J Palliat Care
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Five situations have been presented to consider whether there are interventions which are "not done in palliative care". No attempt was made to cover all possible circumstances. The only limits which emerged are (a) an absolute limitation on criminal action and (b) a relative limitation on non-beneficial treatment. Determination of what is non-beneficial is subject to various considerations: firstly, not recommending non-beneficial interventions; secondly, giving special allowance for experimental interventions in properly conducted trials; and, thirdly, accepting the patient's right to gamble on a trial of therapy.
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Pain is a common, distressing symptom experienced by cancer patients and their family caregivers. An important aspect of coping with cancer pain is the ability to make meaning of the experience. ⋯ It also presents an integrated approach to assisting patients and their family caregivers with the meaning-making process associated with cancer pain. Approaches to intervening are integrated within a model developed through previous research.
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During the last 10 years interest in palliative care research has grown. This interest has brought about an awareness of the unique ethical issues related to research in this special population. Issues related to the vulnerability of patients and families, consent protocols, unstable mental status, and the invasiveness of assessments have been discussed. ⋯ However, until now, administrators, governments, and clinicians have planned palliative care programs to have only service and some teaching components. And traditional research-sponsoring agencies have not allocated priority to palliative care in their funding strategies. The palliative care community must take the initiative in this debate.