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Background material by Professor Omar Hasan Kasule Sr. for Year 3 Semester 1 Medical PPSD on 14th August 2008.
Aim of palliative care
Palliative care recognizes that cure is not possible and it focuses on relief of pain and other distressing symptoms. The aim of palliative care is good death which includes: pain control, psychological support, emotional support, and spiritual support. By its essence palliative care is holistic focusing on the whole person.
Death can be made a pleasant experience with good and effective palliative care.
Palliative care was traditionally in the family but it has recently moved to institutions. Lessons about palliative care can be learned from the terminal illness of the prophet and his companions.
Palliative care is provided in a hospices unit of a hospital, a free-standing hospice, or at home.
General palliation can be carried out by anybody. Specialist palliation requires a multi-disciplinary team.
Principles of palliative care
(a) Focus on quality and not quantity of life
(b) Holistic approach
(c) Involvement of both the patient and the family
(d) Respect for patient autonomy
(e) Open communication with the patient
Use of pain killers
The principle of double effects operates in control of pain. Some of the pain killers may actually cause death by causing respiratory depression. The physician should always consult his conscience and intentions when prescribing sedation or analgesia.
Some patients may prefer some pain to being heavily sedated and their wishes should be respected.