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From cure to palliation: concept, decision and acceptance
R Löfmark1, T Nilstun, I Agren Bolmsjö
1Centre for Bioethics at Karolinska Institutet and Uppsala University, Uppsala, Sweden. rurik.lofmark@telia.com
Journal of Medical Ethics
|December 7, 2007
Summary
Nurses and physicians desire clearer communication and decision-making processes during patient transitions to palliative care. Improved training in end-of-life communication and ethical considerations is essential for better palliative care delivery.
Area of Science:
- Medical Ethics
- Palliative Care Research
- Healthcare Communication
Background:
- Patient transition from curative to palliative care presents complex challenges.
- Healthcare professionals' perspectives on this transition are crucial for improving care quality.
- Existing practices often lack clarity in communication, decision-making, and acceptance of patient situations.
Purpose of the Study:
- To analyze nurses' and physicians' qualitative feedback on patient transitions to palliative care.
- To explore ethical considerations and practical challenges encountered by healthcare providers.
- To identify areas for improvement in palliative care delivery and training.
Main Methods:
- A questionnaire was distributed to 1672 nurses and physicians across 10 specialties.
- A response rate of 52% (n=844) was achieved, with over one-third providing comments.
- Responses were analyzed using four ethical theories: virtue ethics, deontology, consequentialism, and casuistry.
Main Results:
- Respondents highlighted significant differences in understanding palliative care concepts.
- Unclear decision-making processes and difficulties in accepting patient situations were frequently reported.
- Virtues like compassion, honesty, and justice, alongside ethical principles, were invoked.
Conclusions:
- Palliative care in Sweden requires significant improvement, particularly in communication and decision-making.
- Enhanced training in end-of-life communication and ethical deliberation is essential for healthcare professionals.
- Explicit communication and dedicated time for reflection are vital for reducing patient suffering and improving care transitions.
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