Palliative Care and End-of-Life Decisions: Ethical and Clinical Approaches to Pain Management and Family Support

In the medical field, palliative care and end-of-life decisions are increasingly important topics, especially in the context of an aging population and the prevalence of chronic diseases. These care approaches focus on pain management and other symptoms, as well as providing emotional support and family support to patients and their loved ones. The integration of advance directives into the care process is crucial for respecting patient wishes and ensuring person-centered care.

Ethical and Clinical Approaches

The ethical management of palliative care requires a multidimensional approach that considers both clinical aspects and the values and preferences of the patient. A model that has gained attention is the Welfare Model, which proposes a team-based approach to assess patient needs, taking into account the prevailing psychosocial, legal, and clinical norms. This model seeks to balance patient autonomy with relevant sociocultural considerations.

In complex situations, such as the use of advanced life support, it is essential to consider the ethical principles of autonomy, beneficence, non-maleficence, and justice. For example, in the context of clinically assisted nutrition and hydration, professionals must be guided by ethical frameworks that promote shared decision-making and respect for patient preferences, as discussed in the article on clinically assisted nutrition and hydration.

Furthermore, the implementation of advance directives and advance care planning is essential to ensure that end-of-life decisions reflect patient wishes. A study in Asia highlights the importance of developing consensual definitions and recommendations for advance care planning, tailored to specific cultural contexts (Delphi study in Asia).

Conclusions

The ethical and clinical approach to palliative care and end-of-life decisions requires a deep understanding of patient wishes, effective pain management, and robust family support. The integration of advance directives and advance care planning are key tools to ensure that decisions reflect the values and preferences of the patient. Healthcare professionals must be prepared to face the ethical and emotional challenges that arise in this context, utilizing well-established ethical and clinical frameworks to guide their decisions.

Referencias

• [1] Multi-dimensional approach to end-of-life care: The Welfare Model
• [2] The ethics of clinically assisted nutrition and hydration in adults and the role of the advanced clinical practitioner
• [3] Definition and recommendations of advance care planning: A Delphi study in five Asian sectors

Created 13/1/2025