Palliative cancer care ethics: Principles and challenges in the Indian setting

Abstract

Palliative cancer treatment is a system of care that seeks to relieve suffering in patients with progressive cancer. Given the intractable symptoms with which certain malignancies manifest, palliative care offers a practical approach towards improving the patient’s quality of life. However, there are an array of ethical issues associated with this treatment strategy such as particular methods of pain relief, a reliable assessment of suffering, autonomy, and multi-specialist care. While these principles are important to increase and improve the network of palliative care, the resource-poor Indian environments present numerous barriers for these principles to be practically applied. As the infrastructure of comprehensive cancer centers develop, paralleled with an increase in training of palliative care professionals, significant improvements need to be made in order to elevate the status of palliative cancer care in India.

New perspective for nutritional support of cancer patients: Enteral/parenteral nutrition

“…Given the intractable symptoms with which certain malignancies manifest, palliative care offers a practical approach towards improving patient QoL. However, there is an array of ethical issues associated with this treatment strategy, such as particular methods of pain relief, a reliable assessment of suffering, autonomy and multi-specialist care (25). The development of palliative care in terms of recognizing the needs of the dying has becoming a nursing and medical speciality.…”

The Perspectives on Including Palliative Care in the Indian Undergraduate Physiotherapy Curriculum

“…but today, the scenario has changed. Laakso et al, concluded that an early PT intervention, followed by a community follow up, improved the maintenance of the functional independence and the quality of life of the patients who received palliative care [22] The patients who receive palliative care experience high levels of functional disability which are related to the disease progression, deconditioning, pain, incontinence, respiratory dysfunction, direct tumour affect and paraneoplastic syndromes or local or systemic effects of the cancer treatment and its complications [7,13,[22][23][24][25]. A decrease in the level of function is one of the major concerns in the decrease of the quality of life of the patients and regaining the functionality is one of the major goals for the patients [23].…”

Impact of the educational session on knowledge and attitude toward palliative care among undergraduate medical, nursing, and physiotherapy students: a comparative study

“…all cancer patients die suggesting that every second person will eventually need palliative care. 5 Every hour more than 60 patients die in India from cancer and in pain. 6 Studies show that doctors and health care professionals lack the ability to provide end-of-life care and cater to the needs of the dying patients due to the inadequate knowledge in administering the adequate dosages of analgesics and sedatives.…”

“…7 Therefore, it is important to reinforce the need and educate health care professionals during their training period itself. 5 Hence, this study was taken up to compare the attitude and knowledge about palliative care and pain management among the undergraduate students of medical, nursing, and physiotherapy before and after an educational session.…”