History of hospice development dates back to medieval times, but modern hospice movement started just in 1967 with the establishment of St. Christopher’s Hospice in London by Cicely Saunders. Hospice’s unique features comprise of caring for all dimensions of the “total pain”: physical, spiritual, psychological, and social problems of the patient and the family. Hospice care can be provided in five organizational forms: inpatient hospices, home care, day care, palliative care units, and hospital palliative care teams. Last two forms present the integration of hospice care in the healthcare system. Presentation of ethical dimension of hospice care starts with the application of the four basic principles of bioethics. They have specific expression in the context of hospice care: respect for autonomy is generally associated with the issue of truth-telling and advance directive; beneficence and non-maleficence are focused on the problems of pain control, primarily on the double effect debate; and justice is associated with respect to the rights of terminally ill patients. Justice is discussed also in relation to guaranteeing a minimum of palliative care to everyone in need. Terminally ill patients are seen as vulnerable population in regard to inclusion in clinical research. Euthanasia and palliative care are generally considered as incompatible.
KeywordsHospice Palliative care Terminally ill Total pain
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