ABSTRACT
Palliative care clinicians caring for patients facing serious illness will inevitably face ethical dilemmas throughout the illness trajectory. Some dilemmas are subtle and, perhaps, not recognized. Others are easily apparent and may lead to conflict. This chapter will discuss several of the more common and vexing ethical issues that arise in the care of patients with advanced serious illness. These include disclosure and truth telling; when and how to engage in advance care planning; responding to requests for treatments of unproven, limited, or no benefit; and, finally, consideration of aggressive measures for responding to intractable suffering. By eliciting patients' values and preferences, avoiding assumptions about patients' informational needs, and leading with an empathic approach and skilled communication, health-care providers will be able to navigate these ethical dilemmas to promote respectful, patient-centered care.
