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We are a victim of our own success! Through advances in preventative medicine, research and medical technology we have an ageing society and a growing population of elderly people with chronic illnesses or dementia who should be able to choose whether to receive death defying, and increasingly expensive, end-of-life medical interventions.
There is increasing public and political interest in advance care planning throughout the world as people recognise the importance of patient autonomy, and the right of patients to say what they want if they reach a point where they can no longer consider or communicate their wishes. This is complemented by the urgent need to improve end-of-life care.
The success of the Inaugural International Advance Care Planning Conference, held in Melbourne in April 2010, led to the establishment of the International Society of Advance Care Planning and End-Of-Life Care (http://www.acpelsociety.com). With hundreds of members from around the world, there was enthusiasm to hold an annual conference, culminating in this conference held in London 22 to 24 June 2011.
There has never been a greater need for advance care planning. Approximately 1% of the population die per annum with almost 60% of these deaths occur in hospital, many during crisis admissions, yet, if given the choice, most people would wish to die at home. The majority of the health dollar is spent in the last year of life while many areas of health care are underfunded. One of the most effective ways to correct this imbalance, while improving quality of care and satisfaction with the health care provided, is to simply ask patients what they would want when they are nearing the end of life. This can be achieved by educating health professionals that this is their responsibility and teaching them the skills to do it.
Initiatives are being undertaken in the UK, Europe, North America, parts of Asia and Australasia. The U.K.'s NHS End-Of-Life Care Strategy and National Gold Standard Framework for End-Of-Life Care are making significant headway, with the UK rated as the top nation in a Quality of Death Survey (http://www.eiu.com/sponsor/lienfoundation/qualityofdeath)
This conference is an opportunity to learn from others, share research, skills and solutions and meet other health professionals equally committed to improving this neglected Cinderella of health care.
We welcome you to London and look forward to your contribution.
Associate Professor William Silvester
International Society of Advance Care Planning and End-Of-Life Care
Professor Keri Thomas
Second Annual Conference of the International Society of Advance Care Planning and End of Life Care, London June 2011