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Background: Palliative care is insufficiently integrated in the continuum of care for older people. It is unclear to what extent healthcare policy for older people includes elements of palliative care and thus supports its integration. Aim: (1) To develop a reference framework for identifying palliative care contents in policy documents; (2) to determine inclusion of palliative care in public policy documents on healthcare for older people in 13 rapidly ageing countries. Design: Directed documentary analysis of public policy documents (legislation, policies/strategies, guidelines, white papers) on healthcare for older people. Using existing literature, we developed a reference framework and data extraction form assessing 10 criteria of palliative care inclusion. Country experts identified documents and extracted data. Setting: Austria, Belgium, Canada, Czech Republic, England, Japan, Mexico, Netherlands, New Zealand, Singapore, Slovenia, South Korea, Spain. Results: Of 139 identified documents, 50 met inclusion criteria. The most frequently addressed palliative care elements were coordination and continuity of care (12 countries), communication and care planning, care for family, and ethical and legal aspects (11 countries). Documents in 10 countries explicitly mentioned palliative care, nine addressed symptom management, eight mentioned end-of-life care, and five referred to existing palliative care strategies (out of nine that had them). Conclusions: Health care policies for older people need revising to include reference to end-of-life care and dying and ensure linkage to existing national or regional palliative care strategies. The strong policy focus on care coordination and continuity in policies for older people is an opportunity window for palliative care advocacy. [ABSTRACT FROM AUTHOR]

This article is based on a case study of a long-term public controversy over the construction of a highway bypass (around Plzeň, Czech Republic). Two principal variants of the bypass were proposed. One of them began gradually to appear preferable, increasingly attractive for experts, but remaining only on paper. In the meantime, however, the other variant became more realistic, pushed through mainly by local politicians and actually constructed. This article shows how purification of science from politics (and vice versa) played a key role in the development and ending of the case. Initial expertization of the case switched to its sharp politicization, when people got frustrated from protraction and indecisive evidence of accumulated expertise. This turned to be fatal for those who consistently staked everything on "pure facts." This article concludes by outlining some general consequences of such a development for both democratic decision making and the political relevance of expertise. [ABSTRACT FROM AUTHOR]