Mouhawej Marie Claire
Saint Joseph University, Beirut, Lebanon
Title: Cultural Challenges in Implementing Palliative Services in Emerging Countries
Biography:
Mouhawej Marie Claire is working in Hôtel-Dieu de France Hospital. He has a research interest in palliative care. He gained his knowledge in the Saint Joseph University, Beirut, Lebanon & inspired many young researchers through her interests.
Abstract:
Palliative care (PC) has been defined by the World Health Organisation (WHO) as ‘an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial, and spiritual’.
Palliative care is a relatively new discipline in Lebanon although progress has been made in recent years. On 2004, The Ministry of Public Health introduced palliative care as a patient right in an article of the Law on “patients’ rights and informed consent” and established on 2011 a National Palliative Care Committee, with the mandate of elaborating national plans for research, education, practice and policy related to palliative care. This Committee launched on October 2012 the national strategies and plans to raise public awareness: introduction of a Primary Palliative Care curriculum into medical and nursing schools and primary care residency programs to ensure that all primary care physicians can provide a basic level of palliative care to the community; recognition of PC as a new specialty; incorporation the standards for Essential Palliative Care into the new hospital accreditation criteria to ensure that all hospitals in Lebanon are providing a minimum level of palliative care to their patients; introduction of new narcotic drugs to the market and facilitating the procedure to renew them.
Many hospitals have already special pain clinic and some of them introduced recently a consultant PC team (mobile team) but only 2 has PC unit. In our hospital, we launched PC services with an interdisciplinary team 3 years ago, then prepared for a PC unit with adequate local and equipments.
Attitudes and approaches to PC vary widely amongst religions and cultures. Decisions are influenced by the beliefs of the caregivers, patients and their families. Several studies stressed the importance of cultural issues when practicing PC. Concepts such as decision making, life support and advance directives, family involvement in the care, suffering and expression of pain, as well as religion and faith differ from one culture to another, and play important roles in how end-of-life care is perceived.
We describe cultural aspects of PC in our country and discuss, based on our clinical experience, the attitudes and practice of physicians and nurses in PC and challenges to implementing PC in emerging countries.