Boundaries of (Im)measurability in Palliative Care
Throughout the years, hospitals have become more commercialized. We can ask ourselves how quality of care can be kept up to the mark, considering the current trend of financial crisis, war on inefficiency, specializations, quantitative parameters and audits, the measuring of the impact in bigger versus smaller hospitals .
The very moment a patient is hospitalized, he is absorbed into a system, into the logic and the rules of an organization. To what extent are we at that moment then still the owner of our own life and body, and where exactly lie the boundaries for the hospital as organization to take over this fundamental ownership? What predominates when questions of life and death are at stake, how are these issues managed within a hospital culture and how can patient, doctor, care-giver and family work together in the (seemingly?) ultimate immeasurable: the end of a life? These and further questions shall be addressed in this essay, using various depersonalized cases from everyday practice at the nursing ward.
KeywordsPalliative care Sedation End of life decisions Dilemma of care Self-determination
- Aries, P. 1974. Western Attitudes Towards Death – From the Middle Ages to the Present. Baltimore: The John Hopkins University Press.Google Scholar
- Beyers, L. 2014. Het wordende denken, Cahiers Campus Gelbergen. nr. 3. Antwerpen: Garant.Google Scholar
- Claessen, S.J.J. 2013. New Developments in Palliative Care: Quality Indicators and the Palliative Care Continuum, 189. Amsterdam: Utrecht/NIVEL/ProefschriftVrijeUniversiteit.Google Scholar
- Habermas, J. 1987. The Theory of Communicative Action, Volume Two: Lifeworld and System: A Critique of Functionalist Reason. Cambridge: Polity.Google Scholar
- Lynn, J., and D.M. Adamson. 2003. Living Well at the End of Life: Adapting Health Care to Serious Chronic Illness in Old Age. Washington, DC: Rand Health.Google Scholar
- Saunders, C., and M. Baines. 1989. Living with Dying: The Management of Terminal Disease. Oxford: Oxford University Press.Google Scholar
- Sobin, L.H., and C. Wittekind. 2002. TNM Classification of Malignant Tumors. 6th ed. New York: Wiley-Liss.Google Scholar