Surgical Palliative Care

Abstract

Surgical palliative care is the treatment of suffering and the promotion of quality of life for seriously or terminally ill patients under surgical care. Core values of surgical culture, nonabandonment, and preservation of hope are consistent with the essence of palliative care as it has developed around the globe as a standard of care for life-limiting, critical, and terminal illness. The conceptual framework for surgical palliative care has antecedents in the history of surgery as well as the hospice concept of care introduced by the late Cicely Saunders. The hospice concept she introduced in the 1960s was subsequently modified and expanded to apply to individuals with longer-term prognoses including those choosing to continue disease-directed treatment. Because of the historical association of hospice and palliative care many patients and clinicians still confuse palliative care with end-of-life care after curative treatment has been abandoned. Palliative care encompasses supportive care for patients and families with serious illness that includes disease-directed treatment and supportive care for patients and families with terminal illness not seeking disease-directed treatment. Team-based palliative care consists of empathic communication, diligent and efficacious symptom management, and attention to psychosocial and spiritual matters. The surgical community has too many seriously ill people in its care and has too much unique experience to offer them to not assume an active role as a provider of palliative care to its patients and families regardless of prognosis.