Welcome to IPCRC.NET

IPCRC.net, the International Palliative Care Resource Center is dedicated to:

  • Making palliative care resources accessible for health care professionals
  • Building palliative care capacity worldwide
  • Providing a dynamic and constantly expanding website read more...close

Here you will find:

  • An extensive array of palliative care resources including comfort, supportive, hospice, end-of-life, terminal and bereavement care.
  • A design based on the Conceptual Framework of Palliative Care and the World Health Organization (WHO) Strategy for developing palliative care capacity.

Why use IPCRC.net?

  • Educational: Use the buttons in the Table of Contents to access the information you want.
  • Informative: Each link has a brief overview of the content at each website.
  • Fast: Downloads quickly even on a slow telephone connection.

We welcome your suggestions for new resources. Send your suggestions for new resources to .

Technical Issues? Contact gdraeger@sweetthursdayweb.com

Treat the Pain / LIFE Before Death

View, share, engage, discuss, learn about…

16. 'Pain in China'
16. Pain in China
There is a widespread cultural fear of the use of opioids in China and other parts of Asia. Pain is often treated with a variety of traditional Chinese medicine techniques rather than with essential medicines.

Read Overview / View the Archived Videos

Barry Ashpole's Media Watch 560: Increasing information dissemination in cancer communication: Effects of using "palliative," "supportive," or "hospice" care terminology

This experimental study was conducted at a major U.S. hospital serving a diverse population. Patients visiting a cancer clinic encountered opportunities to learn more about cancer care. They were offered health materials that were described as reporting on "palliative," "supportive," or "hospice" care and the primary outcome was whether a patient decided to select or reject each. As a secondary outcome, the study measured the patient's level of interest in receiving each. In this study, the terminology used had a large effect and, compared with alternatives, the information labeled as being about "supportive" care was significantly more likely to be selected. If these effects are supported by additional research, there may be low-cost, highly feasible changes in language choice that increase the dissemination of relevant health information. Abstract: view source »

Medical assistance in dying: A paediatric perspective

PAEDIATRICS & CHILD HEALTH, 2018;23(2): 125-130.
In June 2016, [Canada's] Bill C-14 was enacted, allowing medical assistance in dying (MAiD) for an eligible adult whose death is "reasonably foreseeable." An independent report on the status of "mature minors" (who are currently excluded under federal legislation), with focus on their potential eligibility for MAiD, was required by the 2016 Act and is expected to be presented to Parliament by December 2018. Ensuring that newborns, children and youth receive the highest possible standard of care as they are dying is a privilege and a responsibility for physicians and allied professionals. Bringing a thoughtful, respectful and personal approach to every end-of-life situation is an essential and evolving duty of care, and the process should meet each patient's (and family's) unique social, cultural and spiritual needs. This statement describes the current Canadian legal and medical context of MAiD and articulates a paediatric perspective that has emerged from – and been informed by – the broad, structured consultation process unfolding in Canada and elsewhere. Although "mature minors" are the only youth currently mandated for further legislative consideration in Canada, the need to examine requests for and attitudes around MAiD for minors of all ages remains compelling for two main reasons: Canadian health care professionals are increasingly being approached by the parents of "never-competent" infants and children, including those too young to make a reasoned decision, and by youth themselves, to discuss MAiD related issues; and, the discussion of MAiD policy in Canada has been framed as much by the issue and context of suffering as by considerations of autonomy. While current legislation clearly prohibits MAiD for incapable persons at the request of any other person, it is possible that parents may request MAiD on behalf of their dying child. Full text: view source »

Extract from the Paediatrics & Child Health article: The role of palliative care

Palliative care (PC) and medical assistance in dying (MAiD) provide philosophically and clinically distinct – though interconnected – medical services. Some parents and clinicians fear PC as being focused on death rather than on life, and education around PC often involves explaining its essential role in optimizing quality of life for as long as possible. If PC physicians were also to engage in the MAiD process, some practitioners believe that fear and apprehension might intensify. At the same time, however, PC practitioners have acquired invaluable wisdom and experience caring for individuals and families living with advanced illness. Requests for MAiD may still arise in the context of excellent PC, and the expertise and experience of PC specialists must remain available to families considering MAiD. Furthermore, paediatric PC physicians may also wish to participate in MAiD, if and when legislative changes extend MAiD to some paediatric patients. Irrespective of personal beliefs, access to high quality PC must be seamless for those in need, whatever end-of-life options are being contemplated.

