{"id":3133,"date":"2026-09-07T12:49:46","date_gmt":"2026-09-07T12:49:46","guid":{"rendered":"http:\/\/localhost\/bpscoretextbooks\/?post_type=content&#038;p=3133"},"modified":"2026-09-08T11:01:50","modified_gmt":"2026-09-08T11:01:50","slug":"chapter-11-palliative-and-end-of-life-care","status":"publish","type":"content","link":"https:\/\/routledgelearning.com\/bpscoretextbooks\/9781032707433-chapter-11-palliative-and-end-of-life-care\/","title":{"rendered":"Chapter 11 &#8211; Palliative and end of life care"},"content":{"rendered":"\n<div class=\"wp-block-group has-background has-global-padding is-layout-constrained wp-block-group-is-layout-constrained\" style=\"background-color:#eedbd1;padding-top:var(--wp--preset--spacing--70);padding-bottom:var(--wp--preset--spacing--70)\">\n<div class=\"wp-block-columns alignwide is-layout-flex wp-container-core-columns-is-layout-7387b849 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:66.66%\"><nav style=\"--separator: &quot;\/&quot;\" class=\"wp-block-breadcrumbs\" aria-label=\"Breadcrumbs\"><ol><li><a href=\"https:\/\/routledgelearning.com\/bpscoretextbooks\/\">Home<\/a><\/li><li><span aria-current=\"page\">Chapter 11 &#8211; Palliative and end of life care<\/span><\/li><\/ol><\/nav>\n\n<h1 class=\"wp-block-post-title\">Chapter 11 &#8211; Palliative and end of life care<\/h1>\n\n\n<p class=\"wp-block-paragraph\">This chapter starts by outlining the principles of palliative care and how it has progressed over time from focusing on cancer to the current application that spans across numerous serious and progressive diseases. We look at public perceptions and awareness of palliative, along with accessibility within different populations. Cultural perspectives about serious disease and dying are introduced to illustrate how beliefs influence patient and family care preferences and decision making. The role of hospice care is introduced alongside advanced care planning. The chapter ends with a discussion about pain relief and end of life care, emphasising the important of dignity, symptom control and quality of life.<\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:33.33%\"><\/div>\n<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-group is-layout-flow wp-block-group-is-layout-flow\">\n<div class=\"wp-block-query alignwide is-layout-flow wp-block-query-is-layout-flow\"><ul class=\"wp-block-post-template is-layout-flow wp-block-post-template-is-layout-flow\"><li class=\"wp-block-post post-3187 content type-content status-publish format-standard hentry content-type-content parent-book-49 resource-type-further-reading\">\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-block-group-is-layout-constrained\"><h2 class=\"alignwide wp-block-post-title\">Chapter 11 &#8211; Key Readings<\/h2>\n\n<div class=\"entry-content alignwide wp-block-post-content is-layout-flow wp-block-post-content-is-layout-flow\">\n<p class=\"wp-block-paragraph\"><strong>These readings have been chosen by the author to support and enhance the chapter material.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Cain, C. L., Surbone, A., Elk, R., &amp; Kagawa-Singer, M. (2018). Culture and palliative care: preferences, communication, meaning, and mutual decision making. <em>Journal of Pain and Symptom Management<\/em>, <em>55<\/em>(5), 1408\u20131419. <a href=\"https:\/\/doi.org\/10.1016\/j.jpainsymman.2018.01.007\">https:\/\/doi.org\/10.1016\/j.jpainsymman.2018.01.007<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Wakefield, D., Kane, C. E., Chidiac, C., Braybrook, D., Harding, R. (2021). Why does palliative care need to consider access and care for LGBTQ people? <em>Palliative Medicine<\/em>, 35(10), 1730-1732. <a href=\"https:\/\/doi.org\/10.1177\/02692163211055011\">https:\/\/doi.org\/10.1177\/02692163211055011<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Waran, E., O&#8217;Connor, N., Zubair, M. Y., &amp; May, P. (2016). &#8216;Finishing up&#8217; on country: Challenges and compromises. <em>Internal Medicine Journal<\/em>, <em>46<\/em>(9), 1108\u20131111. <a href=\"https:\/\/doi.org\/10.1111\/imj.13186\">https:\/\/doi.org\/10.1111\/imj.13186<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Worldwide Hospice Palliative Care Alliance. (2020). <em>Global Atlas of Palliative Care<\/em> (2<sup>nd<\/sup> edn.). Worldwide Hospice Palliative Care Alliance. <a href=\"https:\/\/www.palliativecare.in\/wp-content\/uploads\/2020\/10\/Global-Atlas-2nd-Edition-2020.pdf?utm_source=chatgpt.com\">https:\/\/www.palliativecare.in\/wp-content\/uploads\/2020\/10\/Global-Atlas-2nd-Edition-2020.pdf<\/a><\/p>\n<\/div><\/div>\n\n<\/li><li class=\"wp-block-post post-3176 content type-content status-publish format-standard hentry content-type-content parent-book-49 resource-type-audio-and-video-links\">\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-block-group-is-layout-constrained\"><h2 class=\"alignwide wp-block-post-title\">Chapter 11 &#8211; Video Resources<\/h2>\n\n<div class=\"entry-content alignwide wp-block-post-content is-layout-flow wp-block-post-content-is-layout-flow\">\n<p class=\"wp-block-paragraph\">There is no video resources for this chapter.<\/p>\n<\/div><\/div>\n\n<\/li><li class=\"wp-block-post post-3164 content type-content status-publish format-standard hentry content-type-content parent-book-49 resource-type-essay-questions\">\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-block-group-is-layout-constrained\"><h2 class=\"alignwide wp-block-post-title\">Chapter 11 &#8211; Reflective Questions<\/h2>\n\n<div class=\"entry-content alignwide wp-block-post-content is-layout-flow wp-block-post-content-is-layout-flow\">\n<p class=\"wp-block-paragraph\"><strong>These questions are designed to prompt deeper thinking about the ideas and themes presented in this chapter.<\/strong><\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Why is it important to understand a person&#8217;s culture, background, or identity (such as being LGBTQI+ or Indigenous) when providing palliative care?<\/li>\n\n\n\n<li>Of what benefit is an advanced decision to refused treatment (advanced directive)? <\/li>\n\n\n\n<li>How has palliative care changed from its initial focus on pain relief and cancer?