Big Duh People! Chiaramonte-Adler Guide a Special Issue Linking Integrative Care and Palliative Medicine

Big Duh People! Chiaramonte-Adler Guide a Special Issue Linking Integrative Care and Palliative Medicine

Sometimes synergies call for a solid moment of appreciation. In early 2019, Delia Chiaramonte, MD, an educator and integrative doctor who works in palliative medicine pinged me under my journal editor hat. How about a special issue of JACM-Paradigm Practice and Policy Advancing Integrative Health to highlight “integrative palliative care”? I liked the idea. I also knew that Chiaramonte, principally a clinician-educator, would be served to have a partner with more research experience. Two days later, Shelley Adler, PhD emailed me. The UCSF educator with fine research chops informed me she would be co-author on the next in a series of quarterly JACM commentaries from the Osher Collaborative for Integrative Medicine. The subject: the integrative-palliative intersection.  Last week the JACM special issue was published with the Chiaramonte-Adler dyad offering the introductory editorial as curators and guest editors. The entire issue is in open access for a month.

I discovered, on linking the two, that an introduction was hardly necessary. They had previously served as co-chairs of the education working group of the Academic Consortium for Integrative Medicine and Health. They jumped at the partnering idea. Adler and her Osher co-authors entitled their commentary “Integrative Palliative Care: Enhancing the Natural Synergy between Integrative Health and Palliative Medicine.” Their call to action provided framing for the issue’s call for papers.

Over 40 manuscripts came in from around the world. Those selected reflected the global interest. The authors herald from11 countries: Brazil, Canada, Chile, China, Greece, Iran, Italy, Norway, South Korea, the United Kingdom, and the United States. The time may indeed be ripe to cast off the unnatural obstacles to this “natural symmetry.”

The JACM Special Focus Issue on Integrative Palliative Care includes 2 review articles, 8 original research pieces, and 4 commentaries. In their introductory editorial, Chiaramonte and Adler guide readers into the content. They begin by drawing out the big Duh! of the overlapping “Core Principles” of the two fields.

Asked to highlight a selection of the papers, the Chiaramonte and Adler chose the following:

Original Research

  • Integrative Medicine: Adjunctive Element or Essential Ingredient in Palliative and Supportive Cancer Care?
  • Acupuncture as a Treatment Within Integrative Health for Palliative Care: A Brief Narrative Review of Evidence and Recommendations
  • A Quality Brief of an Oncological Multisite Massage and Acupuncture Therapy Program to Improve Cancer-Related Outcomes
  • “Making Peace with Our Bodies”: A Qualitative Analysis of Breast Cancer Survivors’ Experiences with Qigong Mind–Body Exercise


  • Integrative and Palliative Medicine Synergy: Structures and Solutions
  • On the Alignment of Yoga Therapy with Palliative Care

A new professional field?

Chiaramonte and Adler choose to present the issue in the context of present public and professional health issues that they believe are themselves arguments for a rapid uptake of the model. They examine the impacts of COVID-19 on the public and practitioners, the endemic stress and burnout among practitioners, and the societal encounter with the systemic levels of racism, policy violence, and concomitant inequities.  They choose to argue for the creation of what is effectively a new specialty, and underscore the value of contextualizing it’s development.

As we advocate for the formal establishment of integrative palliative care, we recognize the unique opportunity to develop a field that does not merely consider health equity to be within its scope, but deliberately incorporates it into its center.

The special issue was supported by a sterling, 8-person Special Issue Advisory team: Jennifer Moore Ballentine, MA, Executive Director, CSU Shiley Institute for Palliative Care; Stephanie Cheng, MD, Assistant Professor of Clinical Medicine,Division of Palliative Medicine, UCSF Department of Medicine; Danielle Josette Doberman, MD, MPH, Course Director, Palliative Care and Pain Clinical Elective, Assistant Professor of Medicine, Johns Hopkins Medicine; Scott A. Irwin, MD, PhD, Director, Supportive Care Services,Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute; Brieze Keeley Bell, MD, Integrative Palliative Care Physician, UCSF Osher Center for Integrative Medicine, Instructor, UCSF Division of Palliative Care; Gabriel Lopez, MD, Medical Director of the Integrative Medicine Center, MD Anderson Cancer Center, Department of Palliative,Rehabilitation, & Integrative Medicine; Robin Majeski, PhD, RN, Clinical Associate Professor, The Erickson School, University of Maryland at Baltimore County; Mary Lynn McPherson, PharmD, MA, MDE, BCPS, CPE, Professor, Executive Director, Advanced Post-Graduate Education in Palliative Care, University of Maryland School of Pharmacy.

The Call for Papers and the reviewing of the submissions benefited from supporting partnerships from two organizations, one from each part of the marriage: the California State University Shiley Institute for Palliative Care, and the Society for Integrative Oncology. They guest editors conclude their editorial this underlining of the value in the marriage:

The articles cover topics that are imperfectly addressed by conventional palliative care approaches and provide palliative indications for complementary modalities that are used in varied populations. Assessed together, they strengthen our assertion that formal attention to the amplification of integrative palliative care can alleviate suffering and optimize the health and well-being of people with serious illness across the life course through high-quality whole-person integrative health care.

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