Palliative Care: Framework, Practice, and Ethical Considerations in NZ

This essay provides an overview of palliative care practices in New Zealand, examining the guiding framework established in 2008 and its focus on holistic patient care, encompassing physical, emotional, and spiritual needs. The essay discusses the application of the Whare Tapa Wha model, emphasizing the importance of pain and symptom management, and patient autonomy in end-of-life care. It highlights the crucial role of nurses and healthcare professionals, including psychological and spiritual support for both patients and their families, while addressing ethical and legal considerations such as patient autonomy, decision-making, and documentation. Furthermore, the essay emphasizes preserving patient dignity through holistic care and provides guidance for health professionals in delivering effective palliative and end-of-life care, referencing relevant research and legal frameworks.

Running Head: SOCIOLOGY
0
Palliative care practice
5/27/2019

SOCIOLOGY
1
.
1. Palliative care in New Zealand aims to optimise an individual’s life quality until the time
they approach to their death, by addressing various s health needs. These needs include
physical, social, emotional, spiritual, cultural, and psychological wellbeing. To discuss
about the current framework that guides the practice of palliative care in the region the
“National Professional development framework for palliative care practice in New
Zealand” has been established back in the year 2008. The framework is founded, to
determine the skills, abilities or competencies required by nurses in order to provide
palliative care practice in health care settings (Oliver, Wilson & Malpas, 2017).
This framework provides adequate support to the health workforce of New Zealand
promotes and collaborates with the staff to ensure effective palliative care to people. In
context to the given word, i.e. Whare Tapa Wha defines the Maori health, through a holistic
model, applicable to any health issue, involving the aspects of physical or psychological
wellbeing (New Zealand Medical Association, 2018).
2. To explain or define the palliative care, it means providing care to the people with any
life-limiting illness, especially in older age. It has been found through palliative care in
New Zealand not only promotes the role of nurse, rather ensures their development.
Therefore, it forms the base of effective care for the patients. Under the established
framework in palliative care, holistic care to the patients has been considered as important
element (Östlund et al., 2019).
For providing holistic care, health care communities focus on population-based approach
to provide health care. Pain and symptom management acts as one practice trend in the
palliative care approach and helps patients to manage their health in context to end-of-life
care. Moreover, in palliative care approach the health professionals must focus upon the
patient needs, and ensure that they have access to palliative care for their chronic illness.
Thus, palliative care approach helps patients and families to relieve from the stress, and other
symptoms of the illness, and leads to positive health outcomes (Wong & Zhukovsky, 2017).
3. Under the palliative care approach or end-of-life care, nurse or professionals play a major
role in encouraging patients towards their life quality. Therefore, two major aspects i.e.

SOCIOLOGY
2
psychological and spiritual aspects of patient care has been found relevant in the end-
of-life care. These two aspects mentioned here provide a support to help patients to live as
actively, they can until the time of deaths. In addition, the framework provides
psychological and emotional support to the family members of the patient, during the
treatment process. It states about ‘family-centred care’ approach that is considered a part
of the end-of-life care for older people. Pain control acts as one major issue in the care of
dying people following the palliative care (Wong & Zhukovsky, 2017).
4. Professional practice in the palliative care or end-of-life care for older people must be
conducted in legal and ethical manner. Health professional face range of ethical or legal
issues in providing care to old-aged people for their life-limiting illness. Ethical issues in
the care of patients include, patient autonomy, decision-making related to withdrawing or
withholding treatment, nutrition, and hydration. The legal issues are faced by the doctors,
professionals include keeping or compliance with the new, or updated laws related to the
treatment of illness (Lee et al., 2018).
The importance of maintaining accurate documents is a legal issue, which needs to be
followed in context to palliative care. Compliance to ACD in context to medical requirements
is legally binding in New Zealand. Power of attorney, is a document used to guide decision-
making and enhance the care of the patients. Therefore, this is one of principles in the
palliative care for old-aged people. It is an important document for the personal care, and
welfare and financial matters related to the person (Hamric & Epstein, 2017).
5. Now, this part of the essay will define the aspects to be considered for providing guidance
to health professionals undertaking the role of palliative and end-of-life care to clients.
From the research, it has been found that an important aspect of palliative care nursing is
to preserve the dignity of the patient. This is essential to provide effective care and
treatment to the patient, living with any life-limiting illness. Conserving the dignity of the
patient is ensured with the practice of holistic care of the patient. This helps professionals
and nurse to gain their trust in palliative care (Shahid et al., 2018). The aspect of dignity
essential for health providers, mentions freedom or respect to the patient autonomy as
there is a greater role of the patient in the care. It defines element of self-care involve
decision-making to withhold, or withdraw the treatment of the patient. Thus, these
aspects ensure correct advises to the patient/clients for managing their chronic condition,
and improving the quality of death situation.

SOCIOLOGY
3

SOCIOLOGY
4
References
Östlund, U., Blomberg, K., Söderman, A. & Harstäde, C. W. (2019). How to conserve
dignity in palliative care: suggestions from older patients, significant others, and
healthcare professionals in Swedish municipal care. BMC palliative care, 18(1), 10.
Shahid, S., Taylor, E. V., Cheetham, S., Woods, J. A., Aoun, S. M. & Thompson, S. C.
(2018). Key features of palliative care service delivery to indigenous peoples in
Australia, New Zealand, Canada and the United States: a comprehensive
review. BMC palliative care, 17(1), 72.
Wong, A. & Zhukovsky, D. S. (2017). Patient Experience and End-of-Life Care: A
Discussion and Analysis of Four Patients. In Ethical Challenges in Oncology (pp. 41-
57). United States: Academic Press.
Oliver, P., Wilson, M. & Malpas, P. (2017). New Zealand doctors and nurses’ views on
legalising assisted dying in New Zealand. NZ Med J, 130(1456), 10-26.
Lee, Y. Y., Ranse, K., Silvester, W., Mehta, A. & Van Haren, F. M. P. (2018). Attitudes
and self-reported end-of-life care of Australian and New Zealand intensive care
doctors in the context of organ donation after circulatory death. Anaesthesia and
intensive care, 46(5), 488-497.
Shahid, S., Taylor, E. V., Cheetham, S., Woods, J. A., Aoun, S. M., & Thompson, S. C.
(2018). Key features of palliative care service delivery to indigenous peoples in
Australia, New Zealand, Canada and the United States: a comprehensive
review. BMC palliative care, 17(1), 72.
New Zealand Medical Association. (2018). Investing into one’s life in New Zealand.
Retrieved from:
https://www.parliament.nz/resource/en-NZ/51SCHE_EVI_51DBHOH_PET63268_1_
A519269/728482953e0a9ab8c4a6bbf8f7fddec457ff674c
Hamric, A. B. & Epstein, E. G. (2017, June). A health system-wide moral distress
consultation service: development and evaluation. In HEC Forum (Vol. 29, No. 2, pp.
127-143). Netherlands: Springer.