<\/li>\n<\/ol>\n<\/div><\/div>\n\n<\/li><li class=\"wp-block-post post-3150 content type-content status-publish format-standard hentry content-type-content parent-book-49 resource-type-flashcards\">\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-block-group-is-layout-constrained\"><h2 class=\"alignwide wp-block-post-title\">Chapter 11 &#8211; Flashcards<\/h2>\n\n<div class=\"entry-content alignwide wp-block-post-content is-layout-flow wp-block-post-content-is-layout-flow\">\n<!-- Swiper -->\n<div class=\"swiper mySwiper\" id=\"swiper-block_e16c576c1d5021bf9e0a3a8fd82e25cd\">\n    <div class=\"swiper-wrapper\">\n\n        \n        <!-- Swiper Slide -->\n        <div class=\"swiper-slide\">\n          <!-- Flashcard -->\n           <button class=\"flip-card\" role=\"button\" tabindex=\"0\" data-front=\"Palliative care\" data-back=\"A holistic type of care than includes physical, emotion, social and spiritual needs, that can be introduced at any stage of progressive or serious life limiting disease.\">\n            <div class=\"flip-card-inner\">\n              <div class=\"flip-card-front\">\n                <p><p>Palliative care<\/p>\n<\/p>\n                <div id=\"flashcard-instruction-block_e16c576c1d5021bf9e0a3a8fd82e25cd\" class=\"flashcard-instruction\">Click to Flip<\/div>\n              <\/div>\n              <div class=\"flip-card-back\"><p>A holistic type of care than includes physical, emotion, social and spiritual needs, that can be introduced at any stage of progressive or serious life limiting disease.<\/p>\n<\/div>\n            <\/div>\n          <\/button>\n        <\/div>\n\n        \n        <!-- Swiper Slide -->\n        <div class=\"swiper-slide\">\n          <!-- Flashcard -->\n           <button class=\"flip-card\" role=\"button\" tabindex=\"0\" data-front=\"Progressive disease\" data-back=\"A disease that gets worse over time, leading to increased symptoms burden and eventual loss of life.\">\n            <div class=\"flip-card-inner\">\n              <div class=\"flip-card-front\">\n                <p><p>Progressive disease<\/p>\n<\/p>\n                <div id=\"flashcard-instruction-block_e16c576c1d5021bf9e0a3a8fd82e25cd\" class=\"flashcard-instruction\">Click to Flip<\/div>\n              <\/div>\n              <div class=\"flip-card-back\"><p>A disease that gets worse over time, leading to increased symptoms burden and eventual loss of life.<\/p>\n<\/div>\n            <\/div>\n          <\/button>\n        <\/div>\n\n        \n        <!-- Swiper Slide -->\n        <div class=\"swiper-slide\">\n          <!-- Flashcard -->\n           <button class=\"flip-card\" role=\"button\" tabindex=\"0\" data-front=\"Patient centred approach\" data-back=\"An approach to care that responds to individual patient needs, preferences and values.\">\n            <div class=\"flip-card-inner\">\n              <div class=\"flip-card-front\">\n                <p><p>Patient centred approach<\/p>\n<\/p>\n                <div id=\"flashcard-instruction-block_e16c576c1d5021bf9e0a3a8fd82e25cd\" class=\"flashcard-instruction\">Click to Flip<\/div>\n              <\/div>\n              <div class=\"flip-card-back\"><p>An approach to care that responds to individual patient needs, preferences and values.<\/p>\n<\/div>\n            <\/div>\n          <\/button>\n        <\/div>\n\n        \n        <!-- Swiper Slide -->\n        <div class=\"swiper-slide\">\n          <!-- Flashcard -->\n           <button class=\"flip-card\" role=\"button\" tabindex=\"0\" data-front=\"Hospice care\" data-back=\"A type of care that may be provided alongside palliative care for symptom control. It can also refer to a place where end of life care is provided.\">\n            <div class=\"flip-card-inner\">\n              <div class=\"flip-card-front\">\n                <p><p>Hospice care<\/p>\n<\/p>\n                <div id=\"flashcard-instruction-block_e16c576c1d5021bf9e0a3a8fd82e25cd\" class=\"flashcard-instruction\">Click to Flip<\/div>\n              <\/div>\n              <div class=\"flip-card-back\"><p>A type of care that may be provided alongside palliative care for symptom control. It can also refer to a place where end of life care is provided.<\/p>\n<\/div>\n            <\/div>\n          <\/button>\n        <\/div>\n\n        \n        <!-- Swiper Slide -->\n        <div class=\"swiper-slide\">\n          <!-- Flashcard -->\n           <button class=\"flip-card\" role=\"button\" tabindex=\"0\" data-front=\"Multidisciplinary team\" data-back=\"A group of healthcare professional from different disciplines (e.g. doctors, nurses, physiotherapists, occupational therapists, social workers, etc). who work together to provide the best care for a patient.\">\n            <div class=\"flip-card-inner\">\n              <div class=\"flip-card-front\">\n                <p><p>Multidisciplinary team<\/p>\n<\/p>\n                <div id=\"flashcard-instruction-block_e16c576c1d5021bf9e0a3a8fd82e25cd\" class=\"flashcard-instruction\">Click to Flip<\/div>\n              <\/div>\n              <div class=\"flip-card-back\"><p>A group of healthcare professional from different disciplines (e.g. doctors, nurses, physiotherapists, occupational therapists, social workers, etc). who work together to provide the best care for a patient.<\/p>\n<\/div>\n            <\/div>\n          <\/button>\n        <\/div>\n\n        \n        <!-- Swiper Slide -->\n        <div class=\"swiper-slide\">\n          <!-- Flashcard -->\n           <button class=\"flip-card\" role=\"button\" tabindex=\"0\" data-front=\"End of life care\" data-back=\"Medical care and support that helps with symptom management, comfort and dignity when a person is dying.\">\n            <div class=\"flip-card-inner\">\n              <div class=\"flip-card-front\">\n                <p><p>End of life care<\/p>\n<\/p>\n                <div id=\"flashcard-instruction-block_e16c576c1d5021bf9e0a3a8fd82e25cd\" class=\"flashcard-instruction\">Click to Flip<\/div>\n              <\/div>\n              <div class=\"flip-card-back\"><p>Medical care and support that helps with symptom management, comfort and dignity when a person is dying.<\/p>\n<\/div>\n            <\/div>\n          <\/button>\n        <\/div>\n\n        \n        <!-- Swiper Slide -->\n        <div class=\"swiper-slide\">\n          <!