II Scientific and Practical Conference "Palliative medicine: yesterday, today, tomorrow"
Palliative medicine is a healthcare field designed to improve the quality of life of patients with progressive forms of chronic diseases when the possibilities of specialized treatment are limited or exhausted. In other words, to alleviate the suffering of patients during the final stage of the disease.
Palliative medicine is focused on controlling symptoms, not on healing the patient. In addition to relieving physical suffering, psycho-social and spiritual support is needed, as well as assistance to the relatives of the dying person in caring for him and in grief of loss. Palliative care deals with a number of aspects of the life of an incurable patient – medical, psychological, social, cultural and spiritual. "We are unable to prolong the patient's life, but we also have no right to shorten it. The time that a person has left to live, he must live with dignity," says Professor G.A.Novikov, one of the founders of palliative medicine in Russia, president of the All–Russian public movement "Medicine for Quality of Life".
Today, not enough is known about palliative medicine in Russia, not only in public circles, but sometimes in narrow circles of specialist doctors. It covers many areas of medicine, but in our country it has been established in the oncological service of the Russian Federation.
Having started developing only 20 years ago, palliative medicine in the Russian Federation needs further improvement and development. Today, not all cancer patients who need palliative care receive it in a timely manner, and in some cases do not have any access to it. It requires not only financial support from the state, but also the revision of current legislation and the training of a new generation of medical specialists in this field.
These and other issues related to palliative medicine were discussed at the II All-Russian Scientific and Practical Conference "Palliative Medicine: yesterday, today, tomorrow", which was held in Moscow on January 30-31, 2008. The organizers were the All-Russian Public Movement "Medicine for Quality of Life" and the Association of Palliative Medicine, the creation of which in December last year became serious a step in the development of palliative medicine in Russia. The main purpose of the Association is to assist professionals, medical specialists in the development of optimal methods of palliative medicine and the principles of its organization.
The conference was held under the patronage of the State Duma of the Russian Federation. For the first time in the Russian Federation, an event dedicated to palliative medicine has acquired such a large scale. 260 delegates from six federal districts of the Russian Federation, with the exception of the Far Eastern Federal District, gathered in the Moscow Government building. Among them were representatives of legislative and executive authorities, heads of leading medical research institutes and universities of the Russian Federation, chief physicians and deputy chief physicians of hospices, hospitals, oncological dispensaries, oncologists, leading specialists in the field of palliative medicine, scientists and representatives of public organizations. In addition to delegates from Moscow and St. Petersburg, the event was attended by representatives from Bryansk, Vladimir, Voronezh, Ivanovo, Kaluga, Kursk, Oryol, Ryazan, Tula, Yaroslavl, Irkutsk, Kemerovo, Novosibirsk, Omsk, Tomsk, Krasnoyarsk Territory, Sverdlovsk, Tyumen, Chelyabinsk, Arkhangelsk, Novgorod, Kirov, Orenburg, Penza, Saratov, Ulyanovsk, Volgograd, Rostov regions, Krasnodar and Stavropol Territories, as well as from the Republic of Bashkortostan and the Republic of Tatarstan.
The conference was opened by the President of the All-Russian public movement "Medicine for Quality of Life", Professor G.A.Novikov.
The Chief oncologist of the Ministry of Health and Social Development of the Russian Federation, Director of the P.A.Herzen Moscow Research Oncological Institute, Academician of the Russian Academy of Medical Sciences, Professor V.I. Chissov wished successful work to the Conference participants.
The head of the Department of Public Health, Social Protection and Employment of the Department of Coordination of the Social Sphere Complex of the Government of Moscow, A.N.Polukhin read out a greeting on behalf of the First Deputy Mayor of Moscow, L.I.Shvetsova, in which it was said that the holding of this event "... is a significant event in the field of healthcare in Moscow and Russia, testifying to the increasing role of the most important medical industry in the system of providing assistance to seriously ill people. This medical and social direction is permeated with humanism and charity, high responsibility for the value of human life."
