Since 2011, the Cicely Saunders Institute has held a high profile annual lecture. Speakers at this event are global leaders whose work has significantly influenced the field. These lectures are a unique opportunity to learn from world leading clinicians and scientists and are aimed at clinicians and researchers. You will be able to watch most of the Cicely Saunders Institute annual lectures videos on this page.
Previous speakers have included:
Rabbi Baroness Julia Neuberger (2018)
Professor David Kissane (2017)
Improving end of life care: lessons learnt, what now, what next?
Speaker: Rabbi Baroness Julia Neuberger DBE, Senior Rabbi, West London Synagogue
About the speaker:Rabbi Baroness Julia Neuberger DBE, is an author, broadcaster and the second woman rabbi in the UK. Baroness Neuberger chaired Camden & Islington Community Health Services Trust and was CEO of the King’s Fund. She is a cross bench Peer, a Trustee of the Van Leer Group Foundation, and Chairman of the Van Leer Jerusalem Institute. She is a founding Trustee of the Walter and Liesel Schwab Charitable Trust, set up in memory of her parents, a Trustee of Full Fact and of the Rayne Foundation and recently appointed Vice Chair of the Mental Health Act Independent Review. Baroness Neuberger also chaired the Review of the Liverpool Care Pathway for Dying Patients, published in July 2013.
Abstract: It has been more than three years since the Liverpool Care Pathway was phased out in favour of personalised end-of-life care plans for individuals. Despite its obvious failings, the LCP ignited a number of conversations, both at a national and political level, about the way the dying are treated in our increasingly medicalised society. 100 years on from the birth of the founder of the modern day hospice movement, Baroness Neuberger examines the lessons learnt from the LCP, reflects on the ways in which recent research has improved the practice of palliative care and highlights the future challenges which face this essential field of medicine.
Professor Baroness Ilora Finlay of Llandaff (2016)
‘Integrating the Existential and Psychosocial into Palliative Medicine: Hope, Value and Meaning counter Demoralization to Sustain Patients, Families and Care Teams’
Speaker: Professor David Kissane MD Head of Psychiatry for Monash University, Australia and recent Chairman of the Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York.
About the speaker: Professor David W. Kissane MD, MPM, FRANZCP, FAChPM, FAPM is an academic psychiatrist, psycho-oncology researcher and palliative care physician. He is currently Chairman, Department of Psychiatry, Monash University, Australia; previously Chairman, Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York; and before that, Foundation Chair of Palliative Medicine, University of Melbourne. He has made seminal contributions to the development of Psycho-Oncology and Palliative Medicine as disciplines. He has contributed significantly to the use of support groups in cancer care, developed a model of family-centered care in both palliative care and bereavement, researched the state of demoralization as a form of existential distress, and built a comprehensive communication skills training program. His measure of demoralization has been translated into >12 languages, revealed a prevalence of clinically significant demoralization in 15% of palliative care patients and stimulated the development of existentially-oriented psychotherapies. Recent books include Oxford Textbook of Communication in Oncology and Palliative Care, Second Edition (Oxford, 2017), Management of Clinical Depression and Anxiety (Oxford, 2017), and Bereavement Care for Families (Routledge, 2014).
Abstract: Existential challenges are a major source of suffering towards the end of life. Demoralization is one such mental state comprising low morale and a sense of poor coping, in which pessimism, helplessness and hopelessness can lead to loss of meaning and purpose in life. A systematic review reported a prevalence rate of 13-18% in 2,295 patients with advanced cancer. Empirical data have shown a stronger relationship between demoralization and suicidal thinking than depression and wish to die. Therapies that aim to restore meaning in life help to ameliorate demoralization. A field survey of 320 clinicians examined perceptions of the utility of demoralization as a ‘specifier’ for diagnoses of adjustment and major depressive disorders. Clinicians assessed comparative clinical vignettes: 95% perceived utility in recognition of “normal grief,” 77% in a diagnosis of “adjustment disorder with demoralization,” but only 33% perceived utility in “adjustment disorder with anxiety” (Cochran’s P<0.001). Sensitivity (77.1%) and specificity (94.1%) were satisfactory for the diagnosis of “adjustment disorder with demoralization.” Demoralization is a useful concept to deepen diagnostic understanding, treatment choice and ability to communicate with clinicians and patients. It is a contagious state of mind, necessitating family and multidisciplinary team work to prevent its inadvertent transmission among care providers.
Dr Eduardo Bruera (2015)
Unintended consequences of legislation at the end of life
Speaker: Professor Ilora Baroness Finlay of Llandaff
About the speaker: Ilora Finlay is a Professor of Palliative Medicine at Cardiff University; Consultant at Velindre Cancer Centre; and Independent Crossbench member of the House of Lords. The first consultant in Palliative Medicine in Wales in 1987, she developed palliative and hospice care services across Wales and established an internationally renowned palliative care course at Cardiff University. She is National Vice President of Marie Curie Cancer Care and Chair of the National Council for Palliative Care.
Abstract: Laws are more than just regulatory instruments. They send social messages. I will examine different types of 'assisted dying' legislation and their effects. First, however, I will deal with my own Access to Palliative Care Bill.
The Health and Social Care Act of 2012 resulted in enormous changes to the organisation and lines of accountability in the NHS. These changes appear to have eroded the financial security and any national framework for hospice and specialist palliative care, resulting in wide variation in provision. By contrast, the more centralized nature of NHS Wales has provided some stability to the sector. The variability of provision in England led me to write the Access to Palliative Care Bill, which has completed its passage through the House of Lords.