-- Flashcard -->\n           <button class=\"flip-card\" role=\"button\" tabindex=\"0\" data-front=\"Advanced care planning\" data-back=\"A way in which an individual can make decisions about future healthcare in case they are unable to communicate their wishes. It may include types of treatment and where they would like to receive that care\">\n            <div class=\"flip-card-inner\">\n              <div class=\"flip-card-front\">\n                <p><p>Advanced care planning<\/p>\n<\/p>\n                <div id=\"flashcard-instruction-block_e16c576c1d5021bf9e0a3a8fd82e25cd\" class=\"flashcard-instruction\">Click to Flip<\/div>\n              <\/div>\n              <div class=\"flip-card-back\"><p>A way in which an individual can make decisions about future healthcare in case they are unable to communicate their wishes. It may include types of treatment and where they would like to receive that care<\/p>\n<\/div>\n            <\/div>\n          <\/button>\n        <\/div>\n\n        \n        <!-- Swiper Slide -->\n        <div class=\"swiper-slide\">\n          <!-- Flashcard -->\n           <button class=\"flip-card\" role=\"button\" tabindex=\"0\" data-front=\"Advanced decision to refuse treatment (advanced care directive)\" data-back=\"A written, witnessed, legal document that details the specific treatments that an individual does not want to receive should they become unable to communicate.\">\n            <div class=\"flip-card-inner\">\n              <div class=\"flip-card-front\">\n                <p><p>Advanced decision to refuse treatment (advanced care directive)<\/p>\n<\/p>\n                <div id=\"flashcard-instruction-block_e16c576c1d5021bf9e0a3a8fd82e25cd\" class=\"flashcard-instruction\">Click to Flip<\/div>\n              <\/div>\n              <div class=\"flip-card-back\"><p>A written, witnessed, legal document that details the specific treatments that an individual does not want to receive should they become unable to communicate.<\/p>\n<\/div>\n            <\/div>\n          <\/button>\n        <\/div>\n\n        \n        <!-- Swiper Slide -->\n        <div class=\"swiper-slide\">\n          <!-- Flashcard -->\n           <button class=\"flip-card\" role=\"button\" tabindex=\"0\" data-front=\"Capacity\" data-back=\"The ability of an individual to understand and retain information in order that they can make informed decisions about their healthcare and communicate these decisions.\">\n            <div class=\"flip-card-inner\">\n              <div class=\"flip-card-front\">\n                <p><p>Capacity<\/p>\n<\/p>\n                <div id=\"flashcard-instruction-block_e16c576c1d5021bf9e0a3a8fd82e25cd\" class=\"flashcard-instruction\">Click to Flip<\/div>\n              <\/div>\n              <div class=\"flip-card-back\"><p>The ability of an individual to understand and retain information in order that they can make informed decisions about their healthcare and communicate these decisions.<\/p>\n<\/div>\n            <\/div>\n          <\/button>\n        <\/div>\n\n        \n        <!-- Swiper Slide -->\n        <div class=\"swiper-slide\">\n          <!-- Flashcard -->\n           <button class=\"flip-card\" role=\"button\" tabindex=\"0\" data-front=\"Cardiopulmonary resuscitation\" data-back=\"An emergency technique that involves chest compression to  pump blood to the brain and often combined with rescue breaths to provide oxygen for someone who has stopped breathing.\">\n            <div class=\"flip-card-inner\">\n              <div class=\"flip-card-front\">\n                <p><p>Cardiopulmonary resuscitation<\/p>\n<\/p>\n                <div id=\"flashcard-instruction-block_e16c576c1d5021bf9e0a3a8fd82e25cd\" class=\"flashcard-instruction\">Click to Flip<\/div>\n              <\/div>\n              <div class=\"flip-card-back\"><p>An emergency technique that involves chest compression to  pump blood to the brain and often combined with rescue breaths to provide oxygen for someone who has stopped breathing.<\/p>\n<\/div>\n            <\/div>\n          <\/button>\n        <\/div>\n\n        \n        <!-- Swiper Slide -->\n        <div class=\"swiper-slide\">\n          <!-- Flashcard -->\n           <button class=\"flip-card\" role=\"button\" tabindex=\"0\" data-front=\"Artificial ventilation\" data-back=\"A machine such as a ventilated that assist or completely takes over an individual&#8217;s breathing.\">\n            <div class=\"flip-card-inner\">\n              <div class=\"flip-card-front\">\n                <p><p>Artificial ventilation<\/p>\n<\/p>\n                <div id=\"flashcard-instruction-block_e16c576c1d5021bf9e0a3a8fd82e25cd\" class=\"flashcard-instruction\">Click to Flip<\/div>\n              <\/div>\n              <div class=\"flip-card-back\"><p>A machine such as a ventilated that assist or completely takes over an individual&#8217;s breathing.<\/p>\n<\/div>\n            <\/div>\n          <\/button>\n        <\/div>\n\n        \n        <!-- Swiper Slide -->\n        <div class=\"swiper-slide\">\n          <!-- Flashcard -->\n           <button class=\"flip-card\" role=\"button\" tabindex=\"0\" data-front=\"Tube feeding\" data-back=\"Delivery of nutrition through a tube into the stomach or intestines, usually used when a person cannot eat.\">\n            <div class=\"flip-card-inner\">\n              <div class=\"flip-card-front\">\n                <p><p>Tube feeding<\/p>\n<\/p>\n                <div id=\"flashcard-instruction-block_e16c576c1d5021bf9e0a3a8fd82e25cd\" class=\"flashcard-instruction\">Click to Flip<\/div>\n              <\/div>\n              <div class=\"flip-card-back\"><p>Delivery of nutrition through a tube into the stomach or intestines, usually used when a person cannot eat.<\/p>\n<\/div>\n            <\/div>\n          <\/button>\n        <\/div>\n\n        \n        <!-- Swiper Slide -->\n        <div class=\"swiper-slide\">\n          <!-- Flashcard -->\n           <button class=\"flip-card\" role=\"button\" tabindex=\"0\" data-front=\"Finishing up\" data-back=\"A term used by some Indigenous People to describe death and traditional ceremonial practices that take pace after death that honours the person and their transition into the spirit world.