The first vice-rector of the I.M.Sechenov MMA, academician of the Russian Academy of Medical Sciences, Professor I.N.Denisov noted that the quality of medical care directly depends on the level and degree of preparedness of the doctor and medical staff. "Today, in the system of postgraduate professional education," he said, "there is a postulate: a single professional development within five years is enough. But we are witnessing a powerful scientific and technological progress when information is updated throughout the year, so such a standard becomes unacceptable. In addition, the issues of palliative medicine should find their place not only in the system of postgraduate professional education, but should also become an integral part of our curricula for basic training of medical university students."
The President of the All-Russian Public Movement "Medicine for Quality of Life" G.A.Novikov in his report spoke about the history of palliative care for cancer patients in Russia and about the role of social movements in the development of palliative medicine in the Russian Federation. The first stage in the development of palliative care in the field of oncology was the creation in 1987 of one of the first analgesic therapy rooms in the Russian Federation as part of the P.A.Herzen Moscow Research Oncological Institute. In 1991, the Republican Scientific and Methodological Center for the Treatment of Chronic Pain Syndromes in Cancer Patients was established, and two years later a decree was issued by the Ministry of Health of the Russian Federation on the establishment of an Expert Council for the organization of Palliative Care for cancer patients. The following years were marked by other equally important achievements: palliative care departments for cancer patients have been organized, the foundation "Palliative Medicine and Rehabilitation of Patients" has been registered, from which the history of the development of the All-Russian public Movement "Medicine for Quality of Life" originates, at the Department of Oncology of the Faculty of Postgraduate Professional Education of the Moscow Medical Academy. Sechenov opened the first palliative care course in Russia.
The funds raised by the foundation "Palliative Medicine and Rehabilitation of Patients" were used to organize meetings, scientific and practical seminars and conferences on palliative care in the regions, training of cadets of the palliative care course (until 2000), publishing activities (in 1996 the scientific and practical journal "Palliative Medicine and Rehabilitation" was registered), as well as organizational-methodological work in the regions.
"The main goals of the All–Russian public movement "Medicine for the quality of Life", – said G.A.Novikov, - is the consolidation of representatives of medicine, legislative and executive authorities and civil society structures to effectively solve the problems of modernization of healthcare, as well as assistance to professionals in the development and implementation of optimal organizational and methodological forms, methods and new high technologies designed to improve the quality of life of the sick and disabled."
The welcoming speech from the Chairman of the State Duma B.V.Gryzlov was delivered by the Deputy Chairman of the Health Protection Committee of the State Duma of the Russian Federation, S.I.Kolesnikov, noting that the problems of palliative medicine are underestimated in Russia: "Incurable patients are often deprived of any medical care due to organizational reasons, as well as lack of funds for the purchase of expensive medicines. Unfortunately, today this problem is mainly in the field of view of foundations and associations, which are making considerable efforts to solve it. I am sure that this Conference will help to realize the tasks set, as well as to identify previously unsolved issues in the field of palliative medicine."
The conference continued with an emotional report by N.A.Osipova, MD, Professor, Head of the Department of Anesthesiology and Resuscitation of the P.A.Herzen Moscow Research Oncological Institute.
"Twenty years ago, palliative care for cancer patients was not considered as a field of medicine at all, but there were associates who could not pass by a cancer patient suffering from pain. Among them are Doctors of Medical Sciences, Professors Z.V.Pavlova, M.E.Isakova, who are employees of the N.N.Blokhin Russian Cancer Research Center of the Russian Academy of Medical Sciences, as well as the founder of the anesthesiological service of the N.N.Petrov Research Institute of Oncology, Professor I.A.Fried. They were pioneers in the field of palliative medicine, and despite the fact that they did not have modern drugs, high-tech equipment, they found ways to help cancer patients. In the future, hospices appeared, the first hospice for cancer patients in Russia was organized by a psychiatrist A.V. Gnezdilov in Leningrad, and in Moscow – V.V.Millionshchikova.
