Hospice Foundation of America
E-Newsletter
Volume 6, Issue 2
February 2006
http://www.hospicefoundation.org

 Message from David Abrams, President

In January, the Supreme Court ruled 6-3 in the case of Gonzales v. Oregon that the United States Attorney General could not enforce the Controlled Substances Act against physicians prescribing drugs for the assisted suicide of the terminally ill as permitted by an Oregon law. Writing for the majority, Justice Anthony Kennedy stated that, “The idea that Congress gave him [the US Attorney General] such broad and unusual authority through an implicit delegation is not sustainable.”

Hospice professionals and others who work in end-of-life care have been watching this case with interest. Many professionals share the concern that increased governmental and regulatory oversight into the prescribing of pain medications will put medical care in the hands of the law, and that doctors will be unduly scrutinized and limited in the help that they can offer to those affected by pain. This reality is being played out in other cases around the country, which is one reason that the Supreme Court ruling was reassuring.

Hospice has consistently provided a model system for the prescribing of controlled substances, and the appropriate delivery of these medications in a home setting. We encourage policy makers to support the good work of skilled medical professionals who have years of knowledge and experience in bringing good pain management to people facing a terminal illness.

Whatever your opinion may be on assisted suicide, if the decision had gone the other way, there would have been a risk that law enforcement agents, whose proper role should be prevention of drug abuse and diversion, would be evaluating the clinical practices of physicians whose patients die while receiving controlled substances.

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Yvette Colón is the Director of Education and Internet Services at the American Pain Foundation, and will be a panelist on HFA’s upcoming teleconference in April. Read an interview with Ms. Colón for an interesting discussion on some of the myths that surround pain management; suggestions on how to overcome these myths and other barriers; and resources that can help both health care providers and consumers ensure access to good pain management.

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What’s New @ HFA

HFA has posted two articles on its website that are relevant to issues surrounding pain management at the end of life. Both articles appear as chapters in HFA’s upcoming publication on “Pain Management at the End of Life: Bridging the Gap Between Knowledge and Practice.” The chapter by W.A. Drew Edmondson focuses on Policy Barriers to Pain Control (PDF). Attorney General Edmondson’s chapter addresses major challenges facing the health care and law enforcement communities in balancing the appropriate management of pain with efforts to prevent misuse and diversion of controlled substances. Drew Edmondson is Oklahoma Attorney General and past President of the National Association of Attorneys General; his chapter summarizes the effort of the National Association of Attorneys General and to address the policy barriers to effective pain control.

In their article Older Adults with Severe Cognitive Impairment: Assessment of Pain (PDF), authors Keela Herr, PhD and Sheila Decker, PhD, describe the science of assessing pain in older adults with severe dementia. In acknowledging that older adults with severe cognitive impairment can experience pain, they describe the process of observing for potential signs of pain by watching body language and behavior and by comparing present behavior with baseline. Herr and Decker also describe tools that are available for assessing pain and some of the limitations of the tools.

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Pain Management at the End of Life: Bridging the Gap Between Knowledge and Practice

One goal of HFA’s upcoming teleconference is to connect professionals and consumers with important resources on pain management. This month’s featured resource is the American Pain Foundation (www.painfoundation.org) The American Pain Foundation is an independent nonprofit organization serving people affected by pain through information, advocacy, and support. It serves as an information clearinghouse and resource center for people with pain, their families and their caregivers, the general public, health care professionals, policymakers, and the media. It promotes recognition of pain as a critical health issue, correcting damaging myths about pain and pain management and seeking to remove the stigma often experienced by those with pain. It advocates for changes in professional training, regulatory policies, and health delivery systems to ensure that people with pain have access to high quality care, encourages healthcare professionals to assess pain routinely and provide immediate, ongoing, effective care and mobilizes a national movement of organizations and individuals who care about better pain management.

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News from the Hospice World

The American Academy of Hospice and Palliative Medicine (AAHPM) is proud to announce the availability of PC-FACS (Fast Article Critical Summaries for Clinicians in Palliative Care), a new electronic publication that each month provides palliative care clinicians with concise summaries of important findings from more than 30 medical and scientific journals. This outstanding resource helps geriatricians, oncologists, pain specialists, and others interested in end-of-life care to stay on top of the latest research in the field, and its relevance to clinical practice.

To join the Academy, or sign up for a complimentary subscription to PC-FACS, visit www.aahpm.org/membership/PC-FACS

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Upcoming Conferences and Educational Opportunities

The Association for Death Education and Counseling (ADEC) Annual Conference, Grief and Loss: Wisdom and Insight, will take place March 29-April 2 in Tampa, FL. ADEC's 28th Annual Conference provides a multidisciplinary forum for the exchange of information in death education, care of the dying and bereavement counseling and support. Details are available on the ADEC Web site at www.adec.org/conf or e-mail adec@adec.org.

George Washington University offers its End-of-Life Care Programs, including a masters degree, a graduate certificate and an MS in Nursing in the field of End-of-Life Care. All three programs offer course work that provides insight, skills and expertise in three broad areas of study; grief and bereavement, the business of dying, and spiritual care. The degree programs also focus on leadership, innovation and change, and examine current issues and trends. For more information, go to http://www.gwumc.edu/healthsci
/Programs/EOLC/index.htm  or call Tina Le at (202) 994-0695.

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Site Coordinator’s Corner

Don’t forget--all registered sites will be automatically entered in a drawing to win one free box of companion books for this year’s broadcast! To be eligible for the drawing, be sure to register by February 17:
https://www.hospicefoundation.org/
teleconference/registration.asp

If you have questions or concerns about your registration, please send an email to telecon@hospicefoundation.org.

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This newsletter is sent to more than 6,400 subscribers on the 2nd Wednesday of every month to keep you informed of what is happening in the fields of hospice, grief and bereavement, and caregiving, as well as what's new at HFA.  We encourage you to forward this e-newsletter to an interest colleague or friend. To subscribe, go to HFA's E-Newsletter sign-up page.

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This newsletter is published by Hospice Foundation of America
David Abrams, President
http://www.hospicefoundation.org/
Board of Directors: David Abrams; Thomas E. Bryant, MD, JD; Myra MacPherson; Priscilla Perry; Patricia Spulak; Thomas Spulak
© Hospice Foundation of America 2006