Bioethics: communication and decision-making in advanced disease

Effective communication is the cornerstone of excellence in patient care, and breakdown in communication is a common problem leading to requests for bioethics consultation. In palliative medicine, issues involving end-of-life decisions inherently involve many potential ethical concerns. Ensuring good communication among the physician, health care professionals, patient, and family will facilitate care, and avoid ethical problems. This chapter will address communication with patients, families, and health care professionals. Common ethical concerns such as withholding and withdrawing treatment modalities, medical futility, euthanasia, and assisted suicide will be discussed.