Something's ironic in Denmark: An otherwise progressive welfare state lags well behind in care of patients at the end of life

Health Policy

Volumn 103, Issue 2-3, 2011, Pages 297-304

  Hoefler, James M ^a,b,c   Vejlgaard, Tove Bahn ^d,e,f  

^a DICKINSON COLLEGE   (United States)

^b Danish Institute for Study Abroad   (Denmark)

^c Carlisle Regional Medical Center Biomedical Ethics Committee   (United States)

^d Palliativt Team Vejle   (Denmark)

^e Danish Association of Palliative Medicine   (Denmark)

^f TRONDHEIM UNIVERSITY HOSPITAL   (Norway)

Author keywords

Hospice care; Palliative care; Terminal care

Indexed keywords

ARTICLE; CLINICAL PRACTICE; DENMARK; HEALTH CARE ACCESS; HEALTH CARE QUALITY; HEALTH CARE SYSTEM; HUMAN; MEDICAL EDUCATION; MULTICENTER STUDY; PALLIATIVE THERAPY; PROFESSIONAL COMPETENCE; RESOURCE ALLOCATION; TERMINAL CARE;

DENMARK; EDUCATION, MEDICAL; HEALTH EXPENDITURES; HUMANS; PAIN MANAGEMENT; PALLIATIVE CARE; PHYSICIAN'S PRACTICE PATTERNS; QUALITY INDICATORS, HEALTH CARE; QUALITY OF HEALTH CARE; RESOURCE ALLOCATION; SOCIAL WELFARE; TERMINAL CARE;

EID: 80255134475     PISSN: 01688510     EISSN: 18726054     Source Type: Journal    
DOI: 10.1016/j.healthpol.2010.11.012     Document Type: Article

References (50)

