Skip to Main Content




Death should simply become a discreet but dignified exit of a peaceful person from a helpful society—without pain or suffering and ultimately without fear.

Philippe Ariès 1977


To enable a person to live in dignity, peace and comfort throughout their illnesses means responding to physical, psychological, emotional, social and spiritual needs.1

E Fairbank, T Banks, Palliative Care: The Nitty Gritty Handbook


Palliative care is comprehensive, continuing, multidisciplinary patient care that involves the patients and their carers, consultants, domiciliary nurses, social workers, clergy and other health professionals who are able to contribute to optimal team care.


The fundamental principles of palliative care are:2


  • good communication

  • management planning

  • symptom control

  • emotional, social and spiritual support

  • medical counselling and education

  • patient involvement in decision making

  • support for carers


The diseases


Palliative care applies not only to incurable malignant disease and HIV/AIDS but also to several other diseases, such as end-stage organ failure (heart failure, kidney failure, respiratory failure and hepatic failure) and degenerative neuromuscular diseases. Thirty per cent of the population will die from cancer.


The special role of the family doctor


The GP is the ideal person to manage palliative care for a variety of reasons—availability, knowledge of the patient and family, and the relevant psychosocial influences. A key feature is the ability to provide the patient with independence and dignity by managing palliative care at home. Someone has to take the responsibility for leadership of the team and the most appropriate professional is a trusted family doctor.


Most patients and their families require answers to the following six questions.3


  • What is wrong?

  • What can medical science offer?

  • Will I suffer?

  • Will you look after me?

  • How long will I live?

  • Can I be looked after at home?


Caring honesty is the best policy when discussing the answers to these questions with the patient and family. Never lie to a patient and always avoid thoughtless candour.


Support for patients and carers


Studies have indicated that the most common complaints of patients are boredom and fear of the unknown. This highlights the importance for the attending doctor of the following points.


  • Give emotional support.

  • Listen and be receptive to unexpressed ‘messages’.

  • Treat the sufferer normally, openly, enthusiastically and confidently.

  • Show empathy and compassion.

  • Employ good communication skills.

  • Give honest answers without labouring the point or giving false hope.

  • Provide opportunities for questions and clarification.

  • Show an understanding of the patient's needs and culture.

  • Adopt a whole-person approach: attend to physical, psychosocial and spiritual needs.

  • Anticipate and be prepared for likely problems.


These next special points are worth emphasising.


  • The ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.


About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

Murtagh Collection Full Site: One-Year Subscription

Connect to a suite of general practice resources from one of the most influential authors in the field. Learn the breadth of general practice, including up-to-date information on diagnosis and treatment, as well as key clinical skills like communication.

$145 USD
Buy Now

Pay Per View: Timed Access to all of Murtagh Collection

48 Hour Subscription $34.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.