Год журнала:
2024,
Номер
93(3)
Опубликована: Сен. 30, 2024
In
the
palliative
and
hospice
medicine
of
Ukraine,
there
are
a
number
unresolved
legal
organizational
problems
that
stand
in
way
dignified
existence
hopelessly
ill
patients
last
days
months
their
lives.
First
all,
these
issues
with
coverage
treatment
care
sufficient
categories
patients:
is
provided
mainly
to
oncological,
cardiovascular
neurological
profiles
treatment.
Secondly,
it
lack
adequate
analgesia
for
significant
inpatients
vast
majority
receiving
at
home.
Availability
recently
legalized
medical
cannabis
remains
low
patients,
euthanasia
not
legalized.
our
previous
research,
we
found
out
Ukrainian
society
ready
dialogue
about
need
legalize
euthanasia,
best
model
preparing
Canadian
one,
which
based
on
comprehensive
study
opinions
general
public
direct
participants
Medical
Assistance
Dying
(MAiD),
as
well
implementation
decisions
federal
court.
The
article
devoted
procedures
socio-medical
aspects
MAiD
Netherlands,
Belgium
Germany.
Certain
legalization,
its
context
circumstances,
compared
conditions
Ukraine.
an
original
theoretical
performed
using
method
systematic
analysis,
comparative
bibliosemantic
methods.
Note
clarifying
terminology
stages
study:
by
patient
himself,
doctor.
opinion,
Ukraine
needs
legalization
all
age
categories,
special
additional
consent
adult
incapacitated
patients.
experience
countries
current
comparison,
paid
attention
prevention
abuses
procedures,
frequent
disregard
norms
law
since
beginning
war.
Keywords:
care,
suicides
Dying,
right
life,
die.
Язык: Английский
Analytical study of the leading causes of death of palliative patients
Inter Collegas,
Год журнала:
2024,
Номер
11(4)
Опубликована: Дек. 30, 2024
Background.
Palliative
and
Hospice
Care
(PHC)
aims
to
prevent
premature
death
of
patients
from
complications
serious
illnesses
their
comorbid
impact
on
vital
functions.
As
well
as
adequate
pain
relief,
treatment
should
be
aimed
at
alleviating
suffering
improving
the
quality
life
such
patients.
The
causes
palliative
patients,
which
are
closely
related
PHC
organization,
in
particular
package
budget
financing
inpatient
mobile
care
for
adults
children,
leading
needs
remain
insufficiently
studied.
Aim.
Analysis
main
depending
diagnosis
determination
organization
hospice
care.
Materials
Methods.
method
system
analysis,
comparative
bibliosemantic
were
used
research.
Results
Conclusions.
Causes
studied
diseases
listed
severe
cases
presence
complications.
analysis
allows
us
deepen
our
understanding
practical
aspects
organizing
meeting
children.
summary
group
these
into
organ
failure;
vascular
crises;
asphyxia;
thromboembolic
conditions;
infectious
up
sepsis;
chronic
intoxication;
tumor
growth
other
organs
with
disruption
functions,
metastasis;
malignancy
benign
tumors;
treatment;
brain
spinal
cord
lesions
due
epileptic
seizures,
injuries,
inflammatory
processes;
endocrine
comas;
gangrene
bedsores;
immunodeficiency;
underdevelopment
or
absence
congenital
malformations;
prematurity;
suicides
depressive
states.
Keywords:
care,
primary
diagnosis,
comorbidity.
Язык: Английский
Civil society and palliative care
Experimental and Clinical Medicine,
Год журнала:
2024,
Номер
93(4)
Опубликована: Дек. 31, 2024
In
Ukraine,
the
participation
of
civil
society
in
development
Palliative
and
Hospice
Care
(PHC)
system
is
not
crucial,
since
professional
Non-Governmental
(Civil)
Organizations
(NGOs)
do
have
resources
powers
necessary
for
such
an
impact.
However,
experience
other
countries
shows
that
NGOs
creation
a
PHC
system,
which
should
be
among
"best
practices",
mandatory.
The
study
was
conducted
to
identify
areas
work
Ukrainian
provision
influence
on
state
policy.
using
method
analysis
bibliosemantic
method,
with
search
sources
by
keywords
English
Google,
Google
Scholar
PubMed.
consists
medical
care,
psychological,
spiritual,
social
legal
support
patients.
Medical
care
psychological
are
entrusted
healthcare
also
coordinate
areas.
actual
overload
workers
leaves
sphere
responsibility
services
NGOs.
specializing
palliative
mainly
associations
doctors
nurses
medicine.
Some
advocate
patients’
rights,
patients
their
relatives
(caregivers),
provide
support.
developed
systems,
can
organize
own
hospices,
coordination
centers
conduct
training,
scientific
research,
even
issue
licenses
care.
many
where
euthanasia
legalized,
had
significant
impact
legalization
process,
studied
public
opinion,
exerted
politicians.
scientists
developing
models
organizing
receive
greater
play
role
further
national
system.
Keywords:
hospice
support,
spiritual
advocacy.
Язык: Английский