\">\n            <div class=\"flip-card-inner\">\n              <div class=\"flip-card-front\">\n                <p><p>Finishing up<\/p>\n<\/p>\n                <div id=\"flashcard-instruction-block_e16c576c1d5021bf9e0a3a8fd82e25cd\" class=\"flashcard-instruction\">Click to Flip<\/div>\n              <\/div>\n              <div class=\"flip-card-back\"><p>A term used by some Indigenous People to describe death and traditional ceremonial practices that take pace after death that honours the person and their transition into the spirit world.<\/p>\n<\/div>\n   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You have selected correct answer.\",\"quick_result_wrong_answer_text\":\"Wrong! 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beliefs\",\"1\":\"\",\"2\":\"\",\"3\":\"\",\"label\":\"\"},{\"0\":\"Tailor care to fit the patient's cultural context\",\"1\":\"\",\"2\":\"1\",\"3\":\"\",\"label\":\"\"},{\"0\":\"Speak only to family members\",\"1\":\"\",\"2\":\"\",\"3\":\"\",\"label\":\"\"}]},\"1511\":{\"question_id\":\"1511\",\"quiz_id\":\"84\",\"question_name\":\"\",\"answer_array\":\"a:4:{i:0;a:5:{i:0;s:40:\\\"Discrimination and lack of tailored care\\\";i:1;s:0:\\\"\\\";i:2;s:1:\\\"1\\\";i:3;s:0:\\\"\\\";s:5:\\\"label\\\";s:0:\\\"\\\";}i:1;a:5:{i:0;s:29:\\\"Culturally inclusive policies\\\";i:1;s:0:\\\"\\\";i:2;s:0:\\\"\\\";i:3;s:0:\\\"\\\";s:5:\\\"label\\\";s:0:\\\"\\\";}i:2;a:5:{i:0;s:24:\\\"Too many service options\\\";i:1;s:0:\\\"\\\";i:2;s:0:\\\"\\\";i:3;s:0:\\\"\\\";s:5:\\\"label\\\";s:0:\\\"\\\";}i:3;a:5:{i:0;s:24:\\\"Exclusive hospice access\\\";i:1;s:0:\\\"\\\";i:2;s:0:\\\"\\\";i:3;s:0:\\\"\\\";s:5:\\\"label\\\";s:0:\\\"\\\";}}\",\"answer_one\":\"\",\"answer_one_points\":\"0\",\"answer_two\":\"\",\"answer_two_points\":\"0\",\"answer_three\":\"\",\"answer_three_points\":\"0\",\"answer_four\":\"\",\"answer_four_points\":\"0\",\"answer_five\":\"\",\"answer_five_points\":\"0\",\"answer_six\":\"\",\"answer_six_points\":\"0\",\"correct_answer\":\"0\",\"question_answer_info\":\"People from gender and sexual minority groups may face barriers in palliative care due to discrimination and lack of tailored care.\",\"comments\":\"1\",\"hints\":\"\",\"question_order\":\"0\",\"question_type\":\"0\",\"question_type_new\":\"0\",\"question_settings\":\"a:13:{s:14:\\\"question_title\\\";s:90:\\\"People from gender and sexual minority groups may face barriers in palliative care due to:\\\";s:8:\\\"required\\\";i:0;s:12:\\\"answerEditor\\\";s:4:\\\"text\\\";s:15:\\\"featureImageSrc\\\";s:0:\\\"\\\";s:11:\\\"matchAnswer\\\";s:6:\\\"random\\\";s:14:\\\"case_sensitive\\\";s:0:\\\"\\\";s:14:\\\"answer_columns\\\";s:0:\\\"\\\";s:16:\\\"image_size-width\\\";s:0:\\\"\\\";s:17:\\\"image_size-height\\\";s:0:\\\"\\\";s:8:\\\"autofill\\\";s:0:\\\"\\\";s:23:\\\"limit_multiple_response\\\";s:0:\\\"\\\";s:17:\\\"file_upload_limit\\\";s:1:\\\"4\\\";s:16:\\\"file_upload_type\\\";s:21:\\\"image,application\\\/pdf\\\";}\",\"category\":\"\",\"linked_question\":\"\",\"deleted\":\"0\",\"deleted_question_bank\":\"0\",\"answers\":[{\"0\":\"Discrimination and lack of tailored care\",\"1\":\"\",\"2\":\"1\",\"3\":\"\",\"label\":\"\"},{\"0\":\"Culturally inclusive policies\",\"1\":\"\",\"2\":\"\",\"3\":\"\",\"label\":\"\"},{\"0\":\"Too many service options\",\"1\":\"\",\"2\":\"\",\"3\":\"\",\"label\":\"\"},{\"0\":\"Exclusive hospice access\",\"1\":\"\",\"2\":\"\",\"3\":\"\",\"label\":\"\"}]},\"1512\":{\"question_id\":\"1512\",\"quiz_id\":\"84\",\"question_name\":\"\",\"answer_array\":\"a:4:{i:0;a:5:{i:0;s:35:\\\"They replace all medical treatments\\\";i:1;s:0:\\\"\\\";i:2;s:0:\\\"\\\";i:3;s:0:\\\"\\\";s:5:\\\"label\\\";s:0:\\\"\\\";}i:1;a:5:{i:0;s:41:\\\"They support and honour cultural identity\\\";i:1;s:0:\\\"\\\";i:2;s:1:\\\"1\\\";i:3;s:0:\\\"\\\";s:5:\\\"label\\\";s:0:\\\"\\\";}i:2;a:5:{i:0;s:35:\\\"They have no impact on care quality\\\";i:1;s:0:\\\"\\\";i:2;s:0:\\\"\\\";i:3;s:0:\\\"\\\";s:5:\\\"label\\\";s:0:\\\"\\\";}i:3;a:5:{i:0;s:44:\\\"They are only relevant in religious settings\\\";i:1;s:0:\\\"\\\";i:2;s:0:\\\"\\\";i:3;s:0:\\\"\\\";s:5:\\\"label\\\";s:0:\\\"\\\";}}\",\"answer_one\":\"\",\"answer_one_points\":\"0\",\"answer_two\":\"\",\"answer_two_points\":\"0\",\"answer_three\":\"\",\"answer_three_points\":\"0\",\"answer_four\":\"\",\"answer_four_points\":\"0\",\"answer_five\":\"\",\"answer_five_points\":\"0\",\"answer_six\":\"\",\"answer_six_points\":\"0\",\"correct_answer\":\"0\",\"question_answer_info\":\"Access to Indigenous spiritual practices is important in end-of-life care because they support and honour cultural identity.\",\"comments\":\"1\",\"hints\":\"\",\"question_order\":\"0\",\"question_type\":\"0\",\"question_type_new\":\"0\",\"question_settings\":\"a:13:{s:14:\\\"question_title\\\";s:78:\\\"Why is access to Indigenous spiritual practices important in end-of-life care:\\\";s:8:\\\"required\\\";i:0;s:12:\\\"answerEditor\\\";s:4:\\\"text\\\";s:15:\\\"featureImageSrc\\\";s:0:\\\"\\\";s:11:\\\"matchAnswer\\\";s:6:\\\"random\\\";s:14:\\\"case_sensitive\\\";s:0:\\\"\\\";s:14:\\\"answer_columns\\\";s:0:\\\"\\\";s:16:\\\"image_size-width\\\";s:0:\\\"\\\";s:17:\\\"image_size-height\\\";s:0:\\\"\\\";s:8:\\\"autofill\\\";s:0:\\\"\\\";s:23:\\\"limit_multiple_response\\\";s:0:\\\"\\\";s:17:\\\"file_upload_limit\\\";s:1:\\\"4\\\";s:16:\\\"file_upload_type\\\";s:21:\\\"image,application\\\/pdf\\\";}\",\"category\":\"\",\"linked_question\":\"\",\"deleted\":\"0\",\"deleted_question_bank\":\"0\",\"answers\":[{\"0\":\"They replace all medical treatments\",\"1\":\"\",\"2\":\"\",\"3\":\"\",\"label\":\"\"},{\"0\":\"They support and honour cultural identity\",\"1\":\"\",\"2\":\"1\",\"3\":\"\",\"label\":\"\"},{\"0\":\"They have no impact on care quality\",\"1\":\"\",\"2\":\"\",\"3\":\"\",\"label\":\"\"},{\"0\":\"They are only relevant in religious settings\",\"1\":\"\",\"2\":\"\",\"3\":\"\",\"label\":\"\"}]},\"1513\":{\"question_id\":\"1513\",\"quiz_id\":\"84\",\"question_name\":\"\",\"answer_array\":\"a:4:{i:0;a:5:{i:0;s:32:\\\"Oversupply of opioid medications\\\";i:1;s:0:\\\"\\\";i:2;s:0:\\\"\\\";i:3;s:0:\\\"\\\";s:5:\\\"label\\\";s:0:\\\"\\\";}i:1;a:5:{i:0;s:50:\\\"Easy access to opioid medications in all countries\\\";i:1;s:0:\\\"\\\";i:2;s:0:\\\"\\\";i:3;s:0:\\\"\\\";s:5:\\\"label\\\";s:0:\\\"\\\";}i:2;a:5:{i:0;s:54:\\\"Unequal access to opioid medications in some countries\\\";i:1;s:0:\\\"\\\";i:2;s:1:\\\"1\\\";i:3;s:0:\\\"\\\";s:5:\\\"label\\\";s:0:\\\"\\\";}i:3;a:5:{i:0;s:32:\\\"Excess use of non-drug therapies\\\";i:1;s:0:\\\"\\\";i:2;s:0:\\\"\\\";i:3;s:0:\\\"\\\";s:5:\\\"label\\\";s:0:\\\"\\\";}}\",\"answer_one\":\"\",\"answer_one_points\":\"0\",\"answer_two\":\"\",\"answer_two_points\":\"0\",\"answer_three\":\"\",\"answer_three_points\":\"0\",\"answer_four\":\"\",\"answer_four_points\":\"0\",\"answer_five\":\"\",\"answer_five_points\":\"0\",\"answer_six\":\"\",\"answer_six_points\":\"0\",\"correct_answer\":\"0\",\"question_answer_info\":\"A major global challenge in palliative care is unequal access to opioid medications in some countries.