LIFE Before Death Care Beyond Cure

"Care Beyond Cure"

Short Film 28 of 50 in the LIFE Before Death documentary series about the global crisis in untreated pain and the dramatic life changing effect palliative care services can deliver to patients and their families around the world.

In this Short Film we learn the importance of good care beyond cure, where illness cannot be cured and patients need good quality care when they are facing end of life. We learn that health care systems are generally not set up to deal with patients in this way, instead they focus on intervention, care and treatment, but there needs to be focus beyond this when cure is not possible.

"Part of the mentality of medicine is a fix-it mentality, we are living in this sort of consumer society where there are black and white solutions to things, and if you can't fix a problem then you don't want to deal with it because it's not something practical. I think people have put a much lower priority on the caring aspects of community, where we are now facing up to chronic disease, problems that can not be fixed so we have to live with them, and how do we live better with them, so I think pain control gets into that category of things," reflects Dr Cynthia Goh (Singapore)

Eugene Murray (Ireland) explains that there tends to be a culture in health care systems that health is about curing people. "For example, you take cancer, in the developed world, 50% of people who get cancer die within 5 years, so death and dying are an integral part of the cancer journey for almost the majority of cancer patients, now that's not a pleasant thing to be saying but so much of the dialogue about cancer care and integrated cancer care, rightly focuses on intervention and care and treatment but so little focuses on care of the dying."

"Modern medicine, till palliative care came into force had precious little to offer if cure was not possible. But that's forgetting the basic purpose of medicine, which is not only to cure when possible, but also to relieve symptoms and to comfort the patient as much as possible," explains Dr MR Rajagopal (India).

Dr Kathleen Foley (USA) continues; "When we use words like 'quality of life' you know people who have cancer who think that they could be cured, will say to you 'I don't care about my quality of life, I care about my quantity of life'. Then there's a point at which they then realize that their quantity of life is going to be shortened and then they do care about their quality of life."

Dr Jim Cleary (Australia) reflects on a personal experience he had with a patient facing end of life who requested physician assisted suicide, Dr Cleary explains that by listening to the patients concerns and working with them to relieve their pain the patient was able to make a more informed decision and was kept comfortable. As a result he had very good quality of life and was kept relatively pain free until he died, allowing him to fully engage with his family during his final months.

Dr Charles Von Gunten (USA) concludes; "Human illness is not just an aberration in the DNA, a bacterium that gets in the wrong place, a malfunction of a muscle somewhere. It's a person experiencing the consequences of that disease. Medicine, good medicine takes care of someone in their physical, emotional, practical and spiritual fears, those are all the responsibility of a doctor, they're all the responsibilities of a nurse, and the health care system as a whole."

Featuring: Dr Cynthia Goh (Singapore), Eugene Murray (Ireland), Professor Michael Cousins (Australia), Dr Natalya Dinat (South Africa) Dr MR Rajagopal (India), Dr Kathleen Foley (USA), Dr Jim Cleary (Australia), Dr Frank Ferris (USA), Dr Charles Von Gunten (USA).

LIFE Before Death comprises 50 short films themed around pain control and end of life issues, releasing one a week for a year from May 2011.

The project is presented by the Lien Foundation and produced by Moonshine Movies.

It is also supported by The International Association for the Study of Pain, The Mayday Fund, The Union for International Cancer Control and The Institute for Palliative Medicine at San Diego Hospice International Programs.

[YourAnjl]

I have two diagnoses that have no cure, so I turn to the issues of quality of life and what I truly want for whatever remains.  That is a critical focus for dying patients.

[LissaSun]

Wish someone would do a video on the states like Nevada that won't give pain care to pallative care patients any longer. It's misery trust me. Can't get it till hospice. My managed care only offers a for profit hospice and most people don't enter it till the last month of their lives. Having to think about moving states.

[Kazanlaw]

Dr Goh and her colleagues make some incredibly important points about how to live with diseases that have yet to be cured. Well done video with perspective.

[rozsa]

Um you know they should be ashamed with themselves to say no to pain relief of someone who really really needs it

[daniel]

in other words forget the Cure and just take a pain killer.

[madtaxpayer]

I do not understand why people feel they can step in and tell someone they do not have the to right to die when they want to die. It is their choice and should remain their choice. It is not about what everyone else thinks is ok, it's what that person thinks is ok. Misery is personal, and no one but the person suffering knows where that breaking point is between, I can do this and I cant do this. This is all about others not being able to deal with death and loss. But, again it is not about how we can or can't deal with someone else dying. The person that is ready to go is the central part of the scenarios and the choice should be left to them.