Palliative and End of Life Care in the Post-Pandemic Era: Old Problems and New Perspectives

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About this Research Topic

Submission deadlines

  1. Manuscript Submission Deadline 31 August 2024

Background

The problem of how to prolong life or accompany death is not new. It is one of the modern medical sciences' most emblematic issues, which Ivan Illich (1976) called the medicalisation of dying, highlighting its particular impact on the dying process in modern culture. In this context, palliative care (initially called "terminal care”) became synonymous with end-of-life management. It can be considered a postmodern specialty because it lacks a specific disease, bodily organ, or life stage to call its own. Therefore, it continues to be subject to prejudice, which relegates the role of palliative care to treating pain in dying patients (Masel & Kreye, 2018).

During the most critical phases of the COVID-19 pandemic, managing end of life became exceedingly complex, especially within emergency wards and intensive care units. This complexity extended even to countries and regions that had previously experienced high mortality rates and whose healthcare workers were well versed at providing compassionate palliative care despite resource limitations and during humanitarian crises (Glass et al., 2020). However, the significant global rise in COVID-19-related deaths further intensified and complicated the delivery of end-of-life and palliative care, requiring innovative approaches beyond existing approaches (Knights et al., 2020). For example, the use of ‘telemedicine’ has been found to be an effective approach to providing palliative care in low- and middle-income countries using readily available resources (Chávarri‐Guerra et al., 2021).

Many doctors and health professionals found themselves ill-prepared to navigate the difficult decisions surrounding ensuring everyone's right to both proper treatment and a dignified death (Nicoli & Gasparetto, 2020). As healthcare resources and facilities face unprecedented pressure, valuable lessons can be learnt from models of care in other settings around the world (Knights et al., 2020).

Although sociological analysis has provided several contributions over the years (e.g. Glaser and Strauss, 1965; Sudnow, 1967; Kaufman, 2005; Timmermans, 2005; Broom, 2015), end-of-life and palliative care are still relatively little-explored topics by health sociology.

This Research Topic aims to explore, particularly, the shifts in perceptions within medical and healthcare fields globally regarding palliative and end-of-life care during and after COVID-19; changes in palliative care models and heath policies in different health systems after the pandemic and their effectiveness (or ineffectiveness) at promoting and disseminating palliative care culture; if critical educational gaps in medical and health professions training in palliative care exist in different countries, and how sociology can help to overcome those gaps.

We welcome contributions from theoretical, empirical (quantitative, qualitative or mixed methods) and innovative research approaches on, but not limited to, the following themes:

• dying patient management in different healthcare settings;
• specific roles and models of palliative care in health systems and organizations;
• medical and health professions education in palliative and end-of-life care management;
• post-COVID-19 palliative care culture changes.

References
Broom, A. (2015). Dying: A Social Perspective on the End of Life (1st ed.) London: Routledge.

Chávarri‐Guerra, Y., Ramos‐López, W.A., Covarrubias‐Gómez, A., Sánchez‐Román, S., Quiroz‐Friedman, P., Alcocer‐Castillejos, N., et al. (2021). Providing Supportive and Palliative Care Using Telemedicine for Patients with Advanced Cancer During the COVID‐19 Pandemic in Mexico. The Oncologist, 26, e512-e515. doi: 10.1002/onco.13568

Glaser, B.G. and Strauss, A.L. (1965). Awareness of Dying. Chicago: Aldine de Gruyter.

Glass, M., Rana, S., Coghlan, R., Lerner, Z.I., Harrison, J.D., Stoltenberg, M., et al. (2020). Global Palliative Care Education in the Time of COVID-19. Journal of Pain and Symptom Management, 60, e14-e19. doi: 10.1016/j.jpainsymman.2020.07.018

Kaufman S.R. (2005). ...And a Time to Die: How American Hospitals Shape the End of Life. New York: Scriber.

Knights, D., Knights, F., and Lawrie, I. (2020). Upside down solutions: palliative care and COVID-19. BMJ Supportive & Palliative Care. doi: 10.1136/bmjspcare-2020-002385

Masel, E. K., & Kreye, G. (2018). Demystification of palliative care: what palliative care teams don't want you to think about them. Memo, 11, 193–195. doi: 10.1007/s12254-018-0420-2

Nicoli, F., & Gasparetto, A. (2020). Italy in a Time of Emergency and Scarce Resources: The Need for Embedding Ethical Reflection in Social and Clinical Settings. The Journal of Clinical Ethics, 31, 92–94.

Sudnow, D. (1967). Passing On: The Social Organization of Dying. Englewood Cliffs, NJ: Prentice Hall.

Timmermans S. (2005). Death Brokering: Constructing Culturally Appropriate Deaths. Sociology of Health & Illness, 27, 993–1013. doi: 10.1111/j.1467-9566.2005.00467.x

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Keywords: end of life care, dying patient management, medicalisation of dying, palliative culture, palliative education, end of life health policies, palliative care

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