\",\"comments\":\"1\",\"hints\":\"\",\"question_order\":\"0\",\"question_type\":\"0\",\"question_type_new\":\"0\",\"question_settings\":\"a:13:{s:14:\\\"question_title\\\";s:47:\\\"A major global challenge in palliative care is:\\\";s:8:\\\"required\\\";i:0;s:12:\\\"answerEditor\\\";s:4:\\\"text\\\";s:15:\\\"featureImageSrc\\\";s:0:\\\"\\\";s:11:\\\"matchAnswer\\\";s:6:\\\"random\\\";s:14:\\\"case_sensitive\\\";s:0:\\\"\\\";s:14:\\\"answer_columns\\\";s:0:\\\"\\\";s:16:\\\"image_size-width\\\";s:0:\\\"\\\";s:17:\\\"image_size-height\\\";s:0:\\\"\\\";s:8:\\\"autofill\\\";s:0:\\\"\\\";s:23:\\\"limit_multiple_response\\\";s:0:\\\"\\\";s:17:\\\"file_upload_limit\\\";s:1:\\\"4\\\";s:16:\\\"file_upload_type\\\";s:21:\\\"image,application\\\/pdf\\\";}\",\"category\":\"\",\"linked_question\":\"\",\"deleted\":\"0\",\"deleted_question_bank\":\"0\",\"answers\":[{\"0\":\"Oversupply of opioid medications\",\"1\":\"\",\"2\":\"\",\"3\":\"\",\"label\":\"\"},{\"0\":\"Easy access to opioid medications in all countries\",\"1\":\"\",\"2\":\"\",\"3\":\"\",\"label\":\"\"},{\"0\":\"Unequal access to opioid medications in some countries\",\"1\":\"\",\"2\":\"1\",\"3\":\"\",\"label\":\"\"},{\"0\":\"Excess use of non-drug therapies\",\"1\":\"\",\"2\":\"\",\"3\":\"\",\"label\":\"\"}]}},\"first_page\":false,\"questions_settings\":[]}\n                    <\/script>\t\t<div class='qsm-quiz-container qsm-quiz-container-84 qmn_quiz_container mlw_qmn_quiz qsm_auto_pagination_enabled quiz_theme_default  '>\n\t\t\t\t\t\t\t\t<form name=\"quizForm84\" id=\"quizForm84\" action=\"\/bpscoretextbooks\/wp-json\/wp\/v2\/content\/3133\/\" method=\"POST\" class=\"qsm-quiz-form qmn_quiz_form mlw_quiz_form\" novalidate enctype=\"multipart\/form-data\">\n\t\t\t\t<input type=\"hidden\" name=\"qsm_hidden_questions\" id=\"qsm_hidden_questions\" value=\"\">\n\t\t\t\t<input type=\"hidden\" name=\"qsm_nonce\" id=\"qsm_nonce_84\" value=\"4944512ed0\">\n\t\t\t\t<input type=\"hidden\" name=\"qsm_unique_key\" id=\"qsm_unique_key_84\" value=\"6aaa8942a0487\">\n\t\t\t\t<div id=\"mlw_error_message\" class=\"qsm-error-message qmn_error_message_section\"><\/div>\n\t\t\t\t<span id=\"mlw_top_of_quiz\"><\/span>\n\t\t\t\t\t\t\t\t\t<div class=\"qsm-auto-page-row qsm-question-page qsm-apc-1\" data-apid=\"1\" data-qpid=\"1\" style=\"display: none;\">\n\t\t\t\t\t\t\t\t<div class=\"quiz_section qsm-question-wrapper question-type-0  question-section-id-1504 slide0 \">\n\t\t\t\t\t\t\t\t\t\t<span class='mlw_qmn_question_number'>1.&nbsp;<\/span>\n\t\t\t\t\t\t\t\t<div class='mlw_qmn_new_question'>Which of the following best describes the shift in the focus of palliative care over recent years: <\/div>\n\t\t\t<div class='mlw_qmn_question  qsm_remove_bold' >\n\t\t<p><\/p>\n\t<\/div>\n\t\t<fieldset>\n\t\t<legend><\/legend>\n\t<div class='qmn_radio_answers mlwRequiredRadio'>\n\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1504-1 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1504\" id=\"question1504_1\" value=\"0\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1504_1\">\n\t\t\t\t\tIt is now exclusively for patients with a terminal diagnosis of cancer\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1504-2 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1504\" id=\"question1504_2\" value=\"1\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1504_2\">\n\t\t\t\t\tIt is only provided in a hospital setting\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1504-3 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1504\" id=\"question1504_3\" value=\"2\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1504_3\">\n\t\t\t\t\tIt now includes people with chronic conditions like heart failure, end stage kidney disease and dementia\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1504-4 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1504\" id=\"question1504_4\" value=\"3\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1504_4\">\n\t\t\t\t\tIt is no longer used for symptom control\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t \t\t\t<label style=\"display: none !important;\" for=\"question1504_none\">None<\/label>\n\t\t\t<input type=\"radio\" style=\"display: none;\" name=\"question1504\" id=\"question1504_none\" checked=\"checked\" value=\"\" \/>\n\t\t\t\t<\/div>\n\t<\/fieldset>\n\t<input type=\"hidden\" name=\"answer_limit_keys_1504\" value=\"\" \/>\n\t\t\t\t<\/div><!-- .quiz_section -->\n\t\t\t\t\t\t\t\t<\/div><!-- .qsm-auto-page-row -->\n\t\t\t\t\t\t\t\t\t\t<div class=\"qsm-auto-page-row qsm-question-page qsm-apc-2\" data-apid=\"2\" data-qpid=\"2\" style=\"display: none;\">\n\t\t\t\t\t\t\t\t<div class=\"quiz_section qsm-question-wrapper question-type-0  question-section-id-1505 slide1 \">\n\t\t\t\t\t\t\t\t\t\t<span class='mlw_qmn_question_number'>2.