In the pair of winning articles, Scott Murray, Aziz Sheikh and Joanne Lynn explore how the lessons learnt from excellent and accessible palliative care provided to people with cancer can be adapted for the growing group of people with fatal non-malignant conditions such as heart failure and dementia. Murray and Sheikh argue that "facilitating a good death should be recognised as a core clinical proficiency, as basic as diagnosis and treatment."
Over the last 14 days, more than 4 000 people from around the world have voted in the BMJ's Making a Difference poll to find the area of health care in which doctors can make the most improvement to the quality of patient care.
Palliative care beyond cancer beat six other topics including drug resistant infections in poor countries, excessive drinking in young women, and improving chronic pain management.
Despite the strong field, palliative care was the undisputed winner with 1 549 votes. Combating drug resistant infections in poor countries was second with 869 votes, and better care for the elderly with multiple health problems took third place with 681 votes.
Leading doctors and scientists championed each area of health care, writing two articles on each topic.
Speaking after the results were announced, Scott Murray, Leader of the Palliative Care Group, University of Edinburgh, UK, who championed palliative care, said: "I am delighted that 'palliative care beyond cancer' came out top. Good end-of-life care for all rather than for only some is surely a worthy aim of a civilised society. It is high time to embrace this challenge, and to work out new ways to care for all, using current research."
By 2030 the annual number of deaths around the world is expected to rise from 58 million to 74 million, with conditions related to organ failure and physical and cognitive frailty responsible for most of this increase. But at present, hospices in economically developed countries provide 90% of their care to patients with cancer.
Dr Fiona Godlee, BMJ Editor said: "I am delighted that the BMJ has helped to remind everyone of areas of health that are less glamorous and are perhaps all too often passed over, even though their impact on individual lives and society is increasing.
Clearly, palliative care for non-malignant disease will play a vital role in improving patient care now and in the future."
The winner and other authors will be speaking at a celebratory event between 08:15 and 09:15 on Friday 25 April, 2008 at the Le Palais des Congres, Hall Maillot (Level 2), Paris, France, where the winning topic will be announced.
The BMJ Group will continue to support and develop the Making a Difference campaign over the next year by commissioning and inviting work on the six key topics in the BMJ and the BMJ Group's 24 specialist journals, in BMJ Clinical Evidence, Best Treatments, and BMJ learning.
Visit http://www.bmj.com to view the six topics
BMJ Making a Difference: Poll results
The total number of votes was 4023
Palliative care for all at the end of life - Number 1549 - Proportion 39%
Combating drug resistant infections in poor countries - Number 869 - Proportion 22%
Better care for the elderly with multiple health problems - Number 681 - Proportion 17%
Improving chronic pain management - Number 484 - Proportion 12%
Reducing excessive drinking in young women - Number 329 - Proportion 8%
Helping to reduce adverse drug reactions in the elderly - Number 111 - Proportion 3%
UK - Number 1375 - Proportion 34.18%
USA - Number 678 - Proportion 16.85%
Australia - Number 362 - Proportion 9.00%
Italy - Number 224 - Proportion 5.57%
Canada - Number 150 - Proportion 3.73%
India - Number 109 - Proportion 2.71%
New Zealand - Number 73 - Proportion 1.81%
Holland - Number 70 - Proportion 1.74%
Germany - Number 69 - Proportion 1.72%
Spain - Number 59 - Proportion 1.47%
Ireland - Number 57 - Proportion 1.42%
Other countries -Number 797 - Proportion 19.81%
British Medical Association