Abstract
Geriatrics Pioneer Dies
Robert (Bob) Butler, M.D. died of acute leukemia at Mount Sinai Hospital in New York City on July 4, 2010. He was followed by the palliative care team and died peacefully with his family beside him. Dr. Butler was widely regarded as the father of modern geriatrics in the United States. A Pulitzer Prize-winning author, Dr. Butler was the first Director of the National Institute on Aging and established the first freestanding Department of Geriatrics in the United States at Mount Sinai Hospital. In more recent years, he established and directed the International Longevity Center. Dr. Butler worked tirelessly and passionately to promote the development of palliative care in the United States. He was a member of the Board of Directors of the Project on Death in America's Faculty Scholar's Program and helped write the legislation to institute Palliative Care Academic Career Awards to be funded by the federal government and introduced by Senator Ron Wyden (D-Ore). He was deeply committed to the development of junior faculty in aging and palliative care and the model of career development that he initiated with the Brookdale National Fellowship Program has been emulated by multiple programs throughout the United States, including the National Palliative Care Research Center. Our field has lost a valuable friend and kindred spirit.
Nurses Afraid To Give Morphine
The national newspaper the Daily Mail in the United Kingdom reported that dying patients are being refused pain relief because nurses fear they will be prosecuted for assisted suicide. On the one hand, to professionals in hospice and palliative medicine, such beliefs seem absurd—particularly in the country that is responsible for disseminating palliative care to the rest of the world. However, it is also reassuring because, if this is still a challenge in the United Kingdom, then the rest of us do not need to feel as badly for not having made better progress in our own countries.
Canadian Report
A report presented to the Canadian Senate called upon federal, provincial, and territorial governments, community organizations, and professional associations to improve palliative care services for Canadians. In a report tabled in the Senate, Senator Sharon Carstairs set out a vision and goals for improved palliative care services, making 17 recommendations to serve as a roadmap to governments and the community for realizing that vision. “Canadians are still needlessly dying in pain and discomfort,” said Senator Carstairs. “We can and must do better. In the last 15 years we have made strides. Yet, we need to raise the bar. We will not have achieved success until we recognize that the passing of life is as important as the birth of that life. To realize a society where all Canadians have access to quality palliative care services we need five things: a culture of care, sufficient capacity, support for caregivers, integrated services, and leadership. The evolution of palliative care is being profoundly affected by the increase in chronic diseases. Combined with an aging population, the system is being stretched and tested as never before. Such reports will not help just Canada; the rest of the world will take note of what is an important issue for health care.
Sub-Saharan Africa
In 2008, there were an estimated 2 million AIDS-related deaths in sub-Saharan Africa. In many countries in this region there is little or no access to adequate pain medication, little or no access to hospice and palliative care, and desperate situations of suffering, stigma, poverty, and isolation. This is particularly acute for women and children. The Foundation for Hospices in Sub-Sarahan Africa, based in the United States, and the National Association of Social Workers in the United States have come together to share resources and information that may be potentially helpful to the other, to those providing care, and to individuals and families in sub-Saharan Africa suffering from HIV/AIDS, cancer, and other life-limiting illnesses. Efforts like these put the fractious efforts to improve palliative care in more developed countries in perspective.