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Routinization and medicalization of palliative care: Losses, gains and challenges

Published online by Cambridge University Press:  15 May 2012

Ciro Augusto Floriani  and
Fermin Rolland Schramm
Ciro Augusto Floriani*
Affiliation:
Bioethics Council, Brazilian National Cancer Institute, Rio de Janeiro, Brazil
Fermin Rolland Schramm
Affiliation:
Bioethics Council, Brazilian National Cancer Institute, Rio de Janeiro, Brazil Social Science Department, National School of Public Health Sérgio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
*
Address correspondence and reprint requests to: Ciro Augusto Floriani, 44/1003 Dr Herotides de Oliveira, Niterói, Rio de Janeiro 24230-230, Brazil. E-mail: [email protected]
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Abstract

This article investigates some of the criticisms that have been directed at the hospice movement in the process of interaction with the traditional Western healthcare system, such as those relative to its routinization and medicalization. It also aims to review some of the consequences of this process of institutionalisation for the field of end-of-life care: surveillance and control over the process of dying, at the expense of decisions preferably based on the patient and that patient's ability to decide how to die, with the loss of wider objectives originally established by the movement, such as unconditional reception for the patient. Based on these criticisms, some considerations are made regarding the moral implications and risks related to this specific mode of action, the hospice way of care.

Keywords

Hospice carePalliative careTerminal careHealth services administration
Type
Review Articles
Information
Palliative & Supportive Care , Volume 10 , Issue 4 , December 2012 , pp. 295 - 303
Copyright
Copyright © Cambridge University Press 2012

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