A patient's concerns and to some degree their values, are constantly fluctuating over time driven by their circumstances both past and current. The essence of "Advance Care Planning (ACP)" is not a means to an end, but an evolving process of communication shared between clinicians and patients which develops over time as priorities and concerns change. The main content of discussion is around the future of medical care based upon the patient's values and life goals, however it is difficult to perform "Advance Care Planning (ACP)" in routine clinical practice due to a number of barriers. In addition, straightforward conversations about future terminal care may adversely affect the patient's family on the contrary. In this session, after reviewing the ACP, we will have a lecture on, "tips and tricks on creating and using opportunities for ACP communications." that could be implemented in our daily patient care.

Pediatric palliative care is a relatively new movement burgeoning since the 1980s. Eighty percent of patients receiving pediatric palliative care have non-cancer illnesses such as congenital malformation and neurologic disorders, whereas 20% have cancer. Pediatric palliative care in Japan is at the developmental phase. In this session, we will first present the current status of pediatric palliative care in Japan. Next, Dr. Chris Feudtner, Chair of the Section on Hospice and Palliative Medicine of the American Academy of Pediatrics, will introduce the current status and clinical practice in pediatric palliative care in the United States. By learning across the international community of pediatric palliative care that has developed primarily in non-cancer illnesses, we hope to gain insight into future directions of palliative care in pediatric medicine as well as adult patients.

Breathlessness (dyspnea) is the representative symptom, related to high burden, affecting daily life, and poor quality of life (QOL) in chronic respiratory disease patients. In this session, Japanese researchers will introduce current findings of pharmacological and non-pharmacological intervention for breathlessness in chronic respiratory disease patients. Then, we would like to ask Prof. Irene Higginson to share the results of her randomized control study of multidisciplinary team intervention for chronic respiratory disease patients and future perspectives on practice and research into breathlessness in patients with chronic respiratory illnesses.

Dr. Rachelle Bernacki is the director of the Serious Illness Care team which pilots a solution to address the gap between seriously ill patients’ goals and priorities and the care they receive. The intervention of this program facilitates more, better and earlier conversations between clinicians and seriously ill patients by equipping non-palliative care clinicians with the skills and system-level support needed to engage in the comprehensive goals of care conversations. In this session, we aim to understand how to implement Advance Care Planning and EOL discussions nation-wide through learning development of the Serious Illness Care Program in the US.

Recently, there has been an increasing awareness of advance care planning (ACP) in patients with chronic progressive illnesses and those receiving palliative care. However, marked regional disparities still exist in the practice of ACP. In this session, we will first discuss the current status of ACP in the United States and Europe where ACP has been implemented at a high level. Second, we will discuss the current practice and future perspectives of ACP in Asian countries including Korea, Taiwan, and Japan. Practice patterns of ACP can be influenced by regional, cultural, and ethnic characteristics. Understanding international perspectives of ACP will help discuss and develop appropriate practice of ACP in each region.

End-of-life (EOL) practice including treatment withdrawal, palliative sedation, physician-assisted suicide, and euthanasia has generated considerable controversy worldwide. EOL practice requires high ethical standards among health care professionals. In addition, it could be heavily influenced by social, cultural, and legal aspects within a given region. This session aims to help discuss ways to improve quality of death and dying in each region by sharing current status of EOL practice as well as cultural and legal aspects associated with the practice in each region.

Prof. Sebastiano Mercadante has published numerous clinical research projects in a wide variety of topics concerning symptom management. Prof. Mecadante has continuously conducted clinical research while engaging in patient care in a number of clinical settings that include, but are not limited to, palliative care unit, home care, and the pain clinic. In this session, Prof. Mercadante will share his views on how to develop research ideas and how best to conduct clinical research in the real world with limited time and resources. Prof. Mercadante’s perspective will help facilitate the development of clinical research in palliative care in Asia and other regions in the world.

Prof. Irene Higginson is a palliative care expert who has achieved tremendous academic accomplishments. Among her expertise are the development of a care delivery system and evidence-based policy in palliative care. In this session, Prof. Higginson will share her experiences and perspectives on how to develop concepts, conduct clinical research, and how to apply research findings in clinical practice.