Dr. Harvey Max Chochinov

Harvey Max Chochinov OC OM FRSC (born March 9, 1958)[1] is a Canadian academic and psychiatrist from Winnipeg, Canada. He is a leading authority on the emotional dimensions of end-of-life, and on supportive and palliative care.[2] He is a Distinguished Professor of Psychiatry at the University of Manitoba and a Senior Scientist at CancerCare Manitoba Research Institute.[3]

Chochinov's research focuses on best practices in psycho-oncology and enhancing the psychological well-being and quality of life of patients with advanced disease. He is credited with meticulously examining the experiential landscape of advanced illness and enriching the care of individuals with advanced illness worldwide.[4]

He completed his MD and PhD (Community Health Sciences) at the University of Manitoba; he completed his residency in psychiatry, followed by a fellowship in psycho-oncology at Memorial Sloan Kettering Cancer Center in New York.

Career

Chochinov is a leading expert in palliative care, with a focus on the dignity of patients, proper communication, and existential suffering. He developed dignity therapy, which is currently used by palliative care practitioners worldwide for its benefits for patients at the end of life, relatives and health professionals.[5][6][7] Dignity therapy involves creating a narrative document with the dying patient that gives them the chance to reflect on their life experiences.[8]

He has also developed the Patient Dignity Inventory (PDI), which is an instrument used to measure dignity related distress in patients with life threatening and life limiting disease.[9] It has been translated and validated in multiple languages for broad usage worldwide.[10][11][12][13][14]

He was co-founder of the Canadian Virtual Hospice, a comprehensive online source of information on advanced illness, palliative care, loss and grief, serving the needs of patients, families and healthcare professionals.[15]

Chochinov has received many prestigious recognitions for his work in psycho-oncology and palliative care, including being appointed an Officer in the Order of Canada[15][16] and an inductee in the Canadian Medical Hall of Fame in 2020.[1] He is the only psychiatrist to be awarded the Canadian Medical Association's Frederic Newton Gisborne Starr Award, described as the Victoria Cross of Canadian medicine, for his contributions to palliative care.[17]

He is also the only psychiatrist to receive the O. Harold Warwick Prize given for significant advances in cancer control. He is a Fellow in the Royal Society of Canada and the Canadian Academy of Health Sciences.[18]

He received a Lifetime Achievement Award from the Canadian Association of Psychosocial Oncology and the Bernard Fox Award from the International Psycho-Oncology Society.[19][20]

In 2023, Chochinov received a CCRA Award for Outstanding Achievements in Cancer Research.[21]

Key Appointments

Chochinov was offered an appointment to the Senate of Canada in October 2016 by Prime Minister Justin Trudeau to fill one of three vacancies available in Manitoba.[22] On February 2, 2017, the Privy Council Office made public that Dr. Chochinov had advised the Prime Minister that he would not accept the appointment to the Senate, citing "personal, family and professional reasons."[23]

In 2015, Chochinov was appointed by the Government of Canada to chair the External Panel on Options for a Legislative Response to Carter v. Canada which informed eventual legislation on medically-assisted death. Chochinov has raised concerns about medically-assisted death, arguing for the need for better palliative care and for stringent safeguards.[24][25]

In April 2016, Chochinov was named by the University of Manitoba to Canada's first Research Chair in Palliative Care Medicine.[26]

Earlier appointments include being appointed as a Soros Faculty Scholar on the Project on Death in America in 1996; and being appointed to the Governing Council of the Canadian Institutes of Health Research (CIHR) in 2005—a position he held for eight years, including chairing the Governing Council's Standing Committee on Ethics.

Publications

Chochinov's research has specifically focused on palliative care and experiences associated with life-limiting cancer, including depression,[27] hopelessness, prognostic awareness, suicidality, desire for death,[28] will-to-live,[29] sense of burden to others, quality of life, dependencey, spirituality and existential distress. He has also researched the patient-healthcare professional relationship, including elements of effective communication, issues related to equity, diversity and inclusiveness, and core efficiencies of dignity conserving care.[30][31][32]

Book cover, Dignity Therapy, Harvey Max Chochinov
Book cover, Dignity in Care, Dr. Harvey Max Chochinov
Book cover, Psychiatry in Palliative Medicine by Harvey Max Chochinov

His research on dignity has provided tangible and practical ways to operationalize considerations of dignity in patient care, including a means of measuring dignity related distress (The Patient Dignity Inventory, translated widely), effective ways of eliciting personhood in clinical practice and a novel narrative-based psychotherapy, coined 'Dignity Therapy.'[33] Dignity Therapy[34] has been implemented in various cancer centres, hospices and palliative care programs around the world. There are also many publications and clinical trials on Dignity Therapy, which explore the merits of such an approach in mitigating distress and enhancing quality of life for patients with life-limiting illness.[35][36]

His recent publications on The Platinum Rule have received wide attention, addressing issues related to bias, promoting equity, diversity and inclusiveness, and raise the bar on person-centred care.[37]

In 2023, he published a paper introducing the idea of Intensive Caring, which describes a new way of approaching suffering for patients who have lost hope and feel their lives no longer matter.[38]

His book publications include: Dignity Therapy: Final Words for Final Days (Oxford University Press, 2012)[39] which won the Prose Award for Professional and Scholarly Excellence in Clinical Medicine (American Publisher's Award).

