Palliative Care in Humanitarian Crises
Innovation or Radical Reclaiming of Roots?
DOI:
https://doi.org/10.21153/thl2019volno0art1033Keywords:
Palliative care, humanitarian action, compassionate careAbstract
Palliative care and humanitarian action share fundamental goals to relieve suffering and uphold dignity; and both hold an ethical root in the recognition of our common suffering in illness and dying, our compassionate action in response to suffering, and our common humanity. The parallels in goals and ethos should make universal application of palliative care in humanitarian crises a norm, but in humanitarian practice today this is not the case.
There is growing consciousness of the imperative to integrate palliative care into humanitarian response. Compassionate palliative care is steeped in humanitarian history, norms and ethics. ‘Small but potent’ acts of compassion are a profound and far-reaching element of palliative care response that can be delivered no matter how scarce the resources. In addition to meeting a neglected need, the broader practice of ‘small but potent’ acts of compassionate palliative care may serve to remind humanitarian actors of the very essence of a humane response and offer a radical reclaiming of the roots of humanitarianism.
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Abel, J., Walter, T., Carey, L., et al (2013), ‘Circles of care: Should community development redefine the practice of palliative care?’, BMJ Supportive and Palliative Care, 3:4, 383-388, doi: 10.1136/bmjspcare-2012-000359.
Al-Sakkaf, N. (2016), ‘What it’s like to be a cancer patient in Yemen today’, Al Jazeera [online] (23 March), www.aljazeera.com/news/2016/03/cancer-patient-yemen-today-160320071120122.html, Accessed 17 October 2018.
Aryal, D., Gentle, S., Goffi, A., et al (2015), ‘Nepal after the Disaster. Insider Points of view for the Future of Critical Care Medicine’, American Journal of Respiratory and Critical Care Medicine, 192:7, 781-784.
Bennett, C. (2018), Constructive Deconstruction: Imagining Alternative Humanitarian Action, HPG Working Paper (London: Humanitarian Policy Group, Overseas Development Institute).
Bogucki, S. and Jubanyik, K. (2009), ‘Triage, Rationing, and Palliative Care in Disaster Planning’, Biosecurity and Bioterrorism: Biodefense Strategy, Practice and Science, 7:2, 221-224, doi: 10.1089/bsp.2009.0025.
Bornstein, E. and Redfield, P (2010), Forces of compassion: humanitarianism between ethics and politics (Santa Fe: School for Advanced Research Press).
Bouvier, P. (2012), ‘Humanitarian care and small things in dehumanised places’, International Review of the Red Cross, 94:888, 1537-1550.
Bramley, L. and Matiti, M. (2014), ‘How does it really feel to be in my shoes? Patients' experiences of compassion within nursing care and their perceptions of developing compassionate nurses’, Journal of Clinical Nursing, 19:20, 2790, doi: 10.1111/jocn.12537.
Calhoun, G. (2008), ‘Chapter 7: The imperative to reduce suffering: charity, progress and emergencies in the field of humanitarian action’, in: Barnett, M. and Weiss, T. (eds), Humanitarianism in question: politics, power, ethics (New York: Cornell University Press).
Cassell, E. (2004a), The nature of suffering and the goals of medicine, (New York: Oxford University Press, 2nd edition).
Cassell, E. (2004b), ‘Pain and suffering’, in Post, S. (ed.) Encyclopedia of Bioethics (USA: Macmillan Reference).
Cherny, N. (2006), ‘Palliative care in situations of conflict: Lessons from Jerusalem’, American Journal of Hospice and Palliative Medicine, 23:6, 469-474, doi: 10.1177/1049909106294878.
Clark, D. (2016), To comfort always: a history of palliative medicine since the nineteenth century, (Oxford: Oxford University Press).
Colombo, S. and Pavignani, E. (2017), ‘Recurrent failings of medical humanitarianism: intractable, ignored, or just exaggerated?’, Lancet, 390, 2314-2324, doi: 10.1016/S0140-6736(17)31277-1.
Dawson-Goodey, E. (2011), ‘Simple kindness: the exceptional support she received from nurses taught Emma Dawson-Goodey about the art of care’, Nursing Standard, 25:37, 26-27.
de Laat, S., Hunt, M., Nouvet, E., et al (2018), ‘Dying in the margins: palliative care, humanitarian crises and the intersection of global and local health systems’, Fifth Global Symposium on Health Systems Research, Liverpool
de Waal, A. (2010), ‘The humanitarians’ tragedy: escapable and inescapable cruelties’, Disasters, 34:S2, S130-S137, doi: 10.1111/j.1467-7717.2010.01149.x.