Licensing 'assisted dying' by law would represent a major change to the criminal law. Before Parliament could contemplate such a step it needs clear evidence that the law as it stands is not fit for purpose and, if that is so, that what would be put in its place would be better. No such evidence has been provided to date and within the last 12 months Parliaments, both north and south of the Scottish border, have rejected proposals for legalisation.
The lecture will explore evidence from around the world of the effects of 'assisted dying' legislation. The recent data reported by Oregon’s Health Division on their Death with Dignity Act shows a 26% rise in the number of deaths from physician assisted suicides in 2015, following a 44% rise in 2014. A similar trend of steeply rising numbers of euthanasia deaths is also seen in the Benelux countries; in The Netherlands in 2014, 1 in 26 of all deaths was the result of euthanasia or assisted suicide and euthanasia is being increasingly extended to patients with mental illness.
Professor Stein Kaasa (2014)
Clinical interventions to enhance the expectation of healing: continuing on the pathway of Dame Cicely
Speaker: Dr Eduardo Bruera, Professor and FT McGraw Chair in the Treatment of Cancer, The University of Texas MD Anderson Cancer Centre
About the speaker: Dr Bruera is Professor and FT McGraw Chair in the Treatment of Cancer, The University of Texas MD Anderson Cancer Centre. He is Chair, Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Centre, USA and Past President, International Association of Hospice and Palliative Care
Abstract: A review of clinical research on how the delivery of palliative care can be more effective by making changes in the physical environment (ambient music, no waiting room), measuring symptoms, posture (sitting vs. standing), communication style, physical exam, giving prompt sheets and audio recording and phone care interventions.
Professor Diane Meier (2013)
Integration of palliative care into public health and cancer care: a vision for the future
Speaker: Professor Stein Kaasa, Institute of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim (NTNU)
About the speaker:Professor Kaasa is Chair of the European Palliative Care Research Centre (PRC), the European Association for Palliative Care Research Network (EAPC RN), the International Association for the Study of Pain (IASP) task force on cancer pain, and principal investigator of the European Palliative Care Research Collaborative (EPCRC). He is also National Cancer Director at the Norwegian Directorate for Health. Professor Kaasa has published more than 300 articles and book chapters. He authored the Nordic Textbook of Palliative Care and co-authored the Oxford Textbook of Palliative Medicine. He also advises many international journals -- either as an advisory board member or as a reviewer.
Abstract: Patients with metastatic cancer are living longer because of multimodal cancer-directed treatment, but are in need of specialised palliative care delivered by organised multidisciplinary teams. The World Health Organization (WHO) has recognised that “palliative care is applicable early in the course of the illness in conjunction with other therapies that are intended to prolong life such as chemotherapy or radiotherapy”. Increasing numbers of patients, new diagnostic techniques and treatments, and high societal expectations of optimised care create challenges for healthcare financing systems, and underscore the need for highly skilled palliative care professionals and collaboration between disciplines when creating care plans.
For decades, most patients have been admitted to palliative care late in the disease trajectory and stay under the care of highly specialised oncology units until they are close to death. Place of death varies widely (13% of patients in Norway die at home, whereas 45% in the Netherlands die at home), and most patients prefer to be at home at the end of life. Early palliative care might improve survival and quality-of-life outcomes.
Two important questions are what the best organisational model of public health is that can offer patients and their families high quality home care at the end of life, and how such a model can include highly specialised oncology care. This lecture considers how to organise comprehensive cancer care from the onset of metastatic disease to the end of life.
Professor Kathy Foley (2012)
Can (or should) palliative care meet the challenges of care for persons with long term chronic illness versus remaining in our end-of-life corner?
Speaker: Dr Diane E. Meier, Director of the Center to Advance Palliative Care (CAPC)
About the speaker: Dr Diane E. Meier is Director of the Center to Advance Palliative Care (CAPC), a national organisation within the United States devoted to increasing the number and quality of palliative care programmes across America. She is also the Vice Chair for Public Policy at the Lilian and Benjamin Hertzberg Palliative Care Institute where she previously served as Director for twelve years. Dr Meier is Professor of Geriatrics and Internal Medicine; and Catherine Gaisman Professor of Medical Ethics at Mount Sinai School of Medicine in New York City. Dr Meier is the recipient of numerous awards, including a five-year National Institute on Aging Academic Career Leadership Award. Dr Meier is Principal Investigator of an National Cancer Institute-funded five-year multisite study on the outcomes of hospital palliative care services in cancer patients, and is an academic partner on project BuildCARE, working with King’s College London and the Cicely Saunders Institute.
Professor David Currow (2011)
International and national policies for palliative care: can they make a difference
Speaker: Professor Kathy Foley is Professor of Neurology, Neuroscience and Clinical Pharmacology at Weill Cornell Medical College, and attending neurologist in the Pain & Palliative Care Service at Memorial Sloan-Kettering Cancer Center in New York City.
About the speaker: Professor Kathy Foley is Medical director of the International Palliative Care Initiative of the Open Society Public Health Program and was elected to the Institute of Medicine of the National Academy of Sciences for her national and international efforts in the treatment of patients with cancer pain. She is the past director of the Project on Death in America, which worked to transform the culture of dying in the United States through initiatives in research, scholarship, and clinical care.
Professor David Currow, Flinders University, Australia: ‘Palliative Care Research – what is the return on investment’