He has also published Dignity in Care: The Human Side of Medicine (Oxford University Press, 2022)[40] and The Handbook of Psychiatry in Palliative Medicine: Psychosocial Care for the Terminally Ill (Oxford University Press, 2022).[41]

References

  1. 1 2 "2020 Inductee, Harvey Max Chochinov, MD PhD". Canadian Medical Hall of Fame.
  2. ↑ "Dr. Harvey Max Chochinov, end-of-life care champion, named to Canadian Medical Hall of Fame" (Press release). The Royal College of Physicians and Surgeons of Canada. 15 January 2020.
  3. ↑ "University of Manitoba - Faculty of Medicine - Psychiatry - Harvey Max Chochinov, MD, PhD, FRCPC". umanitoba.ca. University of Manitoba. Retrieved October 27, 2016.
  4. ↑ "CAPO - Dr. Harvey Max Chochinov: Nominated for induction into the Canadian Medical Hall of Fame".
  5. ↑ Martínez, Marina; Arantzamendi, María; Belar, Alazne; Carrasco, José Miguel; Carvajal, Ana; Rullán, María; Centeno, Carlos (2017). "'Dignity therapy', a promising intervention in palliative care: A comprehensive systematic literature review". Palliative Medicine. 31 (6): 492–509. doi:10.1177/0269216316665562. PMC 5405836. PMID 27566756.
  6. ↑ Donato, Suzana Cristina Teixeira; Matuoka, Jéssica Yumi; Yamashita, Camila Cristófero; Salvetti, Marina de Goés (2016). "Effects of dignity therapy on terminally ill patients: A systematic review". Revista da Escola de Enfermagem da USP. 50 (6): 1014–1024. doi:10.1590/S0080-623420160000700019. PMID 28198968.
  7. ↑ Chochinov, Harvey Max; Kristjanson, Linda J.; Breitbart, William; McClement, Susan; Hack, Thomas F.; Hassard, Tom; Harlos, Mike (2011). "Effect of dignity therapy on distress and end-of-life experience in terminally ill patients: A randomised controlled trial". The Lancet Oncology. 12 (8): 753–762. doi:10.1016/S1470-2045(11)70153-X. PMC 3185066. PMID 21741309.
  8. ↑ "For The Dying, A Chance To Rewrite Life". NPR.org. Retrieved 2018-12-17.
  9. ↑ Chochinov, H. M.; Hassard, T.; McClement, S.; Hack, T.; Kristjanson, L. J.; Harlos, M.; Sinclair, S.; Murray, A. (2008). "The patient dignity inventory: A novel way of measuring dignity-related distress in palliative care". Journal of Pain and Symptom Management. 36 (6): 559–571. doi:10.1016/j.jpainsymman.2007.12.018. PMID 18579340.
  10. ↑ Ripamonti, Carla Ida; Buonaccorso, Loredana; Maruelli, Alice; Bandieri, Elena; Pessi, M Adelaide; Boldini, Stefania; Primi, Caterina; Miccinesi, Guido (2012). "Patient Dignity Inventory (PDI) Questionnaire: The Validation Study in Italian Patients with Solid and Hematological Cancers on Active Oncological Treatments". Tumori Journal. 98 (4): 491–500. doi:10.1177/030089161209800415. PMID 23052167. S2CID 208183346.
  11. ↑ Rodríguez-Mayoral, O.; Galindo-Vázquez, O.; Allende-Pérez, S.; Arzate-Mireles, C.; Peña-Nieves, A.; Cantú-Quintanilla, G.; Lerma, A.; Chochinov, H. M. (2021). "Validation of the Patient Dignity Inventory in Mexican Cancer Patients". Journal of Palliative Medicine. 24 (11): 1626–1633. doi:10.1089/jpm.2020.0572. PMID 33761289. S2CID 232354862.
  12. ↑ Li, Y. C.; Wang, H. H.; Ho, C. H. (2018). "Validity and reliability of the Mandarin version of Patient Dignity Inventory (PDI-MV) in cancer patients". PLOS ONE. 13 (9): e0203111. Bibcode:2018PLoSO..1303111L. doi:10.1371/journal.pone.0203111. PMC 6126806. PMID 30188928.
  13. ↑ Oh, Si Nae; Yun, Young Ho; Keam, Bhumsuk; Kim, Young Sung; Koh, Su-Jin; Kim, Yu Jung; Kang, Jung Hun; Lee, Kangkook; Hwang, In Cheol; Oh, Ho-Suk; Song, Eun-Kee; Shim, Jae Yong (2021). "Korean Version of the Patient Dignity Inventory: Translation and Validation in Patients with Advanced Cancer". Journal of Pain and Symptom Management. 62 (2): 416–424.e2. doi:10.1016/j.jpainsymman.2021.01.003. PMID 33484796. S2CID 231693984.