Downar, J. and Seccareccia, D. (2010), ‘Palliating a pandemic: ‘All patients must be cared for’’, Journal of Pain and Symptom Management, 39:2, 291-295, doi: 10.1016/j.jpainsymman.2009.11.241.
Downing, J. (2014), ‘Palliative nursing and the Ebola crisis’, International Journal of Palliative Nursing, 20, 575, doi: 10.12968/ijpn.2014.20.12.575.
Dunant, H. (1959), A Memory of Solferino (Geneva: International Committee of the Red Cross).
Fink, S. (2018), ‘Nearly a year After Hurricane Maria, Puerto Rico revises death toll to 2,975’, The New York Times [Online], https://www.nytimes.com/2018/08/28/us/puerto-rico-hurricane-maria-deaths.html, Accessed 5 September 2018.
Gaita, R. (1999), A common humanity: thinking about love & truth & justice (Melbourne: Text Publishing).
Gaita, R. (2004), Good and evil: An absolute conception, London: Routledge, 2nd edition).
Gomez-Baptiste, X. and Connor, S. (2017), Building integrated palliative care programs and services (Catalonia: WHO Collaborating Centre, Worldwide Hospice and Palliative Care Alliance and “la Caixa” Banking Foundation).
Huffman, J. (2011), ‘Surgical palliative care in haiti’, Surgical Clinics of North America, 91:2, 445-457, doi: 10.1016/j.suc.2011.01.001.
Hunt, M., Chenier, A., Bezanson, K., et al (2018), ‘Moral experiences of humanitarian health professionals caring for patients who are dying or likely to die in a humanitarian crisis’, Journal of International Humanitarian Action, 3:12, doi: 10.1186/s41018-018-0040-9.
Kleinman, A. (1988), The illness narratives: suffering, healing, and the human condition (New York: Basic Books).
Knaul, F., Farmer, P., Krakauer, E., et al (2018), ‘Alleviating the access abyss in palliative care and pain relief-an imperative of universal health coverage: the Lancet Commission report’, Lancet, 391, 1391-1454, doi: 10.1016/S0140-6736(17)32513-8.
Medical Aid for Palestinians (2019), ‘The situation in Gaza is critical’ [Online], https://medicalaidforpalestinians.cmail20.com/t/ViewEmail/t/A90A3990312B115B2540EF23F30FEDED/D4024FAECDECBB2A7F4E5A579FEBB2E9, Accessed 17 June 2019.
Miles, S. (2005), Simone Weil: An anthology (London: Penguin).
Mistry, B., Bryant, D., Bainbridge, D., et al (2015), ‘What matters most for end-of-life care? Perspectives from community-based palliative care providers and administrators’, BMJ Open, 5, e007492, doi: 10.1136/bmjopen-2014-007492.
Nouvet, E., Sivaram, M., Bezanson, K., et al (2018), ‘Palliative care in humanitarian crises: a review of the literature’, Journal of International Humanitarian Action, 3:5, doi: 10.1186/s41018-018-0033-8.
Nouwen, H., McNeill, D. and Morrison, D. (2006), Compassion: A reflection on the Christian life (Doubleday: Random House).
Powell, R., Schwartz, L., Nouvet, E., et al (2017), ‘Palliative care in humanitarian crises: always something to offer’, Lancet, 389, 1498-1499, doi: 10.1016/S0140-736(17)30978-9.
Rattner, M. and Berzoff, J. (2016), ‘Rethinking suffering: Allowing for suffering that is intrinsic at end of life’, Journal of Social Work in End-of-Life & Palliative Care, 12:3, 240-258, doi: 10.1080/15524256.2016.1200520.
Redfield, P. (2013), Life in crisis: the ethical journey of Doctors Without Borders (Berkeley: University of California Press).
Ricoeur, P. (1992), Oneself as another, translated by Kathleen Blamey (Chicago: University of Chicago Press).
Rosoff, P. (2010), ‘Should palliative care be a necessity or a luxury during an overwhelming health catastrophe?’, Journal of Clinical Ethics, 21, 312-320.
