An Ethical Perspective on Palliative Care

Abstract

Continuing Professional Education (CPE) Information The Continuing Professional Education (CPE) quiz for this article is available for free to Academy members through the MyCDRGo app (available for iOS and Android devices) and via www.eatrightPRO.org. Simply log in with your Academy of Nutrition and Dietetics or Commission on Dietetic Registration username and password, go to the My Account section of My Academy Toolbar, click the “Access Quiz” link, click “Journal Article Quiz” on the next page, then click the “Additional Journal CPE quizzes” button to view a list of available quizzes. Non-members may take CPE quizzes by sending a request to [email protected] There is a fee of $45 per quiz (includes quiz and copy of article) for non-member Journal CPE. CPE quizzes are valid for 1 year after the issue date in which the articles are published. A multi-dimensional paradigm shift in health care continues to spread as palliative care grows into an overarching concept integrated throughout the field. Once thought of in terms of hospice and long-term care units, research indicates that the concept can improve not only quality of life and patient satisfaction, but perhaps extend life as well in patients who might otherwise suffer less-desirable outcomes. 1 Temel J.S. Greer J.A. Muzikansky A. et al. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med. 2010; 363: 733-742 Crossref PubMed Scopus (5031) Google Scholar , 2 Kelley A.S. Meier D.E. Palliative care—A shifting paradigm. N Engl J Med. 2010; 363: 781-782 Crossref PubMed Scopus (116) Google Scholar , 3 Dionne-Odom J.N. Azuero A. Lyons K.D. et al. Benefits of early versus delayed palliative care to informal family caregivers of patients with advanced cancer: Outcomes from the ENABLE III Randomized Controlled Trial. J Clin Oncol. 2015; 33: 1446-1452 Crossref PubMed Scopus (296) Google Scholar , 4 Greer J.A. Pirl W.F. Jackson V.A. et al. Effect of early palliative care on chemotherapy use and end-of-life care in patients with metastatic non-small-cell lung cancer. J Clin Oncol. 2012; 30: 394-400 Crossref PubMed Scopus (402) Google Scholar , 5 American Academy of PediatricsPolicy Statement: Pediatric palliative care and hospice care commitments, guidelines, and recommendations. Pediatrics. 2013; 132: 966-972 Crossref PubMed Scopus (291) Google Scholar These quantitative results, added to strong anecdotal support, help build a compelling case for the shift, particularly as it appeals to a heightened sense of ethics in terms of beneficence, non-maleficence, and justice. This brings a multi-dimensional dynamic to the discussion of wellness and improved outcomes, and registered dietitian nutritionists (RDNs) accustomed to the concept report it’s completely in line with the profession’s traditional model of optimizing patient health through nutrition. The objective of the present article is to first explain the concept of palliative care, consider it from the perspective of ethics, and offer examples of challenges faced in the field of nutrition, as well as resources for the practitioner’s benefit. The Continuing Professional Education (CPE) quiz for this article is available for free to Academy members through the MyCDRGo app (available for iOS and Android devices) and via www.eatrightPRO.org. Simply log in with your Academy of Nutrition and Dietetics or Commission on Dietetic Registration username and password, go to the My Account section of My Academy Toolbar, click the “Access Quiz” link, click “Journal Article Quiz” on the next page, then click the “Additional Journal CPE quizzes” button to view a list of available quizzes. Non-members may take CPE quizzes by sending a request to [email protected] There is a fee of $45 per quiz (includes quiz and copy of article) for non-member Journal CPE. CPE quizzes are valid for 1 year after the issue date in which the articles are published.