Palliative Psychiatry

This issue of the AMA Journal of Ethics explores palliative psychiatry as one response to pharmacological futility that reinvigorates core philosophy of medicine investigations into what health care is for.

Uncertainty about which psychiatric interventions are palliative stems from psychiatry’s prioritization of symptom management regardless of diagnosis. 

This commentary on a case considers the course of a palliative approach to care of a patient with a serious and persistent mental illness.

This commentary on a case considers the ethical feasibility of palliative psychiatry in the care of patients with severe and enduring anorexia nervosa.

Treatment-resistant schizophrenia can create a high disease burden for some patients, making it hard to get good outcomes.

Palliative psychiatry can facilitate compassionate resolution of ethical conflicts in end-of-life care decision making with persons with substance use disorders.  

This commentary on a case considers moral reasons to adopt a palliative approach to the care of some psychiatric patients.

Futility can function as a moral counterweight to a duty to treat, helping clinicians  find balance between over- and undertreatment. 

Some individuals with severe and enduring anorexia nervosa experience dramatically degraded quality of life in the face of refractory illness and compulsory treatment. 

This article examines conceptual limitations of extant accounts of palliative psychiatry, with a focus on obligations to distinguish among and clearly formulate goals of care. 

Dr Amy Johnson joins Ethics Talk to discuss clinical end-of-life skills that psychiatrists need to have to care well for patients with terminal psychiatric illnesses.

Dr Brent M. Kious joins Ethics Talk to discuss his article, coauthored with Dr Ryan H. Nelson: “Does It Matter Whether a Psychiatric Intervention Is ‘Palliative’?”

Dr Anna L. Westermair joins Ethics Talk to discuss her article, coauthored with Dr Manuel Trachsel: “Moral Intuitions About Futility as Prompts for Evaluating Goals in Mental Health Care.”

Dr Cynthia Geppert joins Ethics Talk to discuss her article: “Is There a Case for Palliative Care Addiction Psychiatry?”

Dr Jonathan Treem joins Ethics Talk to discuss his article, coauthored with Drs Joel Yager and Jennifer L. Gaudiani: “A Life-Affirming Palliative Care Model for Severe and Enduring Anorexia Nervosa.”

Dr Awais Aftab joins Ethics Talk to discuss his article: “What Should Clinicians Know About Palliative Psychopharmacology?”

Dr Cynthia Geppert joins Ethics Talk to discuss how teaching health professions students and trainees about palliative psychiatry reinvigorates core philosophy of medicine investigations into what health care is for.