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A Public Health Perspective on End of Life Care$
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Joachim Cohen and Luc Deliens

Print publication date: 2012

Print ISBN-13: 9780199599400

Published to Oxford Scholarship Online: May 2012

DOI: 10.1093/acprof:oso/9780199599400.001.0001

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Aggressive treatment and palliative care at the end of life

Aggressive treatment and palliative care at the end of life

Chapter:
(p.73) Chapter 6 Aggressive treatment and palliative care at the end of life
Source:
A Public Health Perspective on End of Life Care
Author(s):

Kirsten Wentlandt

Camilla Zimmermann

Publisher:
Oxford University Press
DOI:10.1093/acprof:oso/9780199599400.003.0035

The use of palliative care services has been increasing for the last few decades. Despite this, many cancer centres and general hospitals still do not have palliative care services, and there is continuation of aggressive treatment at the end of life (defined broadly as treatments and settings designed for prolonging life, rather than improving quality of life). An aggressive approach is often sustained even in patients who are close to death, and in countries such as the United States, Belgium, and Canada, more than 40% of all deaths still occur in hospital acute care units. This chapter reviews the literature pertaining to aggressiveness of care and use of palliative care and hospice services near the end of life. It examines characteristics associated with aggressiveness of care or hospice/palliative care use on the level of the physician, patient, and health care system, and discusses implications for quality of care and quality of life for patient and family.

Keywords:   palliative care services, aggressive treatment, end-of-life care, hospice services, quality of care, quality of life

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