Redefining Palliative Care—A New Consensus-Based Definition

TLDR

Palliative care has been defined by the International Association for Hospice and Palliative Care as relief of serious health‑related suffering, building on the Lancet Commission’s global call for access to palliative care and pain relief. This article aims to present the research underpinning a new consensus‑based definition of palliative care. The authors conducted a three‑phase consensus process involving 38 experts and 412 members from 88 countries, who evaluated, refined, and ultimately agreed on the definition’s components. The resulting definition describes palliative care as active, holistic care for all ages with serious illness‑related suffering, especially near end of life, and emphasizes improving quality of life for patients, families, and caregivers, while noting challenges in reconciling differing views on the scope of care.

Abstract

ContextThe International Association for Hospice and Palliative Care developed a consensus-based definition of palliative care (PC) that focuses on the relief of serious health-related suffering, a concept put forward by the Lancet Commission Global Access to Palliative Care and Pain Relief.ObjectiveThe main objective of this article is to present the research behind the new definition.MethodsThe three-phased consensus process involved health care workers from countries in all income levels. In Phase 1, 38 PC experts evaluated the components of the World Health Organization definition and suggested new/revised ones. In Phase 2, 412 International Association for Hospice and Palliative Care members in 88 countries expressed their level of agreement with the suggested components. In Phase 3, using results from Phase 2, the expert panel developed the definition.ResultsThe consensus-based definition is as follows: Palliative care is the active holistic care of individuals across all ages with serious health-related suffering due to severe illness and especially of those near the end of life. It aims to improve the quality of life of patients, their families and their caregivers. The definition includes a number of bullet points with additional details as well as recommendations for governments to reduce barriers to PC.ConclusionParticipants had significantly different perceptions and interpretations of PC. The greatest challenge faced by the core group was trying to find a middle ground between those who think that PC is the relief of all suffering and those who believe that PC describes the care of those with a very limited remaining life span.