The main impetus in the field of palliative medicine was the emergence of one of the first analgesic therapy cabinets in the Russian Federation as part of the P.A.Herzen Moscow Research Oncological Institute, where a young cohort of doctors and scientists began to form who were imbued with the significance of this problem. They were G.A.Novikov, B.M.Prokhorov, M.A.Weissman, S.V.Rudoy. The fact that our patients, whom, unfortunately, we cannot cure, are in a hopeless situation, forced them to immerse themselves in scientific research, to defend their candidate and doctoral dissertations. From the moment when the core of researchers, doctors, well-oriented in this field, was formed, the movement began with the support of the director of the Institute, Academician V.I. Chissov and with my support as a supervisor. It was possible to create a base for the treatment of cancer patients with chronic forms of progressive diseases, of which there are about 1.5 million in the country, then publications began, books began to be published, various forums and conferences were held, i.e. the problem of palliative care acquired a public character.
Today, the Department of palliative care for cancer patients is operating in the Moscow City Clinical Hospital No. 11. It is now known what to treat, the best drugs for this purpose are known, but there are many reasons why palliative care is not readily available: insufficient training of our doctors, lack of knowledge of drug treatment, etc. All this forms an invisible barrier to the provision of palliative care to the patient. To eliminate it, a decision is required at the regional and federal levels.
Based on the above, I would like to wish the participants success in solving these and other issues in the field of palliative medicine, because providing help to the infirm terminally ill people is a sign of the moral health of society."
The Conference participants were greeted by V.V.Millionshchikova, Chief Physician of the First Moscow Hospice of the Moscow City Health Department. "As a doctor of practical healthcare, having led the First Moscow Hospice for fifteen years, I hope that the introduction of the specialties of doctor and nurse of palliative medicine into the nomenclature of specialties will happen this century."
The main event of the Conference was the awarding of an honorary prize to twenty-six laureates in connection with the 20th anniversary of the organization of palliative care services in Russia. For the first time in Russia, a commemorative diploma of the laureate of the Palliative Medicine award "For outstanding contribution to the creation of a palliative care system for cancer patients" was awarded. They received the right to participate in one of the international conferences organized by the All-Russian Public Movement "Medicine for Quality of Life" for the current year.
Annual awards were awarded to specialists in the field of palliative care for patients in the following categories: "For contribution to the development of the palliative care system for cancer patients", "For contribution to the creation of a scientific school" and "For contribution to methodological and educational work".
The laureates received a commemorative diploma and the right to a free subscription to the scientific and practical journal "Palliative Medicine and Rehabilitation" for 2008, as well as the opportunity to order one of the publications for free:
"A course of lectures on palliative care for cancer patients" in two volumes edited by Professor G.A.Novikov, Academician of the Russian Academy of Medical Sciences, Professor V.I.Chissov, Professor O.P.Modnikov, Moscow, 2004.
"Treatment of chronic pain of oncological genesis" edited by Professor G.A.Novikov, Professor N.A.Osipova, Moscow, 2005.
"Palliative care for cancer patients" edited by Professor G.A.Novikov, Academician of the Russian Academy of Medical Sciences, Professor V.I.Chissov.
The second day of the conference was held in the building of the Moscow City Clinical Hospital No. 11, where participants got acquainted with the palliative care department for cancer patients with 40 beds, and a plenary session was held.
There were speeches devoted to the development and improvement of palliative medicine as one of the important and integral areas of domestic healthcare; problems of medical and social care for patients with progressive forms of chronic diseases, the relevance and prospects of integrating palliative medicine into healthcare, as well as medical education and personnel policy in this area.
The annual scientific and practical conference "Palliative medicine: yesterday, today, tomorrow" is becoming a good tradition in medical circles and is of invaluable importance for the recognition of palliative medicine as an independent direction of domestic medicine and its inclusion in the program of modernization of healthcare. An important role is played by the fact of establishing a dialogue between specialist doctors and representatives of the legislative and executive authorities, which makes it possible to accelerate the process of ensuring an adequate quality of life for patients with progressive forms of chronic diseases.
The next conference "Palliative Medicine: Yesterday, today, tomorrow" will be held at the end of January 2009.
Portal "Eternal youth" www.vechnayamolodost.ru based on the materials of the OOD "Medicine for the quality of life"
14.02.2008