The primary role of the doctor (medical practitioner) in end of life care is to facilitate the provision of good quality patient-centred care that emphasises continuous, open, informed communication and collaboration between the patient, the health care team, and, where appropriate, the patient’s carers, family members and/or substitute decision-maker.

 

Good quality end of life care should:

 

• ensure the patient is always treated as an individual, with respect, dignity and compassion in a culturally sensitive manner

 

• endeavour to meet the patient’s care needs and uphold their care preferences which should guide decision-making and planning

 

• strive to ensure that the patient is free from suffering

 

• endeavour to facilitate care in the patient’s environment of choice, where practical, recognising that a patient’s health care needs may change in the course of their condition

 

• ensure that the patient’s goals and values for end of life care are respected

 

• respect the patient’s privacy and confidentiality, even after death

 

• support not only the physical needs of the patient but also the psychological,emotional, religious and spiritual needs of the patient and their family members and carers

 

• empower patients and, where appropriate, their family members and carers toparticipate in managing their treatment

 

• provide counselling and other support to patients, their family members and carers throughout the patient’s condition, including support for family members and carers beyond the patient’s death

 

• ensure patients and their family members and carers have access to good quality palliative care resources such as educational materials as well as physical aids in a timely, easily accessible and coordinated manner

 

• ecognise the role of doctors, allied health care professionals, carers and the wider community in working together to meet the needs of patients

 

• facilitate continuity and coordination of care within and between medical, health and community services including when the patient transitions from medical care that is primarily focussed on curative treatments to care that is focussed on palliative treatments.

 

Death, dying and bereavement are all an integral part of life; however, reflecting on and discussing death can be profoundly confronting and difficult.

Open and frank discussion of death and dying including end of life care options, approach to futile treatment, caring and bereavement should be encouraged within the profession and in the wider community.

 

(AMA, 2014 )