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The boundaries of palliative care are continually expanding. In the July PACED digest, we explore the evolution of approaches to treating severe, therapy-resistant mental disorders: from recognising patients' autonomy to analysing the most complex ethical dilemmas at the end of life. This issue also includes material on cultural differences in psychiatrists' views across countries on preserving patients' quality of life, a practical analysis of the appropriateness of a palliative approach for long-standing anorexia nervosa, and a retrospective study of the experience of integrating psychiatric care into palliative care units.
If you wish to continue any of the topics listed below through a discussion or webinar, please do not hesitate to contact us at info@paced.org.uk.
The boundaries of palliative care are continually expanding. In the July PACED digest, we explore the evolution of approaches to treating severe, therapy-resistant mental disorders: from recognising patients' autonomy to analysing the most complex ethical dilemmas at the end of life. This issue also includes material on cultural differences in psychiatrists' views across countries on preserving patients' quality of life, a practical analysis of the appropriateness of a palliative approach for long-standing anorexia nervosa, and a retrospective study of the experience of integrating psychiatric care into palliative care units.
If you wish to continue any of the topics listed below through a discussion or webinar, please do not hesitate to contact us at info@paced.org.uk.
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The Existence of Palliative Psychiatry
Traditional psychiatry aims for remission, but when severe mental disorders (such as schizophrenia or severe depression) become treatment-resistant, a different approach is required. Palliative psychiatry shifts the focus from aggressive therapy to alleviating suffering, protecting dignity, and improving the patient's quality of life. In an article in the African Journal of Health, Nursing and Midwifery, the authors analyse key barriers to the development of this field—from stigmatisation to the lack of international standards—and offer practical recommendations for integrating palliative principles into psychiatric practice.
Traditional psychiatry aims for remission, but when severe mental disorders (such as schizophrenia or severe depression) become treatment-resistant, a different approach is required. Palliative psychiatry shifts the focus from aggressive therapy to alleviating suffering, protecting dignity, and improving the patient's quality of life. In an article in the African Journal of Health, Nursing and Midwifery, the authors analyse key barriers to the development of this field—from stigmatisation to the lack of international standards—and offer practical recommendations for integrating palliative principles into psychiatric practice.
Doctors on Palliative Psychiatry
A survey of psychiatrists from India and Switzerland found that most doctors support implementing a palliative approach for patients with severe, treatment-resistant mental disorders. This approach does not mean abandoning the patient—on the contrary, it is designed to reduce suffering and improve the person's daily life when a cure is impossible. At the same time, the study revealed cultural differences: for example, Indian specialists are much more focused on suicide prevention and are categorically unwilling to sacrifice patients' life expectancy for the sake of quality of life, which underscores the need to combine palliative and classical treatment methods with consideration for the local context.
A survey of psychiatrists from India and Switzerland found that most doctors support implementing a palliative approach for patients with severe, treatment-resistant mental disorders. This approach does not mean abandoning the patient—on the contrary, it is designed to reduce suffering and improve the person's daily life when a cure is impossible. At the same time, the study revealed cultural differences: for example, Indian specialists are much more focused on suicide prevention and are categorically unwilling to sacrifice patients' life expectancy for the sake of quality of life, which underscores the need to combine palliative and classical treatment methods with consideration for the local context.
Palliative for Psychiatry or Psychiatry for Palliative?
This review analyses the most complex ethical dilemmas in providing care to patients with severe mental disorders at the end of life. The authors demonstrate how the principle of autonomy clashes with the challenges of assessing patients' decision-making capacity, while justice is constrained by stigma and the division of medicine into somatic and psychiatric, leaving such individuals frequently deprived of quality care. Special attention is paid to the dilemma of ‘therapeutic tenacity’ and the appropriateness of a palliative care approach in psychiatry. The study emphasises that, due to patients' isolation, doctors' compassion becomes a key tool for protecting their dignity, while patients' voices are still rarely taken into account.
This review analyses the most complex ethical dilemmas in providing care to patients with severe mental disorders at the end of life. The authors demonstrate how the principle of autonomy clashes with the challenges of assessing patients' decision-making capacity, while justice is constrained by stigma and the division of medicine into somatic and psychiatric, leaving such individuals frequently deprived of quality care. Special attention is paid to the dilemma of ‘therapeutic tenacity’ and the appropriateness of a palliative care approach in psychiatry. The study emphasises that, due to patients' isolation, doctors' compassion becomes a key tool for protecting their dignity, while patients' voices are still rarely taken into account.
Psychiatry in the Palliative Care Unit
In a retrospective study published in the journal Medicine, Turkish scientists analysed psychiatric consultation practices in a palliative care unit. Data from 97 patients showed that agitation was the most frequent reason for calling a specialist, and sleep disorders were the most common diagnosis. The researchers identified clear gender and age differences and concluded that integrating psychiatrists into palliative care teams is critical for the timely recognition and treatment of conditions that significantly worsen the quality of life of terminally ill people.
In a retrospective study published in the journal Medicine, Turkish scientists analysed psychiatric consultation practices in a palliative care unit. Data from 97 patients showed that agitation was the most frequent reason for calling a specialist, and sleep disorders were the most common diagnosis. The researchers identified clear gender and age differences and concluded that integrating psychiatrists into palliative care teams is critical for the timely recognition and treatment of conditions that significantly worsen the quality of life of terminally ill people.
The Role of Palliative Psychiatry in Enduring Anorexia Nervosa
In an article published in The Journal of Pediatrics, the authors consider the appropriateness, timing, and role of introducing palliative care for patients with severe and enduring anorexia nervosa (SEAN). When long-standing treatment yields no results, a palliative approach, applied alongside conventional therapy, helps shift the focus from forced cure to improving quality of life, assessing the patient's mental capacity, and protecting their dignity. This approach allows doctors to act humanely, respecting the individual's autonomy when all traditional treatment options have been exhausted.
In an article published in The Journal of Pediatrics, the authors consider the appropriateness, timing, and role of introducing palliative care for patients with severe and enduring anorexia nervosa (SEAN). When long-standing treatment yields no results, a palliative approach, applied alongside conventional therapy, helps shift the focus from forced cure to improving quality of life, assessing the patient's mental capacity, and protecting their dignity. This approach allows doctors to act humanely, respecting the individual's autonomy when all traditional treatment options have been exhausted.
DIGEST