The tyrannies of palliative care (original) (raw)

International Journal of Palliative Nursing, 2001

Abstract

I have previously argued that palliative care is in danger of suffering from ideological stagnation (Aranda, 1998). By this I meant that the philosophy of palliative care had become so enshrined in rhetoric that practitioners are able to claim that they provide whole person, family-centred and multidisciplinary care, while failing to explore the limits to which this is achieved within the context of contemporary health-care delivery. The words of palliative care philosophy role off the tongue but we rarely challenge what we do. However, in today’s health-care world, and with increasing governmental funding of palliative care services, demands to be accountable for the outcomes of palliative care are growing. The challenge is no longer one of proving the place of palliative care, but rather of demonstrating the effect of our interventions so that they can be taken up more broadly in health care. Some of the forces preventing this I have labelled the tyrannies of palliative care. The word tyranny means oppressive action or behaviour. In this context though it refers to the ways in which our behaviours limit the extent to which palliative care can be self-critical and reflective. The three tyrannies I have identified are not exhaustive but can perhaps begin us on a process of self-critique that will be essential to our continued growth as an integral part of contemporary health care.

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