2016-02-09-noticia-ICS-entrevista

topic A TLANTES Lectures are lectures on a core palliative care topic, usually held annually at position by a leading member or representative of the international palliative care community discipline. They are organized by the ATLANTES Program of Institute for Culture and Society.

"From the beginning, we at ICS have sought multidisciplinarity and international outreach. Bringing in outstanding professionals enriches our speech, raises the level of our discussion and brings us innovative ideas to be able to go further in our research", says Carlos Centeno, researcher principal of the ATLANTES Program.

Philip Larkin, President of the association European Palliative Care, gave an ATLANTES Lecture entitled 'Compassion in Palliative Care. Bringing an abstract concept into everyday professional internship and academic publications'.

Why is compassion so important in palliative care?

Compassion opens the door to human relationship, which is, in fact, the basis of palliative care. It's generally about you as a human being being being with another human being. That is important and transforms the way people live their lives at the end of life. Doctors and nurses can learn that it's not always about qualifications or skills, but about taking the time to share inner moments. We do that through a compassionate response.

How can compassion be promoted in the internship of healthcare professionals?

I think people especially at the end of their lives expect us to treat them with compassion, but unfortunately, in recent years, and particularly in the UK, there has been a lot of criticism that nurses and doctors have lost compassion in their practices, and this leads to the question of how to provide end-of-life care. I firmly believe that if you can define compassion, explain what it is and demonstrate it, the internship of palliative care can be improved.

As is well known, the foundation of palliative care is based on the work of Cicely Saunders, a woman with deeply Christian values. If you read some of her books, particularly 'Watch with me', you will intensely perceive the fact that Christian values underlie her initial thinking. To some extent, since palliative care is now well integrated into the standard internship , I sometimes feel that we have lost sight of those spiritual values of caring, respect, dignity, listening to others, sharing... So I think, through Education, demonstrating it on internship, people receiving palliative care can see that those virtues and values underlie what we do, that it is not just an example of good medical internship , but that it is something more.

What is the main challenge of palliative care today?

I think is to make sure that we fit into the political diary of the countries; in some nations it is a subspecialty of Medicine and in others it is not even recognized. And the problem is that when you try to remind governments and politicians that it is an important topic for the population, they don't even know what it is.

And we [palliative care managers] ourselves have a problem: we are not always clear about the messages we put out. So I think one of the challenges for us in Europe is to have a very clear message about what palliative care is and what it can contribute to the quality of life of the population as a whole. If we do that, citizens will see that it is not a question of money; you can even integrate palliative without additional costs because it is often a way of developing the internship rather than a different internship in itself.

Can you mention some examples of good palliative practices in Europe?

Fortunately, through my work as president of the European Palliative Care association I have traveled to many countries and have seen many examples of good practice.

One of them may be the case of the Netherlands. They have a very good system of involving the public through volunteers, who are a very important part of the palliative care service. They have what they call "the buddy system": in some cases, the first person the patient sees is not a doctor or a nurse, but a volunteer. This is the person who introduces the service, so the patient sees someone from the community involved in the world of palliative care. And then the fear that people sometimes have about palliative care diminishes.

In Spain I am also impressed by the quality of Education and training. I am particularly interested in the interdisciplinary approach , the idea of uniting people from different disciplines in the same team.

And in my own country [Ireland], we developed the "compassionate community," which means involving everyone in the locality or in the community to understand how they can support someone around them. So it's not about commissions providing care, it's about the community understanding what this is all about.

How is it possible to involve society in palliative care?

One of the challenges is that many people need to understand what palliative care is and what it is not, so we need a process of engaging the public. We can do that through surveys, working with the media....

For example, in Portugal they made a very interesting project with sugar sachets. Just like in Spain, everybody in Portugal drinks coffee, and on the sugar packets they found a small message about what palliative care is. Every time they looked at it they found this information. And through assessment we found out that the population had improved their understanding of palliative care knowledge . In addition, it was successful in disseminating a clear message.

We have to find ways to engage people, and a big part of that is listening to their fears. If you can open the door to teach others what your work is about and then listen to any fears they may have about medication or treatments at the end of life, citizens will better understand what palliative care can do for them. 

Carlos Centeno: "We cannot make research in palliative care without having a point of contact with the clinical internship , which is impregnated with compassion".

Carlos Centeno, researcher principal of the ATLANTES Program of the ICS, assures that "compassion is more important in the internship of palliative care than in the research. However, we could not perform research in this discipline without having a point of contact with the clinical internship , which is impregnated with compassion".

"Somehow, it seems to me that talking about palliative care without talking about compassion and research in palliative care without having this contact with compassionate patient care wouldn't make sense," he says.

"One of the issues that the ATLANTES team is working on is promote compassion in society and to bring the positive vision of palliative care to society. We do not intend to bring a speech to society, but rather to highlight what we believe to be the intrinsic properties of palliative care. We want society to know the reality of palliative care, which has at its heart properties such as compassion and professionalism. In a way, it is advanced medicine for the end of life," he said.

"We want society to know that, faced with end-of-life situations that are difficult and compromising, there is a different way of dealing with them, a truly humane way that is also professional and advanced."