&nbsp;<\/span>\n\t\t\t\t\t\t\t\t<div class='mlw_qmn_new_question'>For an Advance Decision to Refuse Treatment to be legally binding in England and Wales, it must: <\/div>\n\t\t\t<div class='mlw_qmn_question  qsm_remove_bold' >\n\t\t<p><\/p>\n\t<\/div>\n\t\t<fieldset>\n\t\t<legend><\/legend>\n\t<div class='qmn_radio_answers mlwRequiredRadio'>\n\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1505-1 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1505\" id=\"question1505_1\" value=\"0\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1505_1\">\n\t\t\t\t\tBe signed by a solicitor\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1505-2 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1505\" id=\"question1505_2\" value=\"1\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1505_2\">\n\t\t\t\t\tBe written and witnessed, especially if it refuses life-sustaining treatment\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1505-3 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1505\" id=\"question1505_3\" value=\"2\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1505_3\">\n\t\t\t\t\tOnly be made with a doctor present\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1505-4 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1505\" id=\"question1505_4\" value=\"3\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1505_4\">\n\t\t\t\t\tBe registered with the NHS\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t \t\t\t<label style=\"display: none !important;\" for=\"question1505_none\">None<\/label>\n\t\t\t<input type=\"radio\" style=\"display: none;\" name=\"question1505\" id=\"question1505_none\" checked=\"checked\" value=\"\" \/>\n\t\t\t\t<\/div>\n\t<\/fieldset>\n\t<input type=\"hidden\" name=\"answer_limit_keys_1505\" value=\"\" \/>\n\t\t\t\t<\/div><!-- .quiz_section -->\n\t\t\t\t\t\t\t\t<\/div><!-- .qsm-auto-page-row -->\n\t\t\t\t\t\t\t\t\t\t<div class=\"qsm-auto-page-row qsm-question-page qsm-apc-3\" data-apid=\"3\" data-qpid=\"3\" style=\"display: none;\">\n\t\t\t\t\t\t\t\t<div class=\"quiz_section qsm-question-wrapper question-type-0  question-section-id-1506 slide2 \">\n\t\t\t\t\t\t\t\t\t\t<span class='mlw_qmn_question_number'>3.&nbsp;<\/span>\n\t\t\t\t\t\t\t\t<div class='mlw_qmn_new_question'>Under the Mental Capacity Act, (2005) in England and Wales a person is considered to lack capacity if they cannot: <\/div>\n\t\t\t<div class='mlw_qmn_question  qsm_remove_bold' >\n\t\t<p><\/p>\n\t<\/div>\n\t\t<fieldset>\n\t\t<legend><\/legend>\n\t<div class='qmn_radio_answers mlwRequiredRadio'>\n\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1506-1 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1506\" id=\"question1506_1\" value=\"0\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1506_1\">\n\t\t\t\t\tFollow medical advice\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1506-2 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1506\" id=\"question1506_2\" value=\"1\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1506_2\">\n\t\t\t\t\tRemember appointments\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1506-3 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1506\" id=\"question1506_3\" value=\"2\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1506_3\">\n\t\t\t\t\tSign documents\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1506-4 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1506\" id=\"question1506_4\" value=\"3\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1506_4\">\n\t\t\t\t\tUnderstand, remember, weigh up, or communicate decisions\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t \t\t\t<label style=\"display: none !important;\" for=\"question1506_none\">None<\/label>\n\t\t\t<input type=\"radio\" style=\"display: none;\" name=\"question1506\" id=\"question1506_none\" checked=\"checked\" value=\"\" \/>\n\t\t\t\t<\/div>\n\t<\/fieldset>\n\t<input type=\"hidden\" name=\"answer_limit_keys_1506\" value=\"\" \/>\n\t\t\t\t<\/div><!-- .quiz_section -->\n\t\t\t\t\t\t\t\t<\/div><!-- .qsm-auto-page-row -->\n\t\t\t\t\t\t\t\t\t\t<div class=\"qsm-auto-page-row qsm-question-page qsm-apc-4\" data-apid=\"4\" data-qpid=\"4\" style=\"display: none;\">\n\t\t\t\t\t\t\t\t<div class=\"quiz_section qsm-question-wrapper question-type-0  question-section-id-1507 slide3 \">\n\t\t\t\t\t\t\t\t\t\t<span class='mlw_qmn_question_number'>4.&nbsp;<\/span>\n\t\t\t\t\t\t\t\t<div class='mlw_qmn_new_question'>Respect for patient autonomy includes: <\/div>\n\t\t\t<div class='mlw_qmn_question  qsm_remove_bold' >\n\t\t<p><\/p>\n\t<\/div>\n\t\t<fieldset>\n\t\t<legend><\/legend>\n\t<div class='qmn_radio_answers mlwRequiredRadio'>\n\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1507-1 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1507\" id=\"question1507_1\" value=\"0\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1507_1\">\n\t\t\t\t\tAlways following family wishes\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1507-2 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1507\" id=\"question1507_2\" value=\"1\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1507_2\">\n\t\t\t\t\tIgnoring cultural values\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1507-3 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1507\" id=\"question1507_3\" value=\"2\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1507_3\">\n\t\t\t\t\tSupporting informed decisions made by the patient\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1507-4 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1507\" id=\"question1507_4\" value=\"3\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1507_4\">\n\t\t\t\t\tAvoiding difficult conversations\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t \t\t\t<label style=\"display: none !important;\" for=\"question1507_none\">None<\/label>\n\t\t\t<input type=\"radio\" style=\"display: none;\" name=\"question1507\" id=\"question1507_none\" checked=\"checked\" value=\"\" \/>\n\t\t\t\t<\/div>\n\t<\/fieldset>\n\t<input type=\"hidden\" name=\"answer_limit_keys_1507\" value=\"\" \/>\n\t\t\t\t<\/div><!-- .quiz_section -->\n\t\t\t\t\t\t\t\t<\/div><!-- .qsm-auto-page-row -->\n\t\t\t\t\t\t\t\t\t\t<div class=\"qsm-auto-page-row qsm-question-page qsm-apc-5\" data-apid=\"5\" data-qpid=\"5\" style=\"display: none;\">\n\t\t\t\t\t\t\t\t<div class=\"quiz_section qsm-question-wrapper question-type-0  question-section-id-1508 slide4 \">\n\t\t\t\t\t\t\t\t\t\t<span class='mlw_qmn_question_number'>5.