  14. ↑ Rullán, M.; Carvajal, A.; Núñez-Córdoba, J. M.; Martínez, M.; Carrasco, J. M.; García, I.; Arantzamendi, M.; Belar, A.; Centeno, C. (2015). "Spanish Version of the Patient Dignity Inventory: Translation and Validation in Patients with Advanced Cancer". Journal of Pain and Symptom Management. 50 (6): 874–81.e1. doi:10.1016/j.jpainsymman.2015.07.016. PMID 26342725.
  15. 1 2 "Winnipeg's Harvey Chochinov gets Order of Canada for palliative care work". CBC News. November 18, 2015. Retrieved March 11, 2017.
  16. ↑ "Canada Research Chairs awarded Order of Canada". www.chairs-chaires.gc.ca. 2012-11-29. Retrieved March 11, 2017.
  17. ↑ "F.N.G. Starr Award".
  18. ↑ "Professor devotes his life to helping those close to death". 21 August 2012.
  19. ↑ "Dr. Harvey Chochinov honoured by peers". Winnipeg Free Press. August 1, 2012. Retrieved March 14, 2017.
  20. ↑ "International Psycho-Oncology Society - Award Winners".
  21. ↑ "Awards - Canadian Cancer Research Alliance".
  22. ↑ "Justin Trudeau set to name nine new senate appointments - National | Globalnews.ca".
  23. ↑ "Trudeau appointee for Manitoba Senate seat turns down the job". CBC News, February 2, 2017.
  24. ↑ "Dr. Harvey Max Chochinov: Assisted suicide for those with mental illness is risky".
  25. ↑ "Opinion | the Saturday Debate: Is Canada trying to make medically assisted dying too easy?". Toronto Star. 5 December 2020.
  26. ↑ "University of Manitoba invests $2.5M to create palliative research chair". CBC News. April 6, 2016. Retrieved March 11, 2017.
  27. ↑ Chochinov, H. M.; Wilson, K. G.; Enns, M.; Lander, S. (1994). "Prevalence of depression in the terminally ill: Effects of diagnostic criteria and symptom threshold judgments". The American Journal of Psychiatry. 151 (4): 537–540. doi:10.1176/ajp.151.4.537. PMID 7511875.
  28. ↑ Chochinov, H. M.; Wilson, K. G.; Enns, M.; Mowchun, N.; Lander, S.; Levitt, M.; Clinch, J. J. (1995). "Desire for death in the terminally ill". The American Journal of Psychiatry. 152 (8): 1185–1191. doi:10.1176/ajp.152.8.1185. PMID 7625468.
  29. ↑ Chochinov, H. M.; Tataryn, D.; Clinch, J. J.; Dudgeon, D. (1999). "Will to live in the terminally ill". Lancet. 354 (9181): 816–819. doi:10.1016/S0140-6736(99)80011-7. PMID 10485723. S2CID 44586921.
  30. ↑ "Opinion | Why is being a patient such a difficult pill to swallow?". Toronto Star. 27 January 2023.
  31. ↑ Chochinov, H. M. (2007). "Dignity and the essence of medicine: The A, B, C, and D of dignity conserving care". BMJ (Clinical Research Ed.). 335 (7612): 184–187. doi:10.1136/bmj.39244.650926.47. PMC 1934489. PMID 17656543.
  32. ↑ "Scientific American: Better patient care calls for a 'Platinum Rule' to replace the golden one".
  33. ↑ Butcher, Lola (4 December 2021). "End-of-life conversations may be helpful to patients and families". Washington Post.
  34. ↑ Chochinov, Harvey Max (4 January 2012). Dignity Therapy: Final Words for Final Days. ISBN 978-0-19-517621-6.
  35. ↑ Barnosky, Andrew R. (20 June 2012). "Dignity Therapy: Final Words for Final Days". JAMA. 307 (23). doi:10.1001/jama.307.23.2550.
  36. ↑ Vedder, Rachel (March 2013). "'Dignity Therapy: Final Words for Final Days', by Harvey Max Chochinov". BMJ Supportive & Palliative Care. 3 (1): 122. doi:10.1136/bmjspcare-2012-000418. S2CID 76465758.
  37. ↑ "Better Patient Care Calls for a 'Platinum Rule' to Replace the Golden One". Scientific American.
  38. ↑ Chochinov, Harvey Max (2023). "Intensive Caring: Reminding Patients They Matter". Journal of Clinical Oncology: JCO2300042. doi:10.1200/JCO.23.00042. PMID 37075272. S2CID 258250711.
  39. ↑ Harvey Max Chochinov (2012). Dignity Therapy: Final Words for Final Days. New York: Oxford Academic. ISBN 9780199933181.
  40. ↑ Harvey Max Chochinov (2022). Dignity in Care: The Human Side of Medicine. New York: Oxford Academic. ISBN 9780199380459.
  41. ↑ Handbook of Psychiatry in Palliative Medicine 3rd edition: Psychosocial Care of the Terminally Ill. Oxford University Press. 30 December 2022. ISBN 978-0-19-758383-8.
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