The Role of Multidisciplinary Teams in Palliative Care: An Essay

This essay delves into the multifaceted aspects of palliative care, emphasizing the crucial role of ethical decision-making within a multidisciplinary team. It examines the ethical principles of autonomy and beneficence in the context of a patient's end-of-life care, considering the cultural beliefs and practices of an Aboriginal patient. The essay highlights the importance of respecting cultural traditions, such as the preference for dying at home and the role of elders in decision-making. Furthermore, it explores the impact of a nurse's personal beliefs on patient care, advocating for professionalism and patient-centered approaches. The paper underscores the significance of culturally sensitive care and the need for nurses to adapt their practices to meet the diverse needs of patients, ultimately promoting optimal patient outcomes in palliative care settings. References include key literature on palliative care, ethical considerations, and cultural sensitivity in healthcare.

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Introduction
Nurses play a critical role in facilitating palliative care as part of the multi-
disciplinary. Palliative care is referred to as care offered to people with lifelong health
conditions and who are living in the last months or years of their lives (Caxaj, Schill
& Janke, 2018). It is aimed at relieving pain and making the life of the patient as
comfortable as possible when they have a terminal illness. This essay identifies the
role of a multi-disciplinary team in caring for patients at John. The paper also
discusses the cultural factors, beliefs, and practices of John, which may influence his
care. The impact of the nurses' personal beliefs on John's care is also discussed in this
article.
Collaborative, ethical decision making is the process of using ethical
principles and moral principles in making decisions regarding the well-being of the
patients. Palliative care for a patient involves a multi-disciplinary team consisting of
professionals such as general practitioners, consultants, psychiatrists, dietitians,
nephrologists, nurses, and pharmacists, physicians, and also spiritual leaders. Every
member of the multi-disciplinary team plays a crucial role in helping to fulfill the
wishes of the patient and helping them to live the last days of their lives. One of the
ethical principles which are relevant when offering Mr. John care is the principle of
autonomy. Autonomy is the ability of a person to make decisions for themselves as
long as they can make the decision (Hernández-Marrero et al., 2019). John can make
his own decisions since he is an adult and of sound produced. The multi-disciplinary
team has to provide Mr. John with all the necessary information that they need to
decide the kind of care they want (McAndrew, 018). John has decided that he want to
die at home, and hence the multi-disciplinary team should facilitate Mr. John to
receive care at home.

The other ethical principle which is applicable in the case of John is
beneficence. This principle requires the team to balance the benefits of treatment and
its costs/risks (McAndrew, 2018). If a treatment intervention poses more risk, and it's
not bound to improve the life of the patient, the medical team should opt against this
intervention. Since Mr. John is suffering from end-stage renal disease, his decisions to
die at home should be respected and should be helped to receive palliative care while
at his home with his family (Cormack & Mazanec, 2019).
Palliative care in Australia requires adherence to the cultural beliefs,
traditions, and values of the patient (Advance Care Planning Australia, 2020). When
Mr. John is receiving palliative care, the multi-disciplinary team should ensure that all
decisions made in collaboration with the patients consider and respects the principles
of culturally sensitive care. Mr. John comes from the Aboriginal and Torres Islander
community who have preserved their heritage and cultures over the years. According
to Callister (2013). the Aboriginal people prefer to die at home rather than dying at
home. Dying at home helps in ensuring that their wishes before death are respected.
Dying at home also ensures that a person goes through all the rituals before and after
death.
Since these ceremonies take precedence over all other activities, some of the
ceremonies that take place include the smoking ceremonies, which are conducted in
the living room of the deceased to drive away from the spirit of the dead (Kelley et
al., 2019). The other ceremony includes the painting of ochre in the space the person
was living before they died and celebrating the life of the deceased with song and
dance. It is therefore difficult for these ceremonies to take place if John dies in the
hospital. Furthermore, most Aboriginal people prefer to die at home so that they can
enjoy the last moments of their lives with their families. They can also get traditional

