Assumtion and principles underlying standards for care of terminally ill

Introduction

at that place is agreement that patients with life-threatening illnesses, including progressive malignancies, need appropriate therapy and dis family throughout the course of illness. At one stage, therapy is directed toward judgment and intervention in order to control and/or to regain such illness and alleviate associated symptoms. For some persons, however, the time comes when regain and remission are beyond current medical expertise. It is and then that the intervention must shift to what is now frequently termed palliative treatment, which is make outing to control pain in the broadest sense and provide in-person support for patients and family during the terminal phase of illness. In general, palliative bid requires limited use of apparatus and technology, extensive personal care, and an rescript of the physical and social environment to be therapeutic in itself.

There are, as it were, two complementary systems of treatment which may often overlap: One system is concerned with eliminating a curable disease and the other with relieving the symptoms resulting from the relentless progress of an incurable illness. There must be openness, interchange, and overlap between the two systems so that the patient receives continuous appropriate care. The patient should not be subjected to aggressive treatment that offers no hope of being effective in curing or controlling the disease and may only cause further distress.



Obviously, the clinician must be on the alert for any shifts that may occur in the course of a terminal illness, which make the patient again a candidate for active treatment.

Patients suffer not only from contrary active care, but also from inept terminal care. This is strong documented by studies that only confirm what dying patients and their families know at first hand.

These principles have been prepared as an instigate to those who have initiated or are planning programs for the terminally ill...

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