The involvement of cancer patients in the four stages of decision-making preceding continuous sedation until death: A qualitative study

PALLIATIVE MEDICINE | Online – 18 April 2018 – Professional guidelines emphasize that the decision to initiate continuous sedation should be made in accordance with the wishes of the dying person and be preceded by their consent. Interviews were conducted with 26 physicians, 30 nurses and 24 relatives caring for 24 patients with cancer who received continuous sedation until death in Belgium, the U.K. and The Netherlands. The authors distinguished four stages of decision-making: initiation, information exchange, deliberation and the decision to start continuous sedation until death. There was wide variation in the role the patient had in the decision-making process. At one end of the spectrum (mostly in the U.K.), the physician discussed the possible use of sedation with the patient, but took the decision themselves. At the other end (mostly in Belgium and The Netherlands), the patient initiated the conversation and the physician's role was largely limited to evaluating if and when the medical criteria were met. The authors recommend building into clinical practice regular opportunities to discuss the goals and preferences of the person who is dying for their future medical treatment and care. Abstract: view source »

Download the complete issue (PDF 750 KB)

Review the 'Global Palliative Care News' Archive »

Read "Behind the Scenes: Media Watch by Barry Ashpole" »


Always Changing

Media Watch

EPERC Fast Facts: What's New (open access)
Review the latest EPERC Fast Facts; access all the Fast Facts

JCO Art of Oncology (open access)
New articles posted monthly… also read this special article:

Download

ELNEC Curricula in Russian and Spanish

  • contact Pam Malloy at for the English version

EPEC-Oncology Curriculum in English


Review the 'New on IPCRC.net' Archive »

New on IPCRC.net


WHO: Noncommunicable diseases country profiles 2011
The noncommunicable diseases (NCDs) situation in 193 countries

ESMO Guide: "How to Get the Most out of Your Oncologist: a Guide for Patients with Advanced Cancer" (PDF 2 MB)
For patients and their family members, it provides practical advice regarding cancer care, communicating with oncologists, important questions to ask, getting information and the challenges of living with an advanced cancer. For practicing oncologists, the guide will serve as a tool to help focus important discussions with their patients and to assist in addressing the many issues their patients are confronting.

I Was Sick and You Cared for Me: a Church-based Response to Palliative Care in Tanzania
A report of a two-year pilot project led by international NGO Tearfund, with support from the Diana Princess of Wales Memorial Fund, to introduce palliative care into the hospitals and remote communities of Tanzania's lake zone, in the north of the country. (PDF 946KB)

Palliative Care Development in Africa: How Can We Provide Enough Quality Care? R A Powell, F N Mwangi-Powell, F Kiyange, L Radbruch, R Harding. BMJ Support Palliat Care 2011;1:113-114

Thinking Ahead: My Life at the End
A resource for people with developmental disabilities to advocate for themselves and stay in control of their lives through the end of their lives. Open access. PDFs available in Chinese, English, Korean, Spanish

Pain Code: Get Pain Under Control Quickly, Charles von Gunten, Provost, the Institute for Palliative Medicine at San Diego Hospice on Medscape
How to get the pain under control quickly when there's a pain crisis.

Palliative Care: What Approaches are Suitable in Developing Countries? By Henry Ddungu, MD, Uganda, in the British Journal of Haematology 2011; 154(6): 728–735. PMID: 21707576.

Balsam: The Lebanese Center for Palliative Care
A non-governmental organization that works to relieve patient suffering and improve quality of life.

Variation between End-of-Life Health Care Costs in Los Angeles and San Diego: Why are They so Different? Kaplan RM. J Palliat Med. 2011 Feb;14(2):215-20. PMID: 21314574 Open Access.
Medical care, particularly at the end of life, is significantly more expensive in Los Angeles (LA) (> US $43,000 in the last 2 years of life) than in San Diego (< US $29,000), yet quality measures tend to favor in San Diego. Non-emergent hospital admissions and inpatient care at the end of life are important contributors to the cost differences. There is little reason to believe that the greater spending for health care in LA results in better patient outcomes

Early Palliative Care for Patients with Metastatic Non-Small-Cell Lung Cancer. Temel JS, Greer JA, Muzikansky A, Gallagher ER, Admane S, Jackson VA, Dahlin CM, Blinderman CD, Jacobsen J, Pirl WF, Billings JA, Lynch TJ. N Engl J Med. 2010 Aug 19;363(8):733-42. PMID: 20818875 Open Access.
Among patients with metastatic non-small-cell lung cancer, early palliative care led to significant improvements in both quality of life and mood. As compared with patients receiving standard care, patients receiving early palliative care had less aggressive care at the end of life but longer survival.

