Core principles for end-of-life care

A new report, developed in conjunction and adopted by 13 specialty medical societies and the Oakbrook Terrace, IL-based Joint Commission on Accreditation of Healthcare Organizations, lists core principles for end-of- life care.

The eleven core principles are:

1. respecting the dignity of both patient and caregivers;

2. being sensitive to and respectful of the patient’s and family’s wishes;

3. using the most appropriate measures that are consistent with patient choices;

4. encompassing alleviation of pain and other physical symptoms;

5. assessing and managing psychological, social, and spiritual/religious problems;

6. offering continuity — the patient should continue to be cared for, if so desired, by his or her primary care and specialist providers;

7. providing access to any therapy that may realistically be expected to improve the patient’s quality of life, including alternative or nontraditional treatments;

8. providing access to palliative care and hospice care;

9. respecting the right to refuse treatment;

10. respecting the physician’s professional responsibility to discontinue some treatments when appropriate, with consideration for both patient and family preferences;

11. promoting clinical evidence-based research on providing care at the end of life.

(The information in this article is from Principles for Care of Patients at the End-of-Life: An Emerg ing Consensus among the Specialties of Medicine, published by the Milbank Memorial Fund.)