In 1959, Victor Frankl considered universal facts of life to be suffering, death and existential guilt and called it the “tragic triad”. Life is suffering, as Lord Buddha concluded. Palliative care tries to reduce this suffering which increases even more near the end of life. Severe pain can compromise the quality of life. Ethicist will guard against counter phobic determination to treat pain as health care team undertreats the pain are worried about excessive sedation and concern for hastening death. Palliative care is best for controlling the symptoms in these difficult situations. Even when goals of care are so clear, still there are lots of ethical question. Most common reasons are conflicts in values between physician and patient or patient and his family. There can also be conflict in expectations. Here we have described ethical issues with ethical analysis with few common clinical scenarios to help the reader associate these in their practice.
Part of the book: Highlights on Several Underestimated Topics in Palliative Care