ABSTRACT
This chapter lies deep within the compost of experiences with death. It explains the health-care worker in that context, faced with the day-to-day tasks and decisions, minute to monumental, that comprise the care of seriously ill and dying individuals. Many factors in a decision-making process can be unconscious. These unconscious, often unexamined factors are the foundation of our own countertransference. They encompass beliefs, values, and needs that comprise the backdrop for personal, professional, institutional, and societal decisions. There are three areas critical to a clinician's understanding of palliative and end-of-life practices. They are, first, ethical principles; second, end-of-life terminology and its shifting meanings; and last, moral and legal controversies in working with seriously ill or dying patients. The principles of beneficence, nonmaleficence, autonomy, mercy, and justice, which are the cornerstone of most ethical guidelines, commonly are not introduced to health-care workers until years after they begin to work in health-care institutions.
