Redefining Palliative Care—A New Consensus-Based Definition
Journal of Pain and Symptom Management, vol. 60, pp. 754–764
Abstract
CONTEXT: The International Association for Hospice and Palliative Care developed a consensus-based definition of palliative care (PC) that focuses on the relief of serious health-related suffering, a concept put forward by the Lancet Commission Global Access to Palliative Care and Pain Relief. OBJECTIVE: The main objective of this article is to present the research behind the new definition. METHODS: The three-phased consensus process involved health care workers from countries in all income levels. In Phase 1, 38 PC experts evaluated the components of the World Health Organization definition and suggested new/revised ones. In Phase 2, 412 International Association for Hospice and Palliative Care members in 88 countries expressed their level of agreement with the suggested components. In Phase 3, using results from Phase 2, the expert panel developed the definition. RESULTS: The consensus-based definition is as follows: Palliative care is the active holistic care of individuals across all ages with serious health-related suffering due to severe illness and especially of those near the end of life. It aims to improve the quality of life of patients, their families and their caregivers. The definition includes a number of bullet points with additional details as well as recommendations for governments to reduce barriers to PC. CONCLUSION: Participants had significantly different perceptions and interpretations of PC. The greatest challenge faced by the core group was trying to find a middle ground between those who think that PC is the relief of all suffering and those who believe that PC describes the care of those with a very limited remaining life span.
Authors 37
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Lukas Radbruch corresponding
University of Bonn · University Hospital Bonn
Affiliation as printed
Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany. Electronic address: Lukas.radbruch@malteser.org
Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany
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Affiliation as printed
International Association for Hospice and Palliative Care, Houston, Texas, USA
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Affiliation as printed
University of Miami Institute for Advanced Study of the Americas, Coral Gables, Florida, USA
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Affiliation as printed
San Nicolash, Argentina
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Affiliation as printed
Kenian Hospice and Palliative Care Association, Nairobi, Kenya
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All India Institute of Medical Sciences
Affiliation as printed
Department of Onco-Anaesthesia and Palliative Medicine, All India Institute of Medical Sciences, New Delhi, India
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University of the Witwatersrand
Affiliation as printed
Wits Centre for Palliative Care, University of the Witwatersrand Johannesburg, Johannesburg, South Africa
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The University of Texas MD Anderson Cancer Center
Affiliation as printed
Department of Palliative Rehabilitation and Integrative Medicine, MD Anderson Cancer Center Houston, Houston, Texas, USA
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Affiliation as printed
School of Pharmacy, University of Panama, Panama City, Panama
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Affiliation as printed
Private Practice, Rio de Janeiro, Brazil
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Affiliation as printed
New York, New York, USA
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Affiliation as printed
Pain and Palliative Care Unit, Kenyatta National Hospital, Nairobi, Kenya
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Clinica Universidad de Navarra
Affiliation as printed
Department of Palliative Medicine, Clinica Universidad de Navarra, Navarra, Spain
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Worldwide Hospice Palliative Care Alliance
Affiliation as printed
Worldwide Hospice Palliative Care Alliance, London, United Kingdom
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Mongolian National University of Medical Sciences
Affiliation as printed
General Practice and Basic Skills Department, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
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Affiliation as printed
International Children's Palliative Care Network, Cape town, South Africa
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Affiliation as printed
New York, New York, USA
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National Cancer Centre Singapore
Affiliation as printed
Division of Palliative Medicine at the National Cancer Centre Singapore, Singapore
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Hospital Infantil Dr. Robert Reid Cabral
Affiliation as printed
Clínica de Linfomas and LMA Cuidados Paliativos and Terapia Metronómica, Hospital Infantil Dr. Robert Reid Cabral, Santo Domingo, Dominican Republic
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Affiliation as printed
Centre for Global Health Palliative Care, King's College London, London, United Kingdom
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Affiliation as printed
Palliative Care Department, Ho Chi Minh City Oncology Hospital, Ho Chi Minh City, Vietnam
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Affiliation as printed
Institut universitaire de formation et de recherche en soins, Universite de Lausanne, Lausanne, Switzerland
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Affiliation as printed
Department of Palliative Care, Makerere University, Kampala, Uganda
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African Palliative Care Association
Affiliation as printed
African Association for Palliative Care, Kampala, Uganda
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Affiliation as printed
International Children's Palliative Care Network, Cape town, South Africa
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Affiliation as printed
Health Education and Practices Laboratory, University Parisse, Villetaneuse, France
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American University of Beirut Medical Center
Affiliation as printed
Palliative and Supportive Care Program at the American University of Beirut Medical Center, Beirut, Lebanon
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Affiliation as printed
International Association for Hospice and Palliative Care, Houston, Texas, USA
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Affiliation as printed
George Washington University's Institute for Spirituality and Health, Washington, District of Columbia, USA
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Affiliation as printed
Trivandrum Institute of Palliative Sciences, Trivandrum, Kerala, India
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Affiliation as printed
Hope Institute Hospital, Kingston, Jamaica
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Affiliation as printed
Australasian Palliative Link International, Melbourne, Australia
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Affiliation as printed
Mehac Foundation, Kochi, Kerala, India
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Sobell House · University of Oxford
Affiliation as printed
Sir Michael Sobell House, Oxford University Hospital, Oxford, United Kingdom
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Affiliation as printed
Melbourne, Australia
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Affiliation as printed
College of Nursing Catholic, University of Korea, Seoul, South Korea
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Affiliation as printed
Department of Palliative Medicine, University Hospital Aachen, Aachen, Germany
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