Table 1. Ten categories of end of life interventions.
Focus | Definition | Examples | |
---|---|---|---|
1 | Policy | Decisions taken or rules adopted by governing
authorities to deliver, facilitate, monitor or regulate end of life issues. |
Strategies, regulatory and monitoring frameworks
for end of life care, resource allocation protocols, standards, and guidelines. |
2 | Advocacy | Expressions or actions on end of life issues that
aim to influence decisions of the institutional elite and/or promote the interests of specific populations, groups or individuals in particular contexts. |
Calls for legalisation of medical aid in dying, assisted
suicide, or euthanasia, concerns about inadequate access to pain medication or hospice and palliative care, ‘Declarations’ of various kinds on end of life issues. |
3 | Educational | Development of knowledge, skills, good judgment
and character required for the delivery of appropriate end of life care |
Educational resources and programmes extending
from professional audiences to lay, family and informal carers and wider publics and interest groups. |
4 | Ethico-legal | Frameworks included within laws, guidelines or
ethical codes that relate to issues at the end of life and which permit, facilitate or require specific courses of action. |
Laws on with-holding or withdrawing treatment,
assisted dying, euthanasia, suicide or the provision of pain relief and palliative care, professional requirements and standards about these issues. |
5 | Service | Medical, nursing and other services for the
prevention, alleviation and/or reduction of suffering at the end of life through inpatient, outpatient, home care or other forms of services |
Palliative care, hospice, pain and bereavement
services, provision for housing with care, institutional and community based, public, private, non-profit. |
6 | Clinical | Medical, nursing, allied health and psycho-social
procedures at the individual level to relieve symptoms and sufferings associated with advanced illnesses and when death is imminent |
Procedures for pain relief, symptom management,
care planning, bereavement care, for adults and children. |
7 | Research | Systematic enquiry on end of life issues for
the purposes of establishing new knowledge and understanding by description, prediction, improvement and/or explanation |
Studies in many disciplines and methodologies
intended to illuminate, evaluate or re-define end of life issues. |
8 | Cultural | Initiatives taken to influence patterns of shared
knowledge and symbolic meanings in particular communities, through which people perceive, interpret, express and respond to end of life issues |
Designated ‘days’ relating to end of life issues, death
cafes, salons, works of art, literature, film, poetry on end of life issues. |
9 | Intangible | Actions to promote the recognition and
significance of aspects of human existence that have intrinsic value at the end of life |
Spiritual care, therapies to promote dignity and
compassion, to enhance the meaning of suffering, provide mutual support. |
10 | Self-
determined |
Actions, decisions or choices made by individuals
to engage in or refrain from something that has implications for them at the end of their life or the life of another |
Voluntary refusal of life prolonging procedures,
treatment, food and fluids, ‘rational suicide’, self-care and support. |