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The July digest revisits the approach to palliative care. Why is it vital to understand and respect cultural differences? Should we listen to older patients to deliver better-quality palliative care? And what about children? What competencies does a doctor need to stay proficient in the psychological aspects of palliative care? Lastly, we will review the latest vote in the House of Commons that opened the door for legalising assisted dying in England and Wales—is it a matter of freedom of choice or an illusion of free will? Read more in the articles below.

If you wish to continue any of the topics listed below in the form of a discussion or webinar, please do not hesitate to contact us at info@paced.org.uk.
Primary Mental Health Competencies for Palliative Care Physicians

Psychological support is a vital element of palliative care—both for patients living with serious mental illnesses or substance use disorders and for many others facing anxiety, depression, or emotional distress at the end of life. Physicians require clear guidance. In this article, an international expert group introduces, for the first time, a consensus-based set of core psychiatric and psychological competencies for palliative care doctors.

The authors identify 36 competencies, organised into three key domains: the psychological foundations of serious illness care, psychiatric conditions in the context of palliative care, and a systems-based approach to team and interdisciplinary practice.

This article provides a useful resource for clinicians to evaluate and improve their skills, for educators to create effective training programmes, and for organisations to enhance systemic improvements in the quality of palliative care.
Read: https://www.sciencedirect.com/science/article/pii/S0885392425006578

What Do Children Want? Rethinking the Approach to Paediatric Palliative Care

While adult patients’ preferences have long been included in clinical palliative care, understanding the wishes and priorities of children remains a complex and underexplored area. We need a more sensitive and inclusive approach to truly grasp what matters most to seriously ill children and their families.

This article examines key aspects of such an approach, including:
  • Why it’s vital to consider not only the perspectives of parents and clinicians, but also the voice of the child,
  • How age, developmental stage, and cultural context influence the child’s experience of care,
  • Why the desire to ‘live a normal life’— being with peers, going to school—is often a central priority for children.
  • And how misunderstandings between parents and care teams can cause conflict.
Ultimately, this is not just about medical treatment; it’s about creating a care system that respects the child’s voice, supports the family, and maintains a delicate balance between clinical care and human connection.

Read: https://hospicenews.com/2025/06/18/moving-mountains-to-understand-pediatric-palliative-patient-preferences/

Advance Care Planning as a Solution to the Vicious Cycle

Hospitals are increasingly unprepared to address the real needs of older adults—especially those experiencing repeated hospital stays and nearing the end of life. These readmissions are not just a sign of poor health but also a reflection of systemic fragmentation and a lack of coordinated care that may contradict the actual wishes of patients and their families.

The authors of the article raise important questions: Are we helping older adults by repeatedly hospitalising them? Why are patients’ preferences—such as dying at home rather than in an ICU—so often ignored? Can advance care planning (ACP) make a difference?

ACP is more than a document; it’s a process—a conversation about values, goals, and the boundaries of medical intervention, agreed upon with loved ones and healthcare providers. While implementing ACP may encounter legal, ethical, and logistical challenges, experiences from other countries demonstrate that it is both achievable and necessary.
Read: https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1624555/full

A Culturally Competent Approach to Palliative Care

In the context of globalisation and rising migration, healthcare systems are becoming more multicultural—and this is felt particularly strongly in palliative care. A new study published in BMC Palliative Care examines the challenges faced by professionals caring for patients from diverse cultural and religious backgrounds.

Language barriers, cultural differences in perceptions of death and care, varying levels of involvement from families and public institutions, lack of flexibility, ethnocentrism, stereotypes, and tensions within multicultural teams—all these factors create obstacles for both providers and patients. The authors emphasise that without understanding the cultural context, delivering truly high-quality palliative care is impossible.

Read: https://bmcpalliatcare.biomedcentral.com/articles/10.1186/s12904-025-01759-6

Legalising Assisted Dying in the UK: A Right to Choose or an Illusion?

Following a historic vote in the House of Commons that paved the way for legalising assisted dying in England and Wales, a fierce debate has erupted within the professional community. A practising doctor from the National Health Service raises serious concerns: behind the appealing language of dignity and patient autonomy may lie far more troubling realities.

In the context of an underfunded palliative care system and stark regional disparities in access, offering a ‘choice’ between support and death becomes morally ambiguous. The author warns that the legalisation of assisted dying is not just a clinical procedure, but a fundamental shift in the role of the physician—one that risks undermining trust and the ethical foundations of medical practice.

Who does the bill protect, and who is left behind? Can we genuinely talk about freedom of choice when the system fails to provide basic end-of-life support? Read more in the opinion piece by Dr. Hassan Ahmed.

Read: https://www.cureus.com/articles/386054-when-choice-isnt-a-choice-the-practical-and-ethical-risks-of-the-terminally-ill-adults-bill-of-england-and-wales#!/

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