Palliative care, also known as comfort care is a significant care given to people with critical illnesses (Lugton & McIntyre, 1). It prolongs their life and relieve from pain affecting them and their intimates. Its goal is to prevent the symptoms and side effects of an illness besides treatment as early as possible. Palliative care is usually given systematically, putting into consideration psychosocial and spiritual needs of the patient and family. Routine for administration of palliative care should be provided by health care professionals.
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The complexity of the situation usually determines if the condition is to proceed to palliative care. It begins from the time of diagnosis of life endangering illness and will continue until death and family grief period. It involves helping the patient relieve the suffering and making their families understand the conditions for change in patient. The effects of these changes should be made clear to them, and this will assist in the future care.
For this succeed, attention is required together with exceptional communication skills. Health professionals should pursue an illness from its early stages of diagnosis to prevent it from advancing. A complex diagnosis proceeds to palliative care (Meie, Isaacs & Hughes, 141). The basic elements of palliative care are pain, and symptom assessment and advanced care planning management.
Palliative care specialists should have the necessary competence in handling disagreement cases (Lugton & McIntyre, 3). In some of them, they are supposed to make decisions on whether to agree with the patients’ opinions or their own opinions (Meie, Isaacs & Hughes, 297). In such cases, the decision taken by the specialist depends on his/her competence. The decision starts from the point where a chronic case is to proceed to palliative care.
Usually, disagreement occurs between them and patients on whether cases will proceed to palliative care or aggressive treatment. Both parties should be able to reach a consensus, with the decision provided by the patient voluntarily. However, there are some cases where there is disagreement, and in such cases, the physician should balance the expected benefits with the risks of patients’ choice as compared to other alternatives.
In most cases, the physician is the decision maker due to patients, failure to make the right decision under that prevailing condition. The decision to be taken by the specialist should depend on the competency of the patient and values at stake (Meie, Isaacs & Hughes, 207). These values underlying standards of competence are promotion of individual well being of the patient and respecting their self determination.
Treatment should be stopped when the condition of the patient is complicated and irreversible. Advancement to palliative care can also occur if the treatment given to the patient is not working and causes a lot of pain to the patient. It can start immediately after the diagnosis of the condition. This implies that palliative care can be provided together with the treatment.
Decision on whether to offer palliative care should be done by both the clinician and the patient. They should be able to agree on such cases. If the patient is not able to make that decision, then it becomes the role of the clinician to do so. In some cases, a family member may demand for aggressive treatment to be given to the patient or may disagree among themselves (Hallenbeck, 163).
The ability to resolve such Medicare conflicts depends on the clinicians’ competency. An effort should be made towards enabling the families understand the suffering inflicted on the patient. Aggressive treatment could be causing a lot of pain on the patient.
This raises a concern on the need to review health care policy and ethics. It is evident in Schiavo’s case, which had a conflict between her husband and health professionals (Meie, Isaacs & Hughes, 179). The doctors’ obligation here is to help Schiavo from suffering, but her intimate feels as the doctor had neglected her. Other cases include Emilio Gonzales case, Hengla Wanglie’s case and Baby L’s case (Truog, 1).
These are few examples of futility cases, which involve disagreements and mistrust between clinician, and patients’ families. The success of a professional resolving such cases depend on communication skills and conflict resolution skills possessed by the physician (Lugton & McIntyre, 6). The obligation of the physician is to serve the interests of the patient and family equally (Lugton & McIntyre, 12). It is recommended that such ethical dilemmas involve hospital ethical committee.
Palliative care does not have a distinct payment insurance benefit. Usually, the cost of palliative care is covered with patients’ health insurance. The patients’ family members may be required to cover up the extra costs. Insurance programs have aided many people in payment of palliative costs.
People should be educated on the importance of joining them. In cases where a person is undergoing palliative care, it is the responsibility of community members to provide support to their family in terms of payment for premiums and psychosocially. It is also their responsibility to demand insurance programs to provide cover during palliative care.
Hallenbeck, James. Palliative Care Perspectives. London: Oxford University Press, 2003. Print.
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Lugton, Jean & McIntyre, Rosemary. Palliative Care: The Nursing Role. California: Elsevier Health Sciences, 2005.Print.
Meie, Diane E., Isaacs, Stephen L. & Hughes, Robert. Palliative Care: Transforming the Care of Serious Illness. London: John Wiley & Sons, 2010. Print.
Truog, Robert. D. Tackling Medical Futility. N Engl J Med. Web. 357; 1-3.