Position Paper- Palliative vs Curative Care

According to the World Heath Organisation (WHO, 2011), Palliative care is an approach, which aims to improve quality of life of patients and families who are crippled with life threatening illnesses. Alternatively, curative care is an approach that aims to prolong life through technological advances and medicine. It seems that the best approach to health care, would be to improve the quality of life as well as prolong life, through a combination of both curative and palliative care. The best approach to health care is a combination of both curative and palliative care.

Combining the best of life prolonging technological advances whilst maximising quality of life should be the ultimate aim of all medical practitioners. The basic endeavour should be to cure an individual; however, if the quality of life is impacted it may not be an advisable or worthwhile process. This is the reason why there is a necessity for the integration of both. By curing someone of their disease or illness whilst concurrently giving them a high quality of life through palliative treatment, the objective is achieved.

This approach is more appropriate than choosing between palliative and curative, due to the blurred boundaries between what represents curative and what represents palliative care. The natural course and the severity of the disease, and a better understanding of symptoms such as pain, cause the blurred boundaries. (Cooney, 2005). The definition between curative and palliative care are considered dichotomous. However, both methods are needed to achieve optimal results. There are many misconceptions that suggest an ‘either-or’ method.

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This is heightened by Medicare policies and regulations, and equivalent requirements of some health plans and insurance guidelines (Byock, 2000). Many do not understand that there is an option for both, which is the ultimate alternative. Within the health care system where cure should be valued vastly, palliative is perceived as the second best option and is only presented when there are no better options is available. However, the basic principle of palliative care stresses the value of consistent stability of care such as symptom management (Byock, 2000).

Curative care is directed towards seeking a cure for an existing disease or medical condition. Through technology and medicine it prolongs life. Paul Jewell’s (2005) article on the sanctity of life states that this notion of the sanctity of life is promoted as an ethical standard, a conduct to professional practice and legislated constraints. His article further suggests that medical practitioners are expected to work in ways that correspond to common social expectations and legal restrictions. Thus, signifying that the main concern should be the wellbeing of the patient.

Within the Australian Medical Association’s code of ethics, it is stated that there is a responsibility to preserve life, however, where death is deemed to be pending and where curative or life-prolonging treatment is absent, one must try to certify that death transpires with dignity and relief through palliative care (AMA, Code of Ethics, 2004). It is through the reasons listed above and a basic understanding of human rights that insist that all individuals should aim to be cured. Curative methods such as chemotherapy are expensive procedures.

According to Simoens et, al. (2010), the smallest proportion of hospital costs are in the palliative care unit. For some this may be a motivation to choose palliative over curative, however, the value of life is more important than the cost. Palliative care is as essential as curative because there is no point in curing a patient and then leaving them with a poor quality of life. The aim of palliative care is to relive symptoms of ill patients and improve quality of life. Despite the technological advancements in medicine, many illnesses elude cure.

Thus it leaves terminally ill patients, and patients with chronic diseases with palliative care being a necessity (Doyle et, al. 20). Therefore palliative is highly important and possibly the only option for the treatment of those individuals. Palliative care specifically cares for those who are terminally ill focusing not on curing them but treating their symptoms, making them comfortable while controlling their pain. It allows the patient to feel in control of their treatment and their quality of life.

It also allows individuals and families to understand that dying is a normal stage and an inherent part of life, and to come to terms with the inevitable. Through a developmental approach, this step presents perspective and opportunity for the individual to discover ways of growing and developing towards a “self-determined sense of completion in personal, interpersonal and spiritual realms of life” (Byock, 2000). During this last stage of life, palliative care of terminally ill patients allows growth and a sense of closure between patients and families, both individually and together (Byock, 2000).

These patients are offered not only relief from pain and other symptoms, but also psychological and emotional support from psychologists and counsellors for them and their families (WHO, 2011). For terminally ill patients, palliative care offers quality of life treatments both at the hospital and at home such as nursing, supportive therapy, and physiotherapy, etc. Simoens et, al. 2010). Aged patients generally choose palliative care over curative despite the fact that their illness may be curable. The suffering of their family and friends around them generally influences this decision.

The Social Cognitive Theory, illustrates how individual aspects as well as environmental factors and human behaviour apply influence upon each other (National Cancer Institute, 2005). Thus careful decision-making needs to be made with the interest of the aged patient in mind. Palliative care is also highly important for individuals who are not suffering from terminal illnesses, and also for those who have chosen curative methods. It allows them to have a better quality of life throughout the procedure and the recovery period.

Without palliative care assisting curative methods, individuals would be unlikely to choose to go through the curative methods knowing there would be a poor quality of life after. In conclusion through a close analysis of both curative and palliative care, the best approach to health care would be an integration of both methods. Each individual circumstance needs to be looked at holistically. Curative methods are essential in pro-longing an individuals life. However, there is sanctity of life, which needs to be valued.

By not providing cure of illness or disease one does not recognise the sanctity of their life. Palliative care is just as important as curative. It is important for patients who are not only terminally ill or aged, but those who choose curative methods. By curing a patient, one needs to palliate them by relieving symptoms of possible pain or discomfort. If palliative care is not provided, there would be no point in curing a patient by giving them a poor quality of life. Thus they need to work in conjunction with each other for the most successful results.

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