Medscape Today recently released a noteworthy piece that attempts to distinguish palliative care form hospice care. The World Health Organization defines palliative care : ” Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.”
“Quality of Life; Treatment of pain and other problems physical, psychosocial and spiritual; Prevention and relief of suffering; Patients and their families facing problems associated with life-threatening illness;”
These areas represent the core medical focus of any general practice physician. They also represent the specific focus of the competently trained and properly accredited Naturopathic doctor. From this definition one can reason that palliative care treats the life of the whole person and their support network. It neither treats nor cures biophysical disease. What is a life-threatening illness? Is it an incurable disease? Does it result in immediate death, eventual death, pain that cannot be masked or removed?
Several vital questions pertinent to the nature of how we might practice scientific inquiry stem from this topic.
The first concerns measuring outcomes of palliative care.
How might quantitative methods demonstrate efficacy?
Are researchers limited to qualitative assessments to describe treatment impacts?
Is money saved a valid index for assessing benefits to the whole person, the larger system or an indication of what is reasonable to expect?
The second concerns understanding what is actually happening in palliative care.
Does the patient experience healthier state?
Is the patient more responsive to disease focused treatments?
Can a bio-physiological process be implicated to describe or track the course of care?
A third focus of inquiry concerns how medicine and health care are predominately practiced.
Is palliative care the legacy of every physician?
Is palliative care inherent in the nature of any physician-patient interaction?
Is the consequence of palliative care healing or quackery?
Does palliative care affect change in a patient’s state of health?
A fourth area of inquiry concerns the domain of palliative care.
Are other types of health care such as complementary or alternative medicine palliative?
Is palliative care another term for placebo or psycho-somatic treatment?
Does an emphasis on “physical, psychosocial or spiritual” aspects of well-being have a place in the prevailing understanding of science-based medicine?
Does or can the practice of medicine legitimately include currently intangible if not intellectually unscientific processes?
Do we need an expanded healthcare paradigm to meet the global human need for access to meaningful care and treatment?
There are no simple or easy answers to these concerns, yet the prevailing technology based model for reaching the more than half of the world’s suffering human beings is too expensive, too toxic and unsustainable. Integrating the best of what we have with what most reliably relieves pain and suffering provides a way toward better healthcare and increased healing on a broad scale.