Defining hospice and palliative care: some further thoughts

Widespread acceptance of hospice in the United States has contributed to increased public and professional interest in improved care, not only for dying persons, but for persons undergoing treatment for conditions that may not pose an immediate threat to their life. 'Palliative care' has been brought into use to denote care that covers a broader category of patients who do not necessarily have a medical condition that is not, at present, life threatening. The use of two related and overlapping terms by health care professionals is confusing and, in the absence of clear definitions, has contributed to needless controversy. Hospice has a specific meaning in the United States. Palliative care, once used as a euphemism for hospice, now has several meanings. This paper is designed to explore the historical evolution of both terms and to reduce the confusion and controversy surrounding their current application.