medicine administered by elders to reduce their pain. In traditional Aboriginal society,
the elders and the family play a critical role in decision making, and they value
respect for their interpersonal relationships (Kirk & Coyle, 2016). Active listening
and accepting the decisions of elders and family members is an essential aspect of
interpersonal relationships. This, therefore, means that trying to persuade a person like
Mr. John to change the decision that they have made is a sign of disrespect, and it is
undesirable behavior. In the Aboriginal culture, relatives of a terminally ill patient
might not want their kin to be told the truth about the seriousness of their condition
because they believe that positive thinking promotes good health (Mazanec et al.,
2019).
Just like the Aboriginal people, I believe in the role of traditional medicine and
spirituality in healthcare. I come from a background where conventional herbal
medicine is highly valued, and therefore, I understand the importance that local
people place on this medicine. I also believe that traditional herbal medicine, when
combined with modern medicine, can be very useful in reducing pain for a person
receiving palliative care. This will, therefore, help me to support Mr. John's family as
they use traditional medicine to help Mr. John as he receives care at home. I also
believe in spirituality as an essential intervention. Spirituality gives a person renewed
hope and faith that they will get well. It is also a form of therapy since it helps a
patient psychologically, and hence they can cope with their conditions and get
prepared to die.
I also believe in the need to consult family and the elders when making
important decisions regarding healthcare. This is because, despite autonomy, people
close to the family have the best interest of the patient at heart, and the decision made
by the patient is bound to affect close family members. Therefore, when offering care

to Mr. John, I would understand his rationale behind consulting in all the decisions
that he made.
Another belief that could impact on the type of care I provide Mr. John is that
I believed that people should be treated and handled the same way irrespective of their
traditional beliefs and customs. I had this belief because I think it is difficult to
understand the expectations, culture, and customs of every patient. I, therefore, saw it
good to treat all people with decorum and respect, notwithstanding their cultural
background. However, I have now come to understand the importance of respecting
and appreciating all cultures so that patients can receive optimal and patient-centered
care. This, therefore, means that in the future, I need to be keener to understand how
patients want to be handled to offer them highly effective and productive care.
The strategy I will use to manage this is that I will ensure that I remain
professional while offering care to Mr. John (Gardner & Doherty, 2019). I will not
allow my personal beliefs and values to get in the way of my work because I have
established that people have different believes and values, and hence it is important to
respect them. My focus will be offering patient-centered care to ensure that Mr. John
gets optimal results.
Conclusion
Ethical decision making is very critical when offering palliative care. One of
the ethical principles considered when making decisions regarding Mr. John is
Autonomy and beneficence. The multi-disciplinary team caring for Mr. John needs to
respect his right to make informed decisions on his treatment. Respect for culture,
beliefs, and traditions is also critical when offering palliative care. The medical team
should seek to understand the culture and traditions of the patient so that they can
adhere to their wishes and ensure that the patient receives the best care during this

period. Some personal beliefs differ with the beliefs and traditions of the patient,
while others are in line with their beliefs. It is critical for a nurse to maintain
professionalism and ensure that personal beliefs will not affect the quality of care
offered to a patient.

References
Advance Care Planning Australia. (2020). Retrieved 4 April 2020, from
https://www.advancecareplanning.org.au/#/
Callister, Lynn. (2013). Cultural Influences on Pain Perceptions and Behaviors. Home
Health Care Management & Practice. 15. 207-211.
10.1177/1084822302250687.
Caxaj, C. S., Schill, K., & Janke, R. (2018). Priorities and challenges for a palliative
approach to care for rural indigenous populations: a scoping review. Health &
social care in the community, 26(3), e329-e336.
Cormack, C., & Mazanec, P. (2019). Cultural considerations in palliative care. Oxford
Textbook of Palliative Nursing, 469.
Gardner, D. S., & Doherty, M. (2019). EXPLORING PALLIATIVE CARE
DISPARITIES IN RACIALLY AND ETHNICALLY DIVERSE
COMMUNITY-DWELLING OLDER ADULTS. Innovation in Aging,
3(Suppl 1), S746.
Hernández-Marrero, P., Fradique, E., & Pereira, S. M. (2019). Palliative care nursing
involvement in end-of-life decision-making: Qualitative secondary analysis.
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Kelley, M. L., Prince, H., Nadin, S., Brazil, K., Crow, M., Hanson, G., ... & Smith, J.
(2018). Developing palliative care programs in indigenous communities using
participatory action research: a Canadian application of the public health
approach to palliative care. Ann Palliat Med, 7(Suppl 2), S52-S72.
Kirk, T., & Coyle, N. (2016). Navigating Ethical Discussions in Palliative Care.
Mazanec, P., Verga, S., Foley, H., & Mehta, A. K. (2019). The Need for Cultural
Inclusivity in Global Palliative Nursing: Caring for Selected Underserved

Populations in the United States. Journal of Hospice & Palliative Nursing,
21(6), E1-E8.
McAndrew, N. S. (2018). Climate of Care, Nursing Family Care and Family Well-
Being in the Intensive Care Unit. In C25. CRITICAL CARE: PATIENT AND
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