Palliative Care
Palliative care is the care assets issued in a comprehensive approach to the person suffering from a disease severe, progressive or terminal Role and tasks of palliative care Palliative care for pain relief mission to improve the quality end of life of people and aim to improve the quality end of life of patients by a multidisciplinary management. Thus, medical treatment or surgery may be indicated for a patient in palliative care, if this treatment can relieve symptoms uncomfortable. The treatment of pain and treatment of uncomfortable symptoms (nausea, constipation or anxiety) are essential components of the palliative phase. Their purpose is broad support for the ill person, both on a medical plan, relieving pain or discomfort source, preserving the dignity of the person in the accompanying psychological difficulties, the patient and his family. Other aspects, including religious, spiritual or even social, are taken into account. Relatives are also supported in their grief process. The mind is as preserving the patient investigations or unreasonable treatment (that is to say, aggressive therapy), in the sense that they can make improvements. There are many definitions of "official" palliative care : definition of the French law (June 1999), the WHO definition, etc.. The introduction of palliative care in France was later than in Britain and the United States , where the party is "hospice movement" after the Second World War. It was formally introduced by the circular Laroque , 1986 "relating to the organization and support of patients in terminal phase " . Since 1991, "such care are among the tasks of hospital and access is presented as a right of patients ( CCNE , Opinion No. 63 ). Today, the Act of June 9, 1999 and the circular of 19 February 2002 DHOS/O2/DGS/SD5D trace the right of access to palliative care, as enshrined in the Code of Medical Ethics of 1995 (art. 37 - 38), which also rejects the aggressive treatment. Finally, following the mission Jean Leonetti "on the cover end of life" conducted in 2002, the " Law on patients' rights and end of life "of 2005 was enacted, while Observatory end of life was inaugurated in February 2010 by the Minister Roselyne Bachelot. The 2002 circular lays down detailed rules for organization of palliative care, said unequal access to them on the national territory. The statutory objectives are: On the other hand: The circular defines the concepts of palliative care units, beds "identified palliative care, mobile teams of palliative care. The ARH (Regional Agency for Hospitalisation) was responsible for this implementation. The development of palliative care is one of the priorities in a speech by President Nicolas Sarkozy in 2007 with more hospital beds, more training of physicians and more support for families of patients. The plan for a 230 million should be funded medical deductibles. This is, however, stated intentions, rather than concrete accomplishments. The coding of SP includes 3 GHS (homogeneous group of holidays) depending on whether the students stayed in bed respectively without special permission (GHS 7956), it takes place in a bed "dedicated" to the SP (GHS 7958), or if the visit takes place in a unit of SP (GHS 7957). Pricing varies according to these 3 cases. In ICD 10, code DP (primary diagnosis) of palliative care is code Z51.5 Palliative care can and should be practiced by all health care teams that specialize in assisting patients at the end of life , both at home and in hospital, there are complex situations requiring the intervention of health care teams palliative (multidisciplinary nature). In France, there are usually: medical services, surgery, or SRH, without having the title of palliative care units can also perform this mission, especially as the needs of the population are well above the number of beds or units dedicated MS. The introduction of palliative care and support in maternity and neonatology is being developed in France. Like any approach to palliative care, it is based on a multidisciplinary support: - Give a great place to listen to the suffering of parents facing the illness of their unborn child or newborn, - Provides medical follow closer to the mother and baby during the time of pregnancy, - To develop a life plan for the baby. In agreement with the parents, the pediatrician sets can receive the care the baby after birth. Comfort care and proportionate care which preclude aggressive treatment and which contribute to the welfare of the baby. - Favors the presence of parents with babies and siblings throughout the lifetime of the sick child. And if the baby's condition permits, he returned to the family home may be considered in conjunction with the attending physician of the family and in collaboration with a network of palliative care at home. This approach to palliative care and support is possible in case of prenatal diagnosis of a lethal disease of the baby, as part of an ongoing pregnancy but also in situations where the prognosis of newborn committed after its birth. These are all values held by the so-called "hospice movement" whose origin dates back to the pioneering Anglo-Saxon "Saint Christopher Hospice" around Cicely Saunders . Dr. Maurice Abiven ( one thousand nine hundred twenty-four - two thousand and seven ), a specialist in internal medicine , was one of the pioneers of palliative care practice in France and Charles-Henri Rapin (1947-2008), Swiss physician geriatrician is in the Francophone world geriatrics. This movement is based on ethical concepts devoting considerable space to the patient's autonomy, the refusal of the stubbornness and the refusal unreasonable to want to hasten the onset of death. Some advocates of palliative care as a concept of care, are opposed to euthanasia, defined as administering lethal doses of substances in order to cause death in a compassionate goal. An important defended by the hospice movement is to recognize the place in our society "who dies". For the hospice movement is important to remember that death is a natural phenomenon of life. Palliative care is active care delivered in a comprehensive approach to the person with a progressive or terminal illness. We must also mention the importance given to taking into account the suffering patient's overall physical, social, psychological, spiritual and his entourage. In an interdisciplinary approach, special attention is given to volunteers in support of the nursing process in the context of supportive care. Other caregivers of palliative care, while ensuring an optimal overall care of the suffering, accept that a patient ask for and obtain-euthanasia. The Roman Catholic Church condemns euthanasia but not palliative care. The Congregation for the Doctrine of the Faith recalled the obligation of feeding and hydrating patients in vegetative state, in a document released September 14, 2007. The Vatican responds to two questions posed by American bishops in the wake of the Schiavo case in 2005. He said yes to the administration of food and water, "morally obligatory" but not to the possibility of interrupting the food and hydration are being supplied by artificial means to a patient in persistent vegetative state Legal aspects
France
Palliative Care and pricing activity
Palliative Care Organization
The organization of palliative care and support in maternity and neonatal
Visions of palliative care
The "movement for palliative care
Doctrine of the Roman Catholic Church
Notes
Bibliography
References
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