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EL ESPECTADOR

For Terminal Patients, Palliative Care Offers 'Another Way To Die'

Easing pain and 'old-fashioned' home care, rather than intensive hospitalization, are proving themselves as better and cheaper ways to treat terminal patients.

A son holding his mother's hand in a palliative care facility in Oakland, United States on June 26, 2015
A son holding his mother's hand in a palliative care facility in Oakland, United States on June 26, 2015
Zacharias Rodriguez Alvarez-Ossorio

BOGOTÁ — An old patient who dies alone in the Intensive Care Unit, unable to say goodbye to his or her family. Or a 94-year-old subjected to surgery that cannot possibly prolong his life. A child who dies crying, while calling parents who are not permitted to enter the room. These are typical situations when there is no palliative care, and real cases I have seen. They happened but never should, in any country or circumstance.

The key is simply to do things well. They say spending more money does not bring happiness - and it certainly does not mean better care for patients nearing the end of their lives. In fact doing things well costs less, not more, and that is no presumption based on theories or mathematical models. It is a firm conclusion we may draw from the results of real programs and experiments showing how earlier palliative care combined with specialist medical attention may yield a holistic response to illness that is social, sanitary and community-oriented. By considering the patient's desires and needs, one can boost clinical efficacy and the satisfaction of patients and their families. And cut costs.

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FOCUS: Russia-Ukraine War

Hide-And-Seek Of Drone Warfare, A Letter From Ukraine's Front Line

A member of the Ukrainian Armed Forces writes his account of the new dynamic of targeting, and being targeted by, the invading Russian troops, as drones circle above and trenches get left behind.

A Ukrainian military drone operator during a testing of anti-drone rifle in Kyiv.

Igor Lutsenko*

KYIV — The current war in Ukraine is a game of hide-and-seek. Both sides are very well-stocked with artillery, enough to destroy the enemy along many kilometers. Swarms of drones fly through the air day and night, keeping a close eye on the earth's surface below. If they notice something interesting, it immediately becomes a target. Depending on the priority, they put it in line for destruction by artillery.

Therefore, the only effective way to survive is to hide, or at least somehow prove to the drones your non-priority status — and avoid moving to the front of the 'queue of death.'

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In general, the nature of this queue is a particular thing. It may seem to be a god, but is instead a simple artillery captain's decision of when to have lunch, and when to fire on the house where several enemy soldiers are staying. It's just a handful of ordinary people (observers, artillerymen) deciding how long their enemies will live depending on their own schedule or the weather, the availability of ammunition or if they're feeling tired.

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Central to the tragic absurdity of this war is the question of language. Vladimir Putin has repeated that protecting ethnic Russians and the Russian-speaking populations of Ukraine was a driving motivation for his invasion.

Yet one month on, a quick look at the map shows that many of the worst-hit cities are those where Russian is the predominant language: Kharkiv, Odesa, Kherson.

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