Tuesday, April 1, 2008 (BASC 201: Lecture 22)
Ethics in Palliative Care
There may be an upcoming TA strike next Monday or Tuesday where there will be picket
lines preventing students from going to class. Because of this interference next week’s
lectures will still take place but will not be on the final. Prof’s take home message: if you
want to see a quick resolution, get involved in your education and apply pressure to the
administration or the TAs’ union depending on your stance.
Introducing Palliative Care
is defined by the WHO as the active total care of patients whose disease is
not responsive to curative treatment. Thus, the emphasis is not on death but on contained
and controlled chronic problems. It also involves the control of pain, of other symptoms
and of psychological, social, and spiritual problems. The goal of palliative care is the
achievement of the best possible
quality of life
for patients and their families. Many
aspects of palliative care are also applicable
in the course of the illness, in
conjunction with anticancer treatment.
Palliative care neither hastens nor postpones death; it integrates the psychological and
spiritual aspects of patient care; and offers a support system to help patients live as
actively as possible until death.
Before palliative care was founded about 30 years ago, dying patients were left to, well,
die. Nowadays they are eligible for radiotherapy, chemotherapy, and surgery, provided
that the symptomatic benefits of treatment clearly outweigh the disadvantages.
Investigative procedures are kept to a minimum.
includes: physicians, nurses, psychologists, social workers,
bereavement coordinators (identify patients at risk for prolonged grief), pastoral care,
occupational therapists, physiotherapists, music therapists, volunteer coordinators,
volunteers, secretaries, and pet therapists.
is a set of principles of right conduct. It is also the study of the general nature of
morals and of the specific moral choices to be made by a person or the moral philosophy.
is the rules or standards governing the conduct of a person or the members
of a profession.
In the clinical context, the bottom line in ethics is proper communication. Oftentimes,
ethical dilemmas result from a breakdown in communication—e.g. unresponsive patients,
difference between family’s and doctor’s opinion, miscommunication, etc.