Lukas Radbruch1, Liliana De Lima2, Felicia Knaul3, Roberto Wenk4, Zipporah Ali5, Sushma Bhatnaghar6, Charmaine Blanchard7, Eduardo Bruera8, Rosa Buitrago9, Claudia Burla10, Mary Callaway11, Esther Cege Munyoro12, Carlos Centeno13, Jim Cleary14, Stephen Connor15, Odontuya Davaasuren16, Julia Downing17, Kathleen Foley11, Cynthia Goh18, Wendy Gomez-Garcia19, Richard Harding20, Quach T Khan21, Phillippe Larkin22, Mhoira Leng23, Emmanuel Luyirika24, Joan Marston17, Sebastien Moine25, Hibah Osman26, Katherine Pettus2, Christina Puchalski27, M R Rajagopal28, Dingle Spence29, Odette Spruijt30, Chitra Venkateswaran31, Bee Wee32, Roger Woodruff33, Jinsun Yong34, Tania Pastrana35. 1. Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany. Electronic address: Lukas.radbruch@malteser.org. 2. International Association for Hospice and Palliative Care, Houston, Texas, USA. 3. University of Miami Institute for Advanced Study of the Americas, Coral Gables, Florida, USA. 4. San Nicolash, Argentina. 5. Kenian Hospice and Palliative Care Association, Nairobi, Kenya. 6. Department of Onco-Anaesthesia and Palliative Medicine, All India Institute of Medical Sciences, New Delhi, India. 7. Wits Centre for Palliative Care, University of the Witwatersrand Johannesburg, Johannesburg, South Africa. 8. Department of Palliative Rehabilitation and Integrative Medicine, MD Anderson Cancer Center Houston, Houston, Texas, USA. 9. School of Pharmacy, University of Panama, Panama City, Panama. 10. Private Practice, Rio de Janeiro, Brazil. 11. New York, New York, USA. 12. Pain and Palliative Care Unit, Kenyatta National Hospital, Nairobi, Kenya. 13. Department of Palliative Medicine, Clinica Universidad de Navarra, Navarra, Spain. 14. Department of Medicine, IU Simon Cancer Center, IU School of Medicine, Indianapolis, Indiana, USA. 15. Worldwide Hospice Palliative Care Alliance, London, United Kingdom. 16. General Practice and Basic Skills Department, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia. 17. International Children's Palliative Care Network, Cape town, South Africa. 18. Division of Palliative Medicine at the National Cancer Centre Singapore, Singapore. 19. Clínica de Linfomas and LMA Cuidados Paliativos and Terapia Metronómica, Hospital Infantil Dr. Robert Reid Cabral, Santo Domingo, Dominican Republic. 20. Centre for Global Health Palliative Care, King's College London, London, United Kingdom. 21. Palliative Care Department, Ho Chi Minh City Oncology Hospital, Ho Chi Minh City, Vietnam. 22. Institut universitaire de formation et de recherche en soins, Universite de Lausanne, Lausanne, Switzerland. 23. Department of Palliative Care, Makerere University, Kampala, Uganda. 24. African Association for Palliative Care, Kampala, Uganda. 25. Health Education and Practices Laboratory, University Parisse, Villetaneuse, France. 26. Palliative and Supportive Care Program at the American University of Beirut Medical Center, Beirut, Lebanon. 27. George Washington University's Institute for Spirituality and Health, Washington, District of Columbia, USA. 28. Trivandrum Institute of Palliative Sciences, Trivandrum, Kerala, India. 29. Hope Institute Hospital, Kingston, Jamaica. 30. Australasian Palliative Link International, Melbourne, Australia. 31. Mehac Foundation, Kochi, Kerala, India. 32. Sir Michael Sobell House, Oxford University Hospital, Oxford, United Kingdom. 33. Melbourne, Australia. 34. College of Nursing Catholic, University of Korea, Seoul, South Korea. 35. Department of Palliative Medicine, University Hospital Aachen, Aachen, Germany.
Abstract
CONTEXT: The International Association for Hospice and Palliative Care developed a consensus-based definition of palliative care (PC) that focuses on the relief of serious health-related suffering, a concept put forward by the Lancet Commission Global Access to Palliative Care and Pain Relief. OBJECTIVE: The main objective of this article is to present the research behind the new definition. METHODS: The three-phased consensus process involved health care workers from countries in all income levels. In Phase 1, 38 PC experts evaluated the components of the World Health Organization definition and suggested new/revised ones. In Phase 2, 412 International Association for Hospice and Palliative Care members in 88 countries expressed their level of agreement with the suggested components. In Phase 3, using results from Phase 2, the expert panel developed the definition. RESULTS: The consensus-based definition is as follows: Palliative care is the active holistic care of individuals across all ages with serious health-related suffering due to severe illness and especially of those near the end of life. It aims to improve the quality of life of patients, their families and their caregivers. The definition includes a number of bullet points with additional details as well as recommendations for governments to reduce barriers to PC. CONCLUSION: Participants had significantly different perceptions and interpretations of PC. The greatest challenge faced by the core group was trying to find a middle ground between those who think that PC is the relief of all suffering and those who believe that PC describes the care of those with a very limited remaining life span.
CONTEXT: The International Association for Hospice and Palliative Care developed a consensus-based definition of palliative care (PC) that focuses on the relief of serious health-related suffering, a concept put forward by the Lancet Commission Global Access to Palliative Care and Pain Relief. OBJECTIVE: The main objective of this article is to present the research behind the new definition. METHODS: The three-phased consensus process involved health care workers from countries in all income levels. In Phase 1, 38 PC experts evaluated the components of the World Health Organization definition and suggested new/revised ones. In Phase 2, 412 International Association for Hospice and Palliative Care members in 88 countries expressed their level of agreement with the suggested components. In Phase 3, using results from Phase 2, the expert panel developed the definition. RESULTS: The consensus-based definition is as follows: Palliative care is the active holistic care of individuals across all ages with serious health-related suffering due to severe illness and especially of those near the end of life. It aims to improve the quality of life of patients, their families and their caregivers. The definition includes a number of bullet points with additional details as well as recommendations for governments to reduce barriers to PC. CONCLUSION:Participants had significantly different perceptions and interpretations of PC. The greatest challenge faced by the core group was trying to find a middle ground between those who think that PC is the relief of all suffering and those who believe that PC describes the care of those with a very limited remaining life span.
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