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 626: Honoring the moral concerns of caregivers afraid of giving morphine

This can create two potential barriers: a belief that morphine kills or a belief that if one agrees to it, she or he is giving up on a loved one, surrendering hope or even displaying insufficient faith in God's ability to heal. Moreover, for caregivers who are not used to giving medication and who are providing care at home, simply giving morphine with a dropper can be frightening. What if I give the wrong dose? What if she has a bad reaction? What if she dies because of me? What if she goes to sleep and never wakes up again? What if this clouds her mind and I never get to talk with her again? Such moral concerns can activate powerful ideas of loyalty, responsibility, and protectiveness that override education and reassurances from healthcare professionals. If we see resistance to morphine as rooted solely in knowledge deficits, emotions, or misconceptions, we may dismiss caregivers as oppositional or irrational. We may miss these deeper moral imperatives. Instead, it can be useful to recognize them when they arise, acknowledge them, and affirm the positive intentions at their core despite the ways such resistance may run counter to effective symptom management. Usually, if we take time to ask, this moral dimension reveals itself. Full text: view source »

Palliative care after the Liverpool Care Pathway: A study of staff experiences

BRITISH JOURNAL OF NURSING, 2019;28(15):1001-1007. The objective of this study was to explore nurses' perceptions of end-of-life care following the withdrawal of the Liverpool Care Pathway (LCP). Thirteen semi-structured interviews were conducted with nurses working in palliative care (PC). Three themes emerged: 1) Perceptions of the LCP; 2) Prevailing issues; and, 3) Patients' and families' experiences. This study suggested that the removal of the pathway has not remedied the issues attributed to it. Further, the way in which the LCP was removed indicates that the non-expert media can play a negative role in how palliative care (PC) is perceived, which inhibits the care process. In this respect it is important that "insider" voices are also heard, in order to educate and also redress disinformation. Similarly, broader, persisting, contextual challenges facing staff need addressing in order to prevent a repeat of the issues leading to the removal of the LCP. Abstract: view source »

From the lay press

Cancer treatment at the end of life

THE NEW YORK TIMES | Online – 5 August 2019 – Too often, people with incurable cancers pursue therapy beyond any hope of benefit except perhaps to the pockets of Big Pharma. There are many reasons this happens. Some patients won't acknowledge that their death is imminent, and some doctors won't admit to them that nothing more can be done to contain the disease. Others with unstoppable cancers think that if they hang in there long enough, a new treatment may come along to reverse their fate. And some patients hope to ward off the Grim Reaper until after a special event, like a child's graduation or wedding or birth of a grandchild. Still others succumb to the urging of family members to try everything modern medicine can offer. Even when people with advanced cancer are relatively healthy, attempting yet another round of treatment often worsens quality of life (QoL) in their final weeks, according to a 2015 study of patients with metastatic solid tumors and a prognosis of six months or less to live.1 About half the patients … opted for end-stage chemotherapy. For those who were sickest at the start, QoL in their last week was no worse than if they had skipped further treatment. But among the 122 patients in the best shape initially, QoL was significantly worse for the 56% who opted for further chemotherapy. Holly G. Prigerson of Weill Cornell Medical College, who directed the study, expected the healthier patients to do better and was surprised by the results. As Dr. Charles D. Blanke wrote about the study… "Chemotherapy is supposed to either help people live better or help them live longer, and this study showed that chemotherapy did neither."2 Sometimes, however, chemotherapy or radiation is offered to patients near the end of life to alleviate debilitating symptoms. But the goal of such palliative therapy should be made clear to patients lest it give them false hopes for a cure. view source »

1. 'Chemotherapy use, performance status, and quality of life at the end of life,' JAMA Oncology, 23 July 2015. [Noted in 27 July 2015 issue of Media Watch (#420, p.3)] Full text: view source »

2. 'Chemotherapy near the end of life. First – and third and fourth (line) – do no harm,' JAMA Oncology, 2015;1(6):785-786. Abstract: view source »

Download the complete issue (PDF 800 KB)

Review the 'Global Palliative Care News' Archive »

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


Crossroads of Grief Project -- Grieving or Bereaved Children: Literature Review (2015-2018)

The Children & Youth Grief Network of Peel Region (in Ontario, Canada) recently published a review of the literature focused on the many different aspects of grief and bereavement among children and young people. The main focus is on the evidence-based studies published in peer-reviewed journals, reflecting current thinking on the many issues identified. You can download/view an overview of the literature (PDF .8 MB) or the full literature review (PDF .8 MB).


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: Sun Jun 30 2019