Translating the World Health Organization definition of palliative care into scientific practice

摘要

According to the World Health Organization (WHO), palliative care is concerned with the physical, psychosocial, and spiritual problems of patients with life-threatening illnesses and of their families. This is a tall order for clinical practice, let alone scientific research. Clearly, this task cannot be mastered by one single profession, but requires a cooperation of several disciplines. This has been a hallmark of palliative care teams since the very beginning – Dame Cicely Saunders, who had been trained as a nurse, social worker, and physician, referred to herself jokingly as a “one-woman multi-professional team.” In clinical practice the exact roles and boundaries within the palliative care team often have to be re-negotiated periodically. The blurring of professional boundaries can be very beneficial for the overall task to be accomplished, but can also lead to misunderstandings and conflicts between team members. Balfour Mount, the great pioneer of palliative medicine, has been quoted as saying: “So you worked in teams? Show me your scars.”