Guidelines in the care of the dying cancer patient

The care of patients in the final stages of cancer requires a high level of clinical vigilance and skill to ensure that the passage from life to death is as free from suffering as possible. Patients who are dying have a right to adequate relief of physical and psychological symptoms, and they and their families have a right to adequate support. The care of patients and their families requires (1) interdisciplinary cooperation of a healthcare team incorporating physicians, nurses, social workers, and other auxiliary supports, and (2) a high level of clinical flexibility to address the evolving needs of the patient and family. Participation in this process challenges the clinician's emotional resources and medical skills. There is, however, the potential for professional satisfaction in helping to orchestrate a "good death," because the relief of suffering is at the very heart of medicine. Familiarity with guidelines in the care of the dying can reduce the potential for distress in this important clinical endeavor.