The ethical and existential dimension of palliative care

Palliative care can be considered as an ethical response to an existential event. It is ethical because spending time and resources on people with an incurable illness is a way of “aiming at the good life, with and for others, in just institutions”, as ethics can be defined (1). It is a deliberately chosen response to human suffering that is embedded in the Hippocratic tradition and moral considerations on human vulnerability, mortality, and suffering. Moreover, palliative care as we know it is based on a specific (morally relevant) idea of what a human being is: a social being, that cannot live, thrive or survive without being connected to other human (or nonhuman) beings. In palliative care, human beings are seen as multidimensional: having a physical, psychological, social and spiritual dimension to their being in the world. This multidimensionality is the basis of the central imperative of palliative care to relieve the suffering of patients and close ones with an interdisciplinary approach. Palliative care is teamwork: it requires the collaboration of people coming from diverse educational backgrounds working together, honouring the uniqueness and autonomy of the patients and close ones. At the same time, palliative care is a response to an existential event. Being diagnosed with an incurable illness, people are confronted with what many consider the most basic cause of anxiety in human life: their own death (2). Being confronted with one’s own death (or that of a close one) shakes the ground of one’s entire existence. It is an incomprehensible annihilation and loss of what we are most attached to: our human identity or ’self’. An event like this transcends the here and now and raises questions about the whole of one’s existence. Therefore, a confrontation like this can be called ‘existential’.