&nbsp;<\/span>\n\t\t\t\t\t\t\t\t<div class='mlw_qmn_new_question'>Palliative care primarily aims to: <\/div>\n\t\t\t<div class='mlw_qmn_question  qsm_remove_bold' >\n\t\t<p><\/p>\n\t<\/div>\n\t\t<fieldset>\n\t\t<legend><\/legend>\n\t<div class='qmn_radio_answers mlwRequiredRadio'>\n\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1508-1 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1508\" id=\"question1508_1\" value=\"0\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1508_1\">\n\t\t\t\t\tCure serious illness\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1508-2 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1508\" id=\"question1508_2\" value=\"1\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1508_2\">\n\t\t\t\t\tProlong life at all costs\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1508-3 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1508\" id=\"question1508_3\" value=\"2\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1508_3\">\n\t\t\t\t\tReplace emergency care\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1508-4 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1508\" id=\"question1508_4\" value=\"3\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1508_4\">\n\t\t\t\t\tRelieve suffering and improve quality of life\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t \t\t\t<label style=\"display: none !important;\" for=\"question1508_none\">None<\/label>\n\t\t\t<input type=\"radio\" style=\"display: none;\" name=\"question1508\" id=\"question1508_none\" checked=\"checked\" value=\"\" \/>\n\t\t\t\t<\/div>\n\t<\/fieldset>\n\t<input type=\"hidden\" name=\"answer_limit_keys_1508\" value=\"\" \/>\n\t\t\t\t<\/div><!-- .quiz_section -->\n\t\t\t\t\t\t\t\t<\/div><!-- .qsm-auto-page-row -->\n\t\t\t\t\t\t\t\t\t\t<div class=\"qsm-auto-page-row qsm-question-page qsm-apc-6\" data-apid=\"6\" data-qpid=\"6\" style=\"display: none;\">\n\t\t\t\t\t\t\t\t<div class=\"quiz_section qsm-question-wrapper question-type-0  question-section-id-1509 slide5 \">\n\t\t\t\t\t\t\t\t\t\t<span class='mlw_qmn_question_number'>6.&nbsp;<\/span>\n\t\t\t\t\t\t\t\t<div class='mlw_qmn_new_question'>According to global health data, how many African countries currently have some form of palliative care service: <\/div>\n\t\t\t<div class='mlw_qmn_question  qsm_remove_bold' >\n\t\t<p><\/p>\n\t<\/div>\n\t\t<fieldset>\n\t\t<legend><\/legend>\n\t<div class='qmn_radio_answers mlwRequiredRadio'>\n\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1509-1 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1509\" id=\"question1509_1\" value=\"0\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1509_1\">\n\t\t\t\t\t37\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1509-2 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1509\" id=\"question1509_2\" value=\"1\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1509_2\">\n\t\t\t\t\t25\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1509-3 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1509\" id=\"question1509_3\" value=\"2\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1509_3\">\n\t\t\t\t\t12\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1509-4 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1509\" id=\"question1509_4\" value=\"3\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1509_4\">\n\t\t\t\t\t54\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t \t\t\t<label style=\"display: none !important;\" for=\"question1509_none\">None<\/label>\n\t\t\t<input type=\"radio\" style=\"display: none;\" name=\"question1509\" id=\"question1509_none\" checked=\"checked\" value=\"\" \/>\n\t\t\t\t<\/div>\n\t<\/fieldset>\n\t<input type=\"hidden\" name=\"answer_limit_keys_1509\" value=\"\" \/>\n\t\t\t\t<\/div><!-- .quiz_section -->\n\t\t\t\t\t\t\t\t<\/div><!-- .qsm-auto-page-row -->\n\t\t\t\t\t\t\t\t\t\t<div class=\"qsm-auto-page-row qsm-question-page qsm-apc-7\" data-apid=\"7\" data-qpid=\"7\" style=\"display: none;\">\n\t\t\t\t\t\t\t\t<div class=\"quiz_section qsm-question-wrapper question-type-0  question-section-id-1510 slide6 \">\n\t\t\t\t\t\t\t\t\t\t<span class='mlw_qmn_question_number'>7.&nbsp;<\/span>\n\t\t\t\t\t\t\t\t<div class='mlw_qmn_new_question'>A culturally competent palliative care provider should: <\/div>\n\t\t\t<div class='mlw_qmn_question  qsm_remove_bold' >\n\t\t<p><\/p>\n\t<\/div>\n\t\t<fieldset>\n\t\t<legend><\/legend>\n\t<div class='qmn_radio_answers mlwRequiredRadio'>\n\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1510-1 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1510\" id=\"question1510_1\" value=\"0\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1510_1\">\n\t\t\t\t\tImpose Western values\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1510-2 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1510\" id=\"question1510_2\" value=\"1\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1510_2\">\n\t\t\t\t\tAvoid discussing cultural beliefs\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1510-3 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1510\" id=\"question1510_3\" value=\"2\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1510_3\">\n\t\t\t\t\tTailor care to fit the patient's cultural context\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1510-4 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1510\" id=\"question1510_4\" value=\"3\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1510_4\">\n\t\t\t\t\tSpeak only to family members\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t \t\t\t<label style=\"display: none !important;\" for=\"question1510_none\">None<\/label>\n\t\t\t<input type=\"radio\" style=\"display: none;\" name=\"question1510\" id=\"question1510_none\" checked=\"checked\" value=\"\" \/>\n\t\t\t\t<\/div>\n\t<\/fieldset>\n\t<input type=\"hidden\" name=\"answer_limit_keys_1510\" value=\"\" \/>\n\t\t\t\t<\/div><!-- .quiz_section -->\n\t\t\t\t\t\t\t\t<\/div><!-- .qsm-auto-page-row -->\n\t\t\t\t\t\t\t\t\t\t<div class=\"qsm-auto-page-row qsm-question-page qsm-apc-8\" data-apid=\"8\" data-qpid=\"8\" style=\"display: none;\">\n\t\t\t\t\t\t\t\t<div class=\"quiz_section qsm-question-wrapper question-type-0  question-section-id-1511 slide7 \">\n\t\t\t\t\t\t\t\t\t\t<span class='mlw_qmn_question_number'>8.