Christopher Hospice-1965) and published a book about death (On Death and Dying-1969). She opened the first modern hospice (named St. Hospice and PC were established in the middle of the year 1900 and the founder who is Dame Cicely Saunders. PC is a specialized medical care for people living with a serious illness. WHO: “ PC is an improves the QOL of patient and family members facing the problems related with life-threatening illness, through the prevention and relief of suffering using of early identification and complete assessment and treatment of pain and other needs specially physical, psychosocial and spiritual”. They worry about pain management and the loss of control over the quality of their lives. EOL helps with anxiety and distressful emotions, such as fear of the future and being a burden to loved ones. Many people have difficulties and suffering at the end of life EOL experience. The goal of the PC is to improve the QOL for both the patient and their family members. Worldwide only about 14% of people who need PC currently receive it, and each year an estimated 56.8 million people, including 25.7 million in the last year of life, require palliative care. Ģ.1 Ethics of palliative care and hospices A good understanding of medical ethics will contribute to the health professional’s decision-making and the daily practice of medicine for EOL patients. The difficulties of ethical issues and moral solutions in palliative care services ethical principles recognized universally are autonomy, beneficence, non-maleficence, and justice. Medical interventions such as artificial nutrition and respiratory support can extend their life and provide secondary support. Although, those new treatments and technologies do not cure chronic diseases. Advanced medicine and modern technologies have both prolonged life expectancies and transformed the natural norms of death. Death is an inevitable part of life and death and should be peaceful, pain-free, and without any suffering. Many people at the EOL experience unnecessary difficulty and suffering. The QOL of life of a cancer patient has a direct connection with the professional and nonprofessional caregiver’s knowledge of supportive care and attitude toward end-of-life (EOL) care. It involves a multi-disciplinary team that provides medical care, pain management, and emotional and spiritual support to a person and family members. The PC team should be knowledgeable enough to provide appropriate care, respect patients, rights, and avoid conflicts. The goal of PC should be to let the patients maintain their dignity and hope while they are alive. Palliative care (PC) alleviates the distressing symptoms in a terminal stage of diseases, avoids harm of intention, and improves the quality of life (QOL). The cases of ethical issues are increasing every day in the palliative care service. In this chapter, we will cover the consideration regarding the ethical principles, ethical issues, ethical challenges, and dilemmas during the palliative care. The ethical principles guide healthcare professionals in the management of these situations and the problem they face in end of life care. Healthcare professionals should understand the principles of ethics, ethical legal documents, advanced care planning, and ethical conflict to help patients make the best decision possible. It should also protect the patient’s rights, dignity, beliefs, and religion. However, physicians, healthcare teams, and nurses are facing difficulties in ethical challenges in end-of-life care. An essential component of the ethical decision-making processes may concern patients’ family members and society. The benefits of ethical decision-making are relief of pain, improving the patient’s recovery, reducing the side effects of treatment, prevention of depression, and increasing quality of life. The goal of end-of-life care for dying patients is to prevent or relieve suffering and respect the patient’s wishes and values. The role of the codes of ethics is to help with these problems. The cases of ethical issues (new and unfamiliar daily circumstances) are increasing every day in palliative care services.
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