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Human relationship: The forgotten dynamic in palliative care

Published online by Cambridge University Press:  26 February 2004

DENISE L. HAWTHORNE
Affiliation:
Douglas College, New Westminster, British Columbia, Canada
NANCY J. YURKOVICH
Affiliation:
Community Advisory Council, Rotary Hospice House, Richmond, British Columbia, Canada

Abstract

Objective: Palliative care is a philosophy of care for individuals experiencing progressive, incurable disease. It encompasses two dynamics, science-based practice and relationship between patient, family, and health professional. Each dynamic is essential for quality palliative care, yet the requisites for each are different.

Methods: The scientific process of observation and measurement requires differentiation, distance, and detachment to fulfill its demands for objectivity, whereas relationship, unobservable and immeasurable, requires sameness, closeness, and connection of a shared humanity. It is science, however, the prevailing world-view, that shapes our thinking and consequently, influences the education and practice of health professionals.

Results: We explore the dynamics of science and relationship and the incongruities between them. We examine the prominence of science in palliative care and its impact on relationship.

Significance of results: We contend that questioning the current emphasis of science in palliative care and discovering the joy and rewards of shared human experience will enrich the quality of life for patients, families, and health professionals.

Type
REVIEW ARTICLE
Copyright
© 2003 Cambridge University Press

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References

REFERENCES

Backer, B.A., Hannon, N.R., & Gregg, J.Y. (1994). To Listen, to Comfort, to Care: Reflections on Death and Dying. Albany, NY: Delmar.
Barnard, D., Towers, A., Boston, & P., et al. (2000). Crossing Over: Narratives of Palliative Care. New York: Oxford University Press.
Bolen, J. (1996). Close to the Bone: Life-threatening Illness and the Search for Meaning. New York: Scribner.
Cousins, N. (1981). Anatomy of an Illness as Perceived by the Patient. New York: Bantam Books.
Danis, M. (1998). Improving end-of-life care in the intensive care unit: What's to become of outcome research? New Horizons, 6, 110118.Google Scholar
Davies, B., Brenner, P., Orloff, & S., et al. (2002). Addressing spirituality in paediatric hospice and palliative care. Journal of Palliative Care, 18, 5967.Google Scholar
Dudgeon, D. (1992). Quality of life: A bridge between the biomedical and illness models of medicine and nursing? Journal of Palliative Care, 8, 1417.Google Scholar
Field, M.J. & Cassel, C.K. (eds.) (1997). Approaching Death: Improving Care at the End of Life. Washington, DC: National Academy Press.
Gino, C. (1985). Rusty: A True Story. London: Pan Books.
Hawthorne, D.L. & Yurkovich, N.J. (2002). Nursing as science: A critical question. Canadian Journal of Nursing Research, 34, 5364.Google Scholar
Matzo, M. & Sherman, D. (eds.) (2001). Palliative Care Nursing: Quality Care to the End of Life. New York: Springer.
Murphy, M. (1997). Relationship-centredness: The essential nature of humane health care. Humane Health Care, 13, 142143.Google Scholar
Nepo, M. (1997). God, self and medicine. In The Patient's Voice: Experience of Illness, Young, M. (ed.), pp. 133141. Philadelphia: F.A. Davis.
Pellegrino, E.D. & Thomasma, D.C. (1997). Helping and Healing: Religious Commitment in Health Care. Washington, DC: Georgetown University Press.
Perlman, J.S. (1995). Science without Limits: Toward a Theory of Interaction between Nature and Knowledge. Amherst, NY: Prometheus Books.
Pope, R. (1997). Illness and Healing: Images of Cancer. Nova Scotia, Canada: Lancelot Press.
Portenoy, R. (1998). First international conference on research in palliative care: Methodologies and outcomes. The Network News, 7, 1.Google Scholar
Roy, D.J. (1988). Ethics and aging: Trends and problems in the clinical setting. In Ethics and Aging: The Right to Live, the Right to Die, Thornton, J. & Winkler, E. (eds.), pp. 3140, Vancouver: University of British Columbia Press.
Roy, D.J. (1992). Measurement in the service of compassion. Journal of Palliative Care, 8, 34.Google Scholar
Roy, D.J. (2000). Care of the sick and the dying: A matter of trust? Journal of Palliative Care, 16, 34.Google Scholar
Roy, D.J. (2002). On being diminished. Journal of Palliative Care, 18, 7576.Google Scholar
Stanworth, R. (2002). Attention: A potential vehicle for spiritual care. Journal of Palliative Care, 18, 192195.Google Scholar
Sulmasy, D.P. & McIlvane, J.M. (2002). Patients' ratings of quality and satisfaction with care at the end of life. Archives of Internal Medicine, 162, 20982104.Google Scholar
SUPPORT Principal Investigators. (1995). A controlled trial to improve care for seriously ill hospitalized patients. Journal of the American Medical Association, 274, 15911598.Google Scholar
Toombs, S.K. (1995). Healing and incurable illness. Humane Health Care, 11, 98103.Google Scholar