Many of the most common ethics consults are rendered at the end of life: A family cannot consent to withdrawal. A patient cannot give up hope and pushes for futile, inappropriate and burdensome treatment. A patient is suffering unnecessarily because a family does not want their loved one sedated. The question presents itself: are these dilemmas purely ethical, or is there another discipline that may seem more appropriate? Many systems draw a clear, differentiating line between palliative care and ethics. I propose using palliative medicine to practice proactive ethics. Tools exist that can serve to address both disciplines. These tools embrace the common denominator, the crossover element in most end-of-life issues, the quality of life factor. And though this phrase may be subjective, subjectivity depends upon understanding. In the United States, palliative care is not embraced with the open arms that it offers a hospital and its' patients. Some administrators view it as a money pit, unnecessary, and a trend that will pass. But the reality is that as a Neurologist treats the brain and Nephrologists treat the kidneys, a Palliative Physician treats the symptoms. That is their organ. And it is our responsibility, as ethicists and advocates, to open the healthcare umbrella up to this realm of medicine. Our consults may benefit and our patients will benefit.
