ABSTRACT
In industrialized countries, there is growing attention to improving the quality of healthcare provided to patients with terminal or chronic illnesses as they near the end of their lives. Many patients in wealthy nations reportedly die in severe pain, but little has been documented about pain or suffering at the end of life in less economically developed nations. This qualitative study explores end of life concerns in the Caribbean among health professionals and people who had lost a loved one. It found that many patients with terminal illnesses chose to die in their homes where they could be cared for by family and/or friends, but that these patients endured much pain and their caregivers also suffered. In the absence of national or institutional policy on pain relief or end of life care, most of these patients and their caregivers seek spiritual comfort. This paper illustrates the need for health professionals and policy makers to do more to relieve suffering at the end of life
Subject(s)
Humans , Terminal Care/psychology , Caregivers , Family , Social Support , Palliative Care/psychology , Attitude to Death , Attitude of Health Personnel , Caregivers/psychology , Culture , Terminally Ill/psychology , Pain/psychology , Stress, Psychological/psychology , Family/psychology , Health Personnel/psychology , Quality of Life/psychology , Quality of Health Care , Caribbean Region , Professional-Family RelationsABSTRACT
Unanticipated questions arose when starting an institutional research ethics committee in Grenada. Research ethics committees are charged with the ethical review of research protocols. They serve to protect people who volunteer as research subjects from harm or wrong that may result from participating in research. The Caribbean has a rich history of medical research involving human subjects. There is a growing will in the region to establish effective and sustainable research ethics committees that adhere to international standards. This paper examines uncertainties and questions that arose in starting a research ethics committee in Grenada, and describes how uncertainties were resolved. The questions centre on which guidelines to follow, who to appoint as members, what procedures to follow, and how to train members. An additional question relates to the role of a Ministry of Health in founding a research ethics committee. Resolution of these uncertainties shows that ethical review of research can be both effective and sustainable in the Caribbean.