This topic will discuss ethical issues in palliative care. Other issues regarding the legal aspects
of end of life care and advance care planning are discussed separately. In addition, issues
related to specific sympto
...
This topic will discuss ethical issues in palliative care. Other issues regarding the legal aspects
of end of life care and advance care planning are discussed separately. In addition, issues
related to specific symptoms for the patient in palliative care and/or at the end of life are
discussed separately.
●(See "Advance care planning and advance directives".)
●(See "Legal aspects in palliative and end of life care".)●(See "Approach to symptom assessment in palliative care".)
●(See "Overview of comprehensive patient assessment in palliative care".)
FRAMEWORK FOR ETHICAL REASONING — The most common framework for ethical
reasoning in the United States (US) is called principalism, after the four guiding principles in
medical ethics:
●Respect for autonomy – Respecting autonomy means ensuring the informed patient’s right
to participate in medical decision making. It is considered to be the centerpiece of modern
American biomedical ethics [1].
●Beneficence – The principle of beneficence mandates that clinicians act in the best
interests of their patients.
●Non-maleficence – The principle of non-maleficence is the instruction for doctors to first,
do no harm.
●Justice – Justice requires that all people be treated well and fairly, and also that health
resources be used equitably.
Applying principalism in palliative care — The four guiding principles above are
indispensable, but are often insufficient to guide health decisions in societies and clinical
environments, especially in the palliative care setting due to multiple factors including [2]:
●Rapidly evolving medical technology
●An increasingly polarized and scrutinized political and medico-legal environment
●Longer life expectancies, including in patients with a significant burden of illness and/or
functional impairment
●Increased awareness of the differing needs of individuals based on cultural, ethnic,
economic, EDUCATIONAL, religious, and many other kinds of diversity
[Show More]
