Table 1 Domains of palliative care

1.

Non-pain symptom assessment and management (dyspnea, nausea and vomiting, delirium, fatigue, etc.)

2.

Pain assessment and management

3.

Natural history (prognosis, time course, mode of death, and symptoms)

4.^a

Palliative care

5.^a

Palliative operation/symptomatic treatment

6.

Necrology (death statistics, including gender, age at death, any racial disparities)

7.

Social issues (interpersonal relationships with spouses or partners, family, and friends supporting these relationships)

8.

Care setting (option for location of end-of-life care, referral to hospice, funeral arrangements)

9.

Psychological issues (depression, anxiety, fear, loneliness, emotional awareness)

10.

Financial issues (cost to patient and family, not insurer or societal cost)

11.

Patient or family values (any discussion regarding patient and/or family goals and values, including advanced directives and “do not resuscitate” orders)

12.

Goal of care (goals of care related to quality of life and end-of-life care)

13.

Physician communication with patient/family (including communication with patient and family about personal grief and bereavement)

14.

Ethics, laws, and policies (individual vs. organization ethics, patients’ self-determination, double effect, legal aspects of withdrawal, and withholding of life support)

15.

Physician roles in advocacy and policy (including pronouncement, autopsy, organ donation, advocacy, and changing institutional policy)

16.

Spiritual issue (abandonment, completion of tasks, acceptance, religious tasks, and choices)

17.

Family roles and responsibilities (communication of patient and family member roles during the process, grief and bereavement, caregiver roles and support)