The Limits of “Life-Limiting”

Research output: Contribution to journalArticle

Abstract

The field of hospice and palliative medicine has struggled to define the conditions that are appropriate for palliative care. “Life-threatening” appropriately encompasses lethal conditions and helpfully incorporates the concept of probability, which is a necessary variable in any risk calculation. Yet it leaves one important group of patients unaccounted for: those whose primary need for palliative care is not expected abbreviation of life but rather the quality of that life. In an attempt to include these patients, the term “life-limiting” has come to be used more frequently. Although attractive in its breadth—and at first glance appearing to be a less threatening way to introduce palliative care—the term is inherently flawed. It denotes a certain outcome, without any consideration of the likelihood of that outcome. Rather than “softening the blow” of introducing palliative care, the term seems to condemn a patient to the very outcome that palliative care is tasked to ameliorate, namely, the limitation of life. As such, it may provide a distorted view of what palliative care is, especially in pediatrics where the term is used with disproportionate frequency. The inherent misplaced certainty of “life-limiting” and the self-defeating message it sends to patients should be acknowledged.

Original languageEnglish (US)
JournalJournal of Pain and Symptom Management
DOIs
StatePublished - Jan 1 2019

Keywords

  • hospice
  • Life-limiting
  • life-threatening
  • pediatric
  • risk
  • terminal

ASJC Scopus subject areas

  • Nursing(all)
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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