Ryan, T. (2010), ‘Aquinas on compassion: Has he something to offer today?’, Irish Theological Quarterly, 75:2, 157-174, doi: 10.1177/0021140009360496.
Sasser, C. and Pulchalski, C. (2010), ‘The humanistic clinician: Traversing the science and art of health care’, Journal of Pain and Symptom Management, 39:5, 936-940, doi: 10.1016/j.jpainsymman.2010.03.001.
Schneider, M., Chappuis, F. and Pautex, S. (2018), ‘How do expatriate health workers cope with needs to provide palliative care in humanitarian emergency assistance? A qualitative study with in-depth interviews’, Palliative Medicine, 1-8, doi: 10.1177/0269216318794091.
Schneider, M., Pautex, S. and Chappuis, F. (2017), ‘What do humanitarian emergency organizations do about palliative care? A systematic review’, Medicine, Conflict and Survival, 33:4, 263-272, doi: 10.1080/13623699.2017.1409167.
Sinclair, S., Beamer, K., Hack, T., et al (2017), ‘Sympathy, empathy, and compassion: A grounded theory study of palliative care patients’ understandings, experiences, and preferences’, Palliative Medicine, 31:5, 437-447, doi: 10.1177/0269216316663499.
Sinclair, S., Norris, J., McConnell, S., et al (2016), ‘Compassion: a scoping review of the healthcare literature’, BMC Palliative Care, 15:6, doi: 10.1186/s12904-016-0080-0.
Sleeman, K., De Brito, M., Etkind, S., et al (2019), ‘The escalating global burden of serious health-related suffering: projections to 2060 by world regions, age groups, and health conditions’, Lancet Global Health, doi: 10.1016/ S2214-109X(19)30172-X.
Slim, H. (2015), Humanitarian ethics : a guide to the morality of aid in war and disaster (Oxford: Oxford University Press).
Smith, J. (2018), ‘Chapter 1: Difficult decision-making, compromise and moral distress in medical humanitarian response’, in: Ahmed, A., and Smith, J. (eds), Humanitarian Action and Ethics (London:Zed Books).
Smith, J. and Aloudat, T. (2017), ‘Palliative care in humanitarian medicine’, Palliative Medicine, 31:2, 99-101, doi: 10.1177/0269216316686258.
Spiegel, P., Khalifa, A., and Mateen, F. (2014), ‘Cancer in refugees in Jordan and Syria between 2009 and 2012: challenges and the way forward in humanitarian emergencies’, Lancet Oncology, 15, E290-297.
Spiegel, P. (2017), ‘The humanitarian system is not just broke, but broken: recommendations for future humanitarian action’, Lancet, doi: 10.1016/ S0140-6736(17)31278-3
The Sphere Project (2018), The Sphere Handbook: Humanitarian Charter and Minimum Standards in Humanitarian Response (Geneva: Sphere).
UN Department of Public Information (2016), ‘Near verbatim transcript of joint press stakeout by UN Special Envoy for Syria, Staffan de Mistura, UN Senior Advisor Jan Egeland and WHO Representative in Syria Elizabeth Hoff’ [online], https://reliefweb.int/report/syrian-arab-republic/near-verbatim-transcript-joint-pressstakeout-un-special-envoy-syria, Accessed 3 October 2018
Webster, S. (2015), ‘Tackling Ebola in Africa: a warning to the world’, Emergency Nurse, 23:6, 18-22.
Wilkinson, A. (2012), ‘The Potential Role for Palliative Care in Mass Casualty Events’, Journal of Palliative Care and Medicine, 2:2, doi:10.4172/2165- 7386.1000e112
Wilson, D. (2015), ‘Inside an ebola treatment unit: a nurse's report’, American Journal of Nursing, 115:2, 28-38, doi: 10.1097/01.NAJ.0000475288.30664.70.
Wolz, A. (2014), ‘Face to face with Ebola: An emergency care center in Sierra Leone’, New England Journal of Medicine, 371:12, 1081-1083, doi: 10.1056/NEJMp1410179.
World Health Organisation (2018). Integrating palliative care and symptom relief into the response to humanitarian emergencies and crises (Geneva: WHO).
Zaman, S., Inbadas, H., Whitelaw, A., et al (2017), ‘Common or multiple futures for end of life care around the world? Ideas from the ‘waiting room of history’’, Social Science and Medicine, 172, 72-79, doi: 10.1016/j.socscimed.2016.11.012.
