Ethical Strategy for Palliative Care Delivery

Introduction

The healthcare sector has, over the last 50 years, improved considerably in its efforts toward cost minimization and service delivery enhancement. Some elements of improvement — such as automation — have resulted from technological advances. However, other elements, such as the application of strategic frameworks, owe their establishment in the health sector to the efforts of thoughtful individuals who understand the value of life and the importance of minimizing suffering during illness.

Palliative care represents one such effort. It denotes a system targeted at delivering respite from painful and distressing symptoms through the affirmation of life and the recognition of death as a natural process. As defined by the World Health Organization, palliative care is an approach that enhances the quality of life (QOL) of patients suffering from life-threatening ailments, and of their families, through prevention and symptom relief. This is achieved through early diagnosis, proper assessment and pain treatment, and spiritual, physical, and psychological care. Although structures have been instituted for the purpose of palliative care, developing efficient strategies to propel the health sector along the right path remains of utmost importance — and this is where a majority of palliative care facilities are found lacking. This paper's objective is to address the subject of strategizing for effective palliative care delivery (Policy Directive, 2010).

Application of External Ethical Standards

Ethical problems typically arise in the palliative care setting due to concerns regarding the type and amount of care appropriate for individuals with short life expectancy. Conflict commonly exists among physicians, nurses, other members of the care delivery team, patients, and their families regarding what constitutes appropriate care, particularly as terminally ill patients approach death. In recent years, the value of ethically grounded medical practice has garnered increasing emphasis. Numerous countries and professional groups have called for a widely accepted, foundational ethics curriculum for healthcare providers.

The many moral and ethical codes outlined in various declarations and oaths form the foundation for ethical healthcare practices. One such oath, widely taken for several hundred years by new graduates in medicine, is the Hippocratic Oath. Despite differences found among various historical documents, several common ethical doctrines and value orientations are consistently highlighted, including kindness, justice, non-maleficence, and respect for patients' confidentiality and autonomy. Will this revival of ethical significance in medicine benefit patients alone? Research indicates that healthcare professionals, including physicians, experience increased stress when they feel the organization they work for does not share their ethical values or standards. Both patients and healthcare providers will benefit from a focus on ethical clinical practice and strong negotiation skills. These aspects are vital and must be considered when developing a strategy for palliative care organizations (Gabel, 2010).

Palliative Care Strategy

The strategy aims to establish an organized, evidence-informed practice approach for palliative care delivery and ethics. The main goals in developing this strategy are as follows:

First, the formulation of a realistic, dependable strategy that reinforces existing structures, including the delivery of quality palliative care services by organizations such as hospitals, hospices, charitable organizations, home support organizations, and elder care facilities. Second, the development of a more responsive system that supervises the ethical assessment conducted by nurses and physicians. Third, the promotion of awareness regarding the importance of maintaining high standards of ethics and professionalism throughout practice. Fourth, the incorporation of other stakeholders — such as local and federal governmental bodies — in governing palliative care practices.

Consistent with these goals, the strategy further mandates that any person acting or working for partner organizations must immediately bring to the attention of authorities any internal or external issue that violates the ethical standards of palliative care. This duty to report represents both a responsibility and a right for all professionals in the health sector. Beyond grassroots-level ethical standards, support for palliative care delivery at the highest levels of government is essential, as is the establishment of structures for the operational and strategic delivery of effective services.

At the level of governmental policy, the strategy must be overseen by a senior health department officer who is recommended to be an expert in the healthcare field. This officer must be entrusted with the overall responsibility of formulating a budget for palliative care as well as ethical policies, prior to commissioning. The strategy also includes the creation of mechanisms, common guidelines, and policy frameworks for handling unethical behaviors in clinical settings, along with the penalties to be applied. As clinical care committees and governments work together in this regard, the responsibility for handling unethical practices must be assigned to an objective, independent body in order to avoid bias (Chambers, 2015).

Conclusion

Delivering compassionate, pain-minimizing medical care to patients and their families is the central aim of palliative care. Improving this sector through the implementation of facilitative strategies is crucial for governments. Authorities must recognize terminally ill patients as being equally deserving of care as their family members; these patients must be supported even at the end of life. A large number of healthcare institutions are left to manage such patients without adequate government support, and the primary cause of this is the absence of strong, effective strategies. Implementation of a strategy such as the one outlined in this paper will help ensure the minimization of preventable deaths and the delivery of superior palliative care (Policy Directive, 2010).