Page 79 - Hospital Authority Convention 2017

Plenary Sessions
Plenary Sessions

P4.1 The Changing Culture in Patient-centred Care 16:15 Convention Hall B

Surgery as Placebo
Harris I
Orthopaedics Department, University of New South Wales, Australia HOSPITAL AUTHORITY CONVENTION 2017
Medicines require rigorous testing against other drugs or placebo in order to establish effectiveness. The same is not true
for surgery, where practice is largely dictated by tradition and observational evidence. This calls the effectiveness of surgery
into question. Placebo surgical studies, when performed, have frequently shown surgery to be relatively ineffective and many
procedures, previously thought to be effective, have now been discarded.

This presentation covers the history or surgery as placebo, the reasons why surgery persists despite good evidence, or
even in the face of evidence of lack of effectiveness and proposes solutions to the current situation in which much of current
surgical practice may be ineffective.

P4.2 The Changing Culture in Patient-centred Care 16:15 Convention Hall B Tuesday, 16 May

Quality Palliative Care Services – the Growing Demand
Goh-fung CR
Division of Palliative Medicine, National Cancer Centre Singapore, Singapore

Palliative care used to be thought of as end-of-Life care. It is now realised that patients diagnosed with life-limiting conditions
may need palliative care for many years before death, and that palliative care does not signal the end of all curative
treatments. Rather, it is part of the continuum of holistic care alongside therapies that alter the course of the disease and
prolong survival. Palliative care helps to alleviate symptoms, optimise physical and mental function and enables patients and
their families to work through the options they have to achieve their life goals.
Public health measures and medical advances have enabled life expectancy to increase, not only in developed economies,
but also low and middle income countries, and the whole world faces an ageing population. Technological improvements
have provided an increasing array of options that may have an incremental improvement to survival. Governments have
difficulty choosing which options, for example, a new drug, should be made available to all, while avoiding an impression
of rationing. For the man in the street, as a consumer of heathcare, it is difficult to work out the trade-offs and alternatives.
All the more is it important to have that conversation at a personal level to achieve the best quality of life consistent with a
person’s life goals.

Yet what constitutes Quality Palliative Care? From whose view point do we measure this?
This presentation will refer to the Quality of Death Index produced by the Economist Intelligence Unit, the tools healthcare
institutions in different parts of the world use to measure and improve quality of care in palliative care, and ask whether the
concerns of all stakeholders, including patients and their families, are being addressed.

77