Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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Guidelines for palliative sedation to dying patients were issued by the Council for Medical Ethics of the Norwegian Medical Association in 2001. This study is a follow up of these guidelines. ⋯ Palliative sedation for dying patients is probably used infrequently in Norway, and not to hasten death. In the cases which we have registered, palliative sedation was given to patients in great discomfort.
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The aim of palliative medicine is the best possible quality of life. Based upon literature and clinical experience we address factors of importance for the meeting between the palliative patient and the physician. Family and network, personality and behaviour vary between palliative patients and have effect upon their coping; these factors should be reflected in the meeting between the physician and the patient. ⋯ The aim is to give patients as good and as long a time as possible in the place in which they want to spend the last part of their lives. Palliative medicine often combines the art of medicine with new technology. The focus on quality of life and the patient perspective is paramount, and the approach to the patient should reflect this.
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Patients with advanced, incurable disease need easy access to qualified care. Basic palliative care should be provided in all clinical hospital departments and in community care. In addition, palliative care units in hospitals and nursing homes, and ambulatory, multidisciplinary, palliative care teams have a supportive role by providing teaching, advice, and care, also in primary care. ⋯ Palliative care requires much collaboration, and the general practitioner has an important role. In addition, hospital-based palliative care teams are important bridges between the different levels of the health care system. The Norwegian Standard for Palliative Care gives recommendations for the organisation of palliative care at all levels, and forms the basis for this article.