1. World Health Organization (WHO) The solid facts: palliative care 2009, WHO, Regional Office for Europe, Copenhagen. E. Davies, I.J. Higginson (Eds.).
2. The Economist Intelligence Unit. The quality of death: ranking end-of-life care across the world. Accessed 23 July 2010. http://www.eiu.com/site_info.asp%3Finfo_name=qualityofdeath_lienfoundation.
3. National Hospice and Palliative Care Organization (NHPCO). Commentary on position statement on artificial nutrition and hydration. National Hospice and Palliative Care Ethics Committee; Approved by the NHPCO Board of Directors, September 12; 2010. Accessed 19 November 2010. http://www.nhpco.org/files/public/ANH_Statement_Commentary.pdf.
4. Cherny N.I., Radbruch L. European Association for Palliative Care (EAPC) recommended framework for the use of sedation in palliative care. Palliative Medicine 2009, 23(7):581-593.
5. Shannon T.A. Nutrition and hydration: an analysis of the recent papal statement in the light of the Roman Catholic bioethical tradition. Christian Bioethics 2006, 12(1):29-41.
6. Walter J.J. Terminal sedation: a catholic perspective. Contemporary issues in bioethics 2005, 225-230. Roman & Littlefield, Oxford, UK. J.J. Walter, T.A. Shannon (Eds.).
7. Ministry of Health, Prevention (DK) Health care in Denmark 2008, Ministeriet for Sundhed og Forebyggelse, Copenhagen.
8. Ministry of Health and Prevention (DK).
9. European Commission European economic statistics 2009, Office for Official Publications of the European Communities, Luxembourg.
10. Centeno C., Clark D., Rocafort J., Flores L.A., Lynch T., Praill D., et al. A map of palliative care specific resources in Europe 2006, European Association for Palliative Care (EAPC) Taskforce on the Development of Palliative Care in Europe, Navarra, Spain.
11. Boerma W.G.W., Dubois C.-A. Mapping primary care across Europe. Primary care in the driver's seat 2005, 44-45. Open University Press, Berkshire, UK. R.B. Saltman, A. Rico, W.G.W. Boerma (Eds.).
12. Cashman C., Slovak A. The occupational medicine agenda: routes and standards of specialization in occupational medicine in Europe. Occupational Medicine 2005, 55:308-311.
13. Neergaard M.A. Palliative home care for cancer patients in Denmark [dissertation] 2009, Arhus University Faculty of Health Sciences, Arhus (DK).
14. Dickinson G.E., Field D. Teaching end-of-life issues: current status in U.K. and U.S. medical schools. American Journal of Hospice and Palliative Care 2002, 19:181-183.
15. Löfmark R., Mortier F., Nilstun T., Bosshard G., Cartwright C., Van Der Heide A., et al. Palliative care training: a survey of physicians in Australia and Europe. Journal of Palliative Care 2006, 22(2):105-110.
16. van Delden J.J., Löfmark R., Deliens L., Bosshard G., Norup M., Cecioni R., et al. Do-not-resuscitate decisions in six European countries. Critical Care Medicine 2006, 34(6):1686-1690.
17. Buiting H.M., van Delden J.J., Rietjens J.A., Onwuteaka-Philipsen B.D., Bilsen J., Fischer S., et al. Forgoing artificial nutrition or hydration in patients nearing death in six European countries. Journal of Pain Symptom Management 2007, 34(3):305-314.
18. Cohen J., Bilsen J., Fischer S., Löfmark R., Norup M., van der Heide A., et al. End-of-life decision-making in Belgium, Denmark, Sweden and Switzerland: does place of death make a difference?. Journal of Epidemiological Community Health 2007, 61:1062-1068.
19. Maltoni M., Pittureri C., Scarpi E., Piccinini L., Martini F., Turci P., et al. Palliative sedation therapy does not hasten death: results from a prospective multicenter study. Annals of Oncology 2009, 20(7):1163-1169.
20. Rietjens J., van Delden J., Onwuteaka-Philipsen B., Buiting H., van der Maas P., van der Heide A. Continuous deep sedation for patients nearing death in the Netherlands: a descriptive study. British Medical Journal 2008, 336:810-815.
21. Seale C. Continuous deep sedation in medical practice: a descriptive study. Journal of Pain and Symptom Management 2009, 39(1):44-53.
22. Miccinesi G., Rietjens J.A., Deliens L., Paci E., Bosshard G., Nilstun T., et al. Continuous deep sedation: physicians' experiences in six European countries. Journal of Pain Symptom Management 2006, 31(2):122-129.
23. Breivik H., Collett B., Ventafridda V., Cohen R., Gallacher D. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. European Journal of Pain 2006, 10:287-333.
24. Centeno, et al.
25. Neergaard; Dickinson, Field; Löfmark, et al.
26. Boerma, Dubois.
27. Breivik, et al.
28. European Commission, 158, 159.
29. European Commission, 59.
30. Dutta S. Global innovation index report 2009-2010. Fontainebleau (FR): INSEAD (European Institute of Business Administration); 2010. 231, 229, 331. http://www.insead.edu/elab.
31. Cashman, Slovak, 309.
32. Dickinson, Field.
33. Löfmark, et al., 107.
34. Löfmark, et al., 107, 109.
35. Boerma, Dubois, 44-45.
36. Continuing medical education requirements in western Europe typically require that physicians take 50 credit hours of classes per year. Desbois EJ, Pardell H, Negri A, Kelner T, Posel P, Kleinoeder T, Maillet B, Maisonneuve H. Continuing Medical Education in Europe: Evolution or revolution? MedEd Global Solutions; 2010, 6-11.
37. Boerma, 44-45.
38. van Delden, et al., 1687. Switzerland: 81%; Sweden: 71%; Belgium: 65%; Denmark: 59%; Netherlands: 57%; Italy: 37%.
39. Buiting, et al., 308. Switzerland: 10%; Sweden: 7%; Belgium: 7%; Denmark: 5%; Netherlands: 11%; Italy: 3%.
40. Maltoni, et al.
41. Rietjens, et al., 1 [Netherlands].
42. Seale, 1 [Great Britain].
43. Cohen, et al., 1065 [Denmark, Sweden, Switzerland, Belgium].
44. Miccinesi, et al., 125 [Italy].
45. Breivik, et al., 300, 307.
46. Breivik, 304.
47. For example, Denmark has a robust system of itinerant nurses who tend to patients in their homes and spends more on home assistance and accommodations for the disabled and the elderly than any other country in Europe except Sweden. European Commission. Social protection in the European Union. Eurostat: statistics in focus 2008. Luxembourg: Office for Official Publications of the European Communities; 2008, 10.
48. Inglehart R. World values survey [internet]. Ann Arbor (MI): University of Michigan Institute for Social Research; 2010. Accessed 9 May 2010 http://www.worldvaluessurvey.org/.
49. Life expectancy is shorter only in Ireland and Portugal. University of California Atlas of Global Inequality. Accessed 13 August 2010 http://ucatlas.ucsc.edu/spend.php.
50. Sandemose A. A fugitive crosses his tracks [English] 1936, Knopf, New York.