August 1, 2005
The following statement was developed by the Task Force on Surgical Palliative Care and the Committee on Ethics, and was approved by the Board of Regents at its February 2005 meeting.
Palliative care aims to relieve physical pain and psychological, social, and spiritual suffering while supporting the patient's treatment goals and respecting the patient's racial, ethnic, religious, and cultural values. Like all good patient care, palliative care is based on the fundamental ethical principles of autonomy, beneficence, nonmaleficence, justice, and duty.
Although palliative care includes hospice care and care near the time of death, it also embraces the management of pain and suffering in medical and surgical conditions throughout life. If palliation is taken to apply solely to care near the time of death, or "comfort measures only," it fails to include the life-affirming quality of active, symptomatic efforts to relieve the pain and suffering of individuals with chronic illness and injury. In this respect, palliative care is required in the management of a broad range of surgical patients and is not restricted to those at the end of life.
The tradition and heritage of surgery emphasize that the control of suffering is of equal importance to the cure of disease. Moreover, by adhering to the standards of professionalism endorsed by the American College of Surgeons, the surgeon is positioned to take a leadership role in advocating for palliative care for all patients.
The Statement of Principles of Palliative Care is an evolutionary step beyond the American College of Surgeons' 1998 Statement of Principles Guiding Care at the End of Life. It describes extending palliative care to a broad range of patients receiving surgical care.
Reprinted from Bulletin of the American College of Surgeons
Vol.90, No. 8, August 2005