Rochester expert Timothy E. Quill, M.D. is co-editor of a new book exploring the ethics of palliative care, the medical specialty that focuses on pain and symptom management, patient and family support, and help with decision making.
“Palliative Care and Ethics” (Oxford University Press, March 2014) addresses important and sometimes controversial issues faced by patients with serious illness and their families, These issues include advance care planning, when to ask for palliative care, how to treat depression, when to use sedation, and how to respond to requests for physician assisted death.
Sometimes confused with hospice care, patients referred for palliative care are not restricted by hospice's requirement of a prognosis of six or fewer months, nor is their care limited to pain and symptom management. In fact, it can accompany any and all aggressive medical treatments. While palliative care has potential to reach a larger population, as a relatively new specialty—only 25 years in existence—its boundaries are not yet well defined and it does not yet include a comprehensive system of care as is provided by hospice.
[It is a] very diverse ethical exploration of this relatively young field that can deepen, stretch, and at times confront any simple notion of the challenges facing patients, their families, professional caregivers, and policy makers.
Through a series of case stories, “Palliative Care and Ethics” explores the challenges of providing care based on real-life examples. The publisher’s notes describe it as a “very diverse ethical exploration of this relatively young field that can deepen, stretch, and at times confront any simple notion of the challenges facing patients, their families, professional caregivers, and policy makers.”
Though geared primarily to health care professionals and medical ethicists, the book provides valuable insight to patients with serious illness, family members, and others interested in the ethical challenges that accompany the practice of palliative care and hospice.
“Palliative care should be part of the treatment plan for all patients with serious illness, but many questions remain as to whether everyone needs specialist palliative care, and what are the boundaries of the practice,” Quill said. “We have some of the most renowned palliative experts in the world addressing these questions from a wide range of perspectives.”
Contributors to the book include University of Rochester faculty members Ronald M. Epstein, M.D., professor of Family Medicine; Robert Gramling, M.D., D.Sc., associate professor of Family Medicine; and Sally A. Norton, Ph.D., R.N., associate professor in the School of Nursing.
The book is co-edited by Franklin G. Miller , senior faculty member in the Department of Bioethics, National Institutes of Health and special expert, National Institute of Mental Health Intramural Research Program.
Quill is the Georgia and Thomas Gosnell Distinguished Professor in Palliative Care, a professor of Medicine, Psychiatry, Medical Humanities, and Nursing at the University of Rochester School of Medicine and Dentistry, and director of the Palliative Care Division. He is a board member and immediate past president of the American Academy of Hospice and Palliative Medicine.
In addition to his practice of palliative care, Quill has authored or edited seven books, including the “Primer of Palliative Care,” in its sixth edition, also due out this month. He has authored multiple peer-reviewed articles in major medical journals and is a regular lecturer and commentator on medical decision making, physician-patient relationships, palliative care, and end-of-life issues.