Principles of palliative care

Guidelines and Suggestions for those Starting a Hospice/Palliative Care Service, 3rd edition

Derek Doyle, OBE, MD

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Principles of palliative care

The principles of palliative care might simply be regarded as those of good clinical practice. A holistic approach, incorporating the whole spectrum of care –medical, nursing, psychological, social, cultural, and spiritual– is good medical practice, whatever the patient’s illness, wherever the patient is under care, whatever his/her social status, creed, culture, or education. In palliative care, it is essential.

Box 1: Content 'Palliative care – its principles and practice'

Attitudes and principles required for successful palliative care

A caring attitude

Consideration of individuality

Caregiver support

Cultural considerations

Consent

Choice of site of care

Communication

Clinical context: Appropriate treatment

Comprehensive inter-professional care

Care excellence

Coordinated care

Continuity of care

Consistent medical care

Crisis prevention (see Consistent medical care)

Continued reassessment

Advance Care Planning

Advance care planning is a means for patients to record their end-of-life values and preferences, including their wishes regarding future treatments (or avoidance of them).

Advance care planning involves several processes:

The principle of advance care planning is not new:

The 'Respecting Choices' program developed in Wisconsin is an example of advance care planning:

Health care provider should have the own advance care planning, then it helps with the conversation about with patients and family.


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