Abstract
The present study was aimed to promote discussions on optimal palliative care for improving the QOL of cancer patients, terminally-ill patients, and patients with intractable diseases in Japan by reviewing the concepts and ethical issues of palliative care in European countries with advanced palliative care. Documents were compared, including reports by the PALLIUM Project and nation-specific reports by the European Association for Palliative Care. Historically reconfirming that based on the hospice philosophy, palliative care for patients is an integration of palliative medicine with holistic care, palliative care in Europe was evaluated according to issues over the WHO's definition of palliative care. In Europe, palliative care was found to be practiced with certain standards, but in different ways depending on cultural background in systems, targets, places of bereavement, indicated periods, ways of disclosure, decision-making in terminal care, and relationships with euthanasia and assisted suicide. These findings are suggestive for the construction of Japanese health care system in which palliative care is available to all those who need it.
