Helping others make the most of life

The scene in China

Butterfly Children's Hospice and the Children's Hospital of Fudan University had on Nov 19 jointly hosted an international forum to promote palliative care. The event in Shanghai was attended by medical professionals from Beijing, Shanghai, Hong Kong, Singapore and Malaysia.

Studies have found that there are 21 million children in the world in need of palliative care. In China, the numbers are estimated to be around 4.5 million though experts say that only few families have access to such care.

According to statistics from the World Health Organization, 98 percent of the provision of palliative care for children is in high-income countries, while 98 percent of the need is in low-and middle income countries such as China.

A March 2016 article titled Barriers in palliative care in China, published in medical journal The Lancet, cited that the country ranked 71st out of 80 countries in the 2015 Quality of Death Index by The Economist Intelligence Unit and is "facing difficulties from slow adoption of palliative care and a rapidly aging population".

Some of the obstacles to palliative care in China, the report added, is the perception that only dying patients require such medical attention, a shortage of national strategies and guidelines, and a lack of trained palliative care physicians.

"Although policy initiatives have been taking steps to promote and improve palliative care in China, the mainstream health care system in China is still structured in a way to prevent its developmentChina's health care reform is underway; the voice of palliative care needs to be strong so that it can be firmly integrated into future health care system," stated the report.

In the case of incurable conditions, patients are often given morphine for pain relief. While it has been proven that morphine can effectively relieve pain and even be safely administered to infants, studies have found that many medical professionals in China are still apprehensive about using the drug. Gould said that Chinese doctors often feel as if they might kill the child because of the perception that morphine is too strong a drug.

Due to drug abuse countermeasures in China and many other countries, only certain doctors are authorized to prescribe morphine. Gould, who often faces problems with acquiring the drug for use in Butterfly Children's Hospice, said that education about morphine needs to improve in China. She emphasized that morphine should be seen as a vital part of palliative care.

"The holistic approach of palliative care means that we don't just treat the medical condition but also think about other aspects such as how a child is thinking and feeling," said Gould.