Palliative care access: a matter of life and death
Bibliographic record
Abstract
More than 61 million people worldwide experience serious health-related suffering that could be relieved with palliative care (PC) 1 -a person-and family-centered approach to alleviating physical, psychological, social, and spiritual distress.Nafilyan and colleagues 2 found an association between severe physical health condition diagnosis and higher suicide risk that underscores the well-established need for PC access as a component of universal health coverage.3 PC integration is recommended at the time of serious illness diagnosis in conjunction with curative treatment to optimize quality of life outcomes.1,3 Nafilyan et al. 2 call for combined physical and mental health support.However, there are several PC implications to consider (Panel).Building on health systems' existing PC infrastructure to provide whole-person interventionsinclusive of mental health care-is a resource-conscious, cost-effective approach 1,3 to better assess individual needs and discriminate between depression, suicidality, and adjustment to illness.Furthermore, health professionals trained in primary PC 4 (e.g., generalist level skills) can help identify critical caregiver and community-based social supports while clarifying patients' concerns and anticipating potential existential crises (Panel).PC also provides a model that can operationalize short-term therapies (e.g., dignity therapy) 5 in rapidly changing clinical circumstances, especially for patients diagnosed with advanced or end-stage disease.The determinants of suffering are varied and subjective; its alleviation requires holistic, concurrent attention to myriad domains of care.PC provision is a moral obligation for all health professionals to protect public safety and wellbeing amid serious illness diagnosis and the heightened risk of suicide.Indeed, it is a matter of life and death.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.014 | 0.044 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.002 | 0.014 |
| Scholarly communication | 0.008 | 0.016 |
| Open science | 0.002 | 0.007 |
| Research integrity | 0.016 | 0.013 |
| Insufficient payload (model declined to judge) | 0.012 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".