Ethical considerations in the treatment of pain in a hospice environment

Most people treated in hospices suffer from pain. The hospice environment offers them a place where they may feel safe and get rest before they die. This particular environment was originally created to solve the many problems terminal patients encountered in busy modern hospitals. However, it is clear that solving some problems frequently means creating new ones. For people who are about to complete their life's journey, a hospice is a place of care and autonomy. Previous losses and severe spiritual distress complicate most of the severe pain conditions seen in hospices. In this paper, some specific ethical problems encountered in hospice practice will be discussed. Patients' autonomy with all its advantages and disadvantages will be highlighted. Acceptance of death may result in an active and creative attitude. Although scientific evidence of the processes taking place is still lacking, the modern hospice may be seen as a complementary, main-stream institution contributing to the development of whole medicine.