Physician-patient communication during the clinical ethical decision-making process in palliative care in Turkey

Despite the advanced scientific knowledge and technology that the physicians use, the ability of communication,ethical and professional values still make up the essence of all clinical operations in the diagnosis-treatment of the diseases. It is obvious that the physicians and the other healthcare personnel would sincerely like to build good relationships with patients and maintain these relationships. Unfortunately, most of them are usually uneducated and inadequate when it comes to communication skills as well as ethical and professional values. It is possible to find unlimited amount of research evaluating the physician-patient interaction and documenting the undesired results of ineffective communication in the medical literature. Similarly, there are a great number of comparative researches which show that the physicians take clinical decisions with a paternalistic attitude. The success of healthcare professionals, who give palliative care, in ethical attitude and ethical dilemma solving does not seem much different from overall clinical practices. That is the reason clinical ethical decision-making process determinants are the same as clinical decision-making process determinants. In this paper, firstly the concept of the physician identity will be discussed based on "professionalism", the "ideal model" will be defined by reviewing the physician-patient communication models, the clinical ethical decision-making process will be defined and the changing aspects of this process in palliative care will be handled. The concepts and applications of medical ethics specific to end-of-life palliative care will be critically discussed.