&nbsp;<\/span>\n\t\t\t\t\t\t\t\t<div class='mlw_qmn_new_question'>People from gender and sexual minority groups may face barriers in palliative care due to: <\/div>\n\t\t\t<div class='mlw_qmn_question  qsm_remove_bold' >\n\t\t<p><\/p>\n\t<\/div>\n\t\t<fieldset>\n\t\t<legend><\/legend>\n\t<div class='qmn_radio_answers mlwRequiredRadio'>\n\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1511-1 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1511\" id=\"question1511_1\" value=\"0\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1511_1\">\n\t\t\t\t\tDiscrimination and lack of tailored care\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1511-2 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1511\" id=\"question1511_2\" value=\"1\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1511_2\">\n\t\t\t\t\tCulturally inclusive policies\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1511-3 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1511\" id=\"question1511_3\" value=\"2\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1511_3\">\n\t\t\t\t\tToo many service options\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1511-4 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1511\" id=\"question1511_4\" value=\"3\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1511_4\">\n\t\t\t\t\tExclusive hospice access\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t \t\t\t<label style=\"display: none !important;\" for=\"question1511_none\">None<\/label>\n\t\t\t<input type=\"radio\" style=\"display: none;\" name=\"question1511\" id=\"question1511_none\" checked=\"checked\" value=\"\" \/>\n\t\t\t\t<\/div>\n\t<\/fieldset>\n\t<input type=\"hidden\" name=\"answer_limit_keys_1511\" value=\"\" \/>\n\t\t\t\t<\/div><!-- .quiz_section -->\n\t\t\t\t\t\t\t\t<\/div><!-- .qsm-auto-page-row -->\n\t\t\t\t\t\t\t\t\t\t<div class=\"qsm-auto-page-row qsm-question-page qsm-apc-9\" data-apid=\"9\" data-qpid=\"9\" style=\"display: none;\">\n\t\t\t\t\t\t\t\t<div class=\"quiz_section qsm-question-wrapper question-type-0  question-section-id-1512 slide8 \">\n\t\t\t\t\t\t\t\t\t\t<span class='mlw_qmn_question_number'>9.&nbsp;<\/span>\n\t\t\t\t\t\t\t\t<div class='mlw_qmn_new_question'>Why is access to Indigenous spiritual practices important in end-of-life care: <\/div>\n\t\t\t<div class='mlw_qmn_question  qsm_remove_bold' >\n\t\t<p><\/p>\n\t<\/div>\n\t\t<fieldset>\n\t\t<legend><\/legend>\n\t<div class='qmn_radio_answers mlwRequiredRadio'>\n\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1512-1 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1512\" id=\"question1512_1\" value=\"0\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1512_1\">\n\t\t\t\t\tThey replace all medical treatments\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1512-2 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1512\" id=\"question1512_2\" value=\"1\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1512_2\">\n\t\t\t\t\tThey support and honour cultural identity\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1512-3 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1512\" id=\"question1512_3\" value=\"2\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1512_3\">\n\t\t\t\t\tThey have no impact on care quality\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1512-4 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1512\" id=\"question1512_4\" value=\"3\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1512_4\">\n\t\t\t\t\tThey are only relevant in religious settings\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t \t\t\t<label style=\"display: none !important;\" for=\"question1512_none\">None<\/label>\n\t\t\t<input type=\"radio\" style=\"display: none;\" name=\"question1512\" id=\"question1512_none\" checked=\"checked\" value=\"\" \/>\n\t\t\t\t<\/div>\n\t<\/fieldset>\n\t<input type=\"hidden\" name=\"answer_limit_keys_1512\" value=\"\" \/>\n\t\t\t\t<\/div><!-- .quiz_section -->\n\t\t\t\t\t\t\t\t<\/div><!-- .qsm-auto-page-row -->\n\t\t\t\t\t\t\t\t\t\t<div class=\"qsm-auto-page-row qsm-question-page qsm-apc-10\" data-apid=\"10\" data-qpid=\"10\" style=\"display: none;\">\n\t\t\t\t\t\t\t\t<div class=\"quiz_section qsm-question-wrapper question-type-0  question-section-id-1513 slide9 \">\n\t\t\t\t\t\t\t\t\t\t<span class='mlw_qmn_question_number'>10.&nbsp;<\/span>\n\t\t\t\t\t\t\t\t<div class='mlw_qmn_new_question'>A major global challenge in palliative care is: <\/div>\n\t\t\t<div class='mlw_qmn_question  qsm_remove_bold' >\n\t\t<p><\/p>\n\t<\/div>\n\t\t<fieldset>\n\t\t<legend><\/legend>\n\t<div class='qmn_radio_answers mlwRequiredRadio'>\n\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1513-1 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1513\" id=\"question1513_1\" value=\"0\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1513_1\">\n\t\t\t\t\tOversupply of opioid medications\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1513-2 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1513\" id=\"question1513_2\" value=\"1\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1513_2\">\n\t\t\t\t\tEasy access to opioid medications in all countries\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1513-3 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1513\" id=\"question1513_3\" value=\"2\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1513_3\">\n\t\t\t\t\tUnequal access to opioid medications in some countries\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"qmn_mc_answer_wrap  mrq_checkbox_class\" id=\"question1513-4 \">\n\t\t\t\t\t\t\t\t\t\t\t<input type='radio' class='qmn_quiz_radio qmn-multiple-choice-input ' name=\"question1513\" id=\"question1513_4\" value=\"3\" \/>\n\t\t\t\t\t<label class=\"qsm-input-label\" for=\"question1513_4\">\n\t\t\t\t\tExcess use of non-drug therapies\t\t\t\t\t<\/label>\n\t\t\t\t\t \t\t\t\t<\/div>\n\t\t\t\t\t \t\t\t<label style=\"display: none !important;\" for=\"question1513_none\">None<\/label>\n\t\t\t<input type=\"radio\" style=\"display: none;\" name=\"question1513\" id=\"question1513_none\" checked=\"checked\" value=\"\" \/>\n\t\t\t\t<\/div>\n\t<\/fieldset>\n\t<input type=\"hidden\" name=\"answer_limit_keys_1513\" value=\"\" \/>\n\t\t\t\t<\/div><!-- .quiz_section -->\n\t\t\t\t\t\t\t\t<\/div><!-- .qsm-auto-page-row -->\n\t\t\t\t\t\t\t<input type=\"hidden\" name=\"qmn_question_list\" value=\"1504Q1505Q1506Q1507Q1508Q1509Q1510Q1511Q1512Q1513Q\" \/>\n\t\t\t\t\t<div class=\"qsm-auto-page-row quiz_section quiz_end empty_quiz_end qsm-d-none\" >\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div id=\"mlw_error_message_bottom\" class=\"qsm-error-message qmn_error_message_section\"><\/div>\n\t\t\t\t\t<input type=\"hidden\" 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