Over the last decades, technology and scientific advances, the acknowledgment of new rights, social changes, and the use of patient advocacy have influenced the medical approach to management of patients with advanced disease, particularly those who are near death. Ethical and legal considerations in decision-making and application of care must be addressed in this process. The need to address ethical concerns while striving to match technical aspects of care with more humanistic aspects is fundamental in palliative medicine. Its philosophy is global, multidimensional and centered on the patient and family. The Department of Pain Medicine and Palliative Care at Beth Israel Medical Center supports this multifaceted approach. Much attention is given to end-of-life issues and related ethical dilemmas. This section presents some of the difficult ethical and legal issues that patients, families and health care providers face in palliative care. Each aspect is discussed briefly. For more information, please consult the reference section.

Department of Pain Medicine and Palliative Care Beth Israel Medical Center, New York City ©2005 Continuum Health Partners, Inc. www.stoppain.org/palliative_care