Ethical communication is critical to palliative care delivery. The goal of palliative care can be achieved through effective communication. Communication ethics in palliative care is concerned with the amount of information that should be disclosed to patients regarding their current medical situation. The intent is to enhance quality of life by minimizing suffering among patients. Ethical communication among health practitioners and between them and patients and family members is considered a part of care. This form of communication should adhere to similar ethical norms that concern clinical care (Ragan, 2016). Thus, it is the role of healthcare providers to observe ethical principles in palliative care communication.
In Chapter Five of the coursebook, Textbook of Palliative Care Communication, Ragan (2016) posits that ethical communication is a type of care subject to ethical norms, including reducing harm, respecting personhood, and optimizing benefit. Ragan emphasizes that the ethical palliative care communication framework entails concepts of sensitivity, confidentiality, truthfulness, as well as deliberation. I concur with the above statement that health practitioners or the palliative care team need to build communication with the patient and family members to maintain patient confidentiality and dignity. I also agree that communicating truthfully is critical in the continuity of effective palliative care. Barker (2017) reiterates the importance of truthfulness in ethical palliative care communication. Therefore, communication can considerably influence overall care outcomes among patients receiving palliative care. However, I believe that telling terminally ill patients the truth can be very demanding.
Ragan (2016) further perceives communication as an ethical obligation in palliative care. Palliative care communication needs to discern as well as integrate the preferences and values of both patients and family members, hence respecting their autonomy. Communication should further seek to maximize benefits to patients and families through engaging and producing better results (Beneficence) and reducing the risk of avoidable harm (Non-maleficence). I agree that health providers’ ethical communication obligation is to ensure that patients benefit and safeguarded from possible harm, to ultimately improve quality of life. Besides, practitioners should recognize the sovereignty of patients in making treatment-related decisions.
In their article, Moss, Guerin, Dwyer, Wills, and Daly (2020) focus on the need to adopt shared decision making between health practitioners and patients. The authors emphasize the need to ensure that decision making is both medically appropriate and consistent with the given patient’s values and preferences. I hold that a patient with decision-making capacity should partner with the healthcare team to make suitable treatment decisions. Kon, Davidson, Morrison, Danis, and White (2016) assert that health providers should open up and tailor the decision-making process, depending on the patient’s preferences. As such, collaborative decision-making can ensure high-quality care and guarantee the best patient and family outcomes. Moss et al. (2020) add that decisions should be made in the best interest of the patient’s belief system and values rather than just the surrogate’s beliefs and wishes in the palliative care context. Hence, I believe that ethical palliative care delivery should be based on either the current or earlier expressed patient’s preferences or values.
In summary, ethical communication is fundamental in offering palliative care. Palliative care health providers should follow an ethical communication framework that respects personhood, reduces harm, and optimizes patient’s benefits. Additionally, health practitioners need to apply ethical principles in communication and decision-making to achieve optimum quality care for patients. The application of ethical principles should consider the patient’s preferences and values concerning palliative care they wish to receive.
References
Barker, P. (2017). Ethical dilemmas in palliative care. InnovAiT: Education and Inspiration for General Practice, 10(8), 489–492. doi:10.1177/1755738017712536
Kon, A. A., Davidson, J. E., Morrison, W., Danis, M., & White, D. B. (2016). Shared decision making in intensive care units: an American College of Critical Care Medicine and American Thoracic Society policy statement. Critical care medicine, 44(1), 188- 201. doi: 10.1097/CCM.0000000000001396
Moss, K. O., Guerin, R., Dwyer, O. M., Wills, C. E., & Daly, B. (2020). On Best Interests: A Case for Clinical Ethics Consultation. Journal of Hospice & Palliative Nursing, 22(1), 5-11. doi: 10.1097/NJH.0000000000000608.
Ragan, S.L. (2016). Overview of communication. In E. Wittenberg, B.R. Ferrell, J. Goldsmith, T. Smith, S.L. Ragan, M. Glajchen, & G.F. Handzo (Eds), Textbook of palliative care communication (pp. 36-58). Oxford University Press.