ACS: American Cancer Society International Fellowships for Beginning Investigators (ACSBI), Application Deadline November 01, 2011
The ACSBI fellowship emphasizes the transfer of knowledge from the host institute to others at the home institute. It offers the fellow the opportunity to be mentored by experts in the chosen field, receive hands on experience in clinical, behavioural or basic research, intellectual stimulation, research guidance, narrative transfer and many other opportunities to evolve scientifically and academically.

APCA: Special report on Palliative Care by the Africa Health Magazine supported by the Diana Fund (PDF 7.3MB)

Frank D. Ferris presents Goals and Challenges of Palliative Care on UCSD TV

Frank D. Ferris discusses Palliative Care on CFAX Canadian Radio (audio only)

Freedom from Pain, Al Jazeera TV, July 20, 2011

For many in the West pain ends with a pill, but elsewhere the war on drugs is cutting people off from pain medication.

Global Task Force on Expanded Access to Cancer Care and Control

An initiative convened by the Harvard Global Equity Initiative, the Harvard Medical School, the Harvard School of Public Health and the Dana-Farber Cancer Institute to design, implement and evaluate innovative, multi-stakeholder strategies for expanding access to cancer prevention, detection and care.

Hospice Palliative Care Association of South Africa Congress, August 2011

View videos of the congress presentations

Human Rights Watch: Ukraine: Uncontrolled Pain Ukraine's Obligation to Ensure Evidence-Based

This 93-page report describes Ukrainian government policies that make it impossible for cancer patients living in rural areas to get essential pain medications.

IOM Report: Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research (open access)

In this report, the IOM offers a blueprint for action in transforming prevention, care, education, and research, with the goal of providing relief for people with pain in America.

Kenya National Cancer Control Strategy 2011-2016 published in August 2011 (PDF 650KB)

The Lancet: Managing pain effectively, 25 June 2011; 377 (9784):2151 (open access)

An overview of The Lancet's new clinical Series focusing on treatments for postoperative, chronic non-cancer, and chronic cancer pain.

MECC: Can We Overcome the Effect of Conflicts in Rendering Palliative Care? An Introduction to the Middle Eastern Cancer Consortium (MECC) Current Oncology Reports 2011; 13 (4): 302-307, PMID: 21538041

"Pawsitive Pals"

A video highlighting San Diego Hospice's Pet Therapy Program

Republic of Georgia Updates

Watch several recent videos on palliative care; download the 2011-2015 Strategic Plan for Palliative Care

Stop Torture in Health Care, Open Society Foundations

The severity of the pain experienced by patients denied pain relief can be as great or greater than that of traditional torture techniques, and it can last longer. Although not acting out of malice, health workers and policymakers restrict access to pain medicines for inappropriate reasons such as exaggerated fears of addiction, failure to educate or train physicians in palliative care, arbitrary regulations on morphine-derived substances, and preoccupation with drug control rather than concern for people with pain.

Strategic Planning Summit for the Advancement of Pain and Palliative Care Pharmacy

The Summit was developed by a multidisciplinary advisory board including pharmacists, physicians and nurses to examine the education and development of pharmacists on pain and palliative care across the entire professional continuum.

Switzerland: National Cancer Program 2005 – 2010

Incorporating palliative care…PDFs available in French, German and English.

Wolfson International Bursaries 2011, Help the Hospices

This grant programme aims to increase and improve the provision of palliative care in commonwealth resource-poor countries.

5 Stories: highlights San Diego Hospice and The Institute for Palliative Medicine

Review the 'New on IPCRC.net' Archive »


IPM International Program Partners

The International Programs at the Institute for Palliative Medicine at San Diego Hospice is delighted to have many partners in our international work.

Review all our Partners

Funding Partners

The Office of International Affairs, National Cancer Institute, Bethesda, Maryland, USA OIA: Office of International Affairs, National Cancer Institute, Bethesda, Maryland
Open Society Foundations IPCI: International Palliative Care Initiative, Public Health Networks,
Open Society Foundations, New York
Diana, Princess of Wales Memorial Fund Diana Fund: The Diana, Princess of Wales Memorial Fund, London, UK
IAHPC: International Association for Hospice and Palliative Care IAHPC: International Association for Hospice and Palliative Care

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Page Last Modified: Tue Sep 6 2016