Informing the Patient about Palliative Care: Legal Considerations

Autor

Abstrakt

The obligation of a doctor to provide information about a patient’s health is a frequently discussed topic in Polish literature on medical law. To date, publications have focused on the topics of providing information about the diagnosis or about possible treatment options and discussing test results, and rarely discuss the termination of causal treatment, giving information instead on specialized symptomatic management and palliative care for patients with a chronic disease or a disease with an unfavourable prognosis. Providing honest and reliable information in this area increases patients’ awareness of their current health status, and thus allows them to make appropriate decisions related to the abandonment of futile therapy, and also reduces the distress associated with a fear of a lack of specialized medical care and physical, social and spiritual suffering. This article presents legal considerations for informing patients about specialist palliative care.

Bibliografia

Ambroziak, J. (2021). Istota i charakter prawny zasad deontologii zawodowej lekarza. Przegląd Prawa Medycznego, 2(2). https://przegladprawamedycznego.pl/index.php/ppm/article/view/78

Bączyk-Rozwadowska, K. (2011). Prawo pacjenta do informacji według przepisów polskiego prawa medycznego. Studia Iuridica Toruniensia, 9, 59–100. https://repozytorium.umk.pl/handle/item/1322

Baile, W.F., Buckman, R., Lenzi, R., Glober, G., Beale, E.A., & Kudelka, A.P. (2000). SPIKES: A six-step protocol for delivering bad news: Application to the patient with cancer. The Oncologist, 5(4), 302–311. https://doi.org/10.1634/THEONCOLOGIST.5–4-302

Bandieri, E., Bigi, S., Nava, M., Borelli, E., Porro, C.A., Castellucci, E., Efficace, F., Bruera, E., Odejide, O., Zimmermann, C., Potenza, L., & Luppi, M. (2024). Early palliative care perceptions by patients with cancer and primary caregivers: Metaphorical language. BMJ Supportive & Palliative Care, 14(e3). https://doi.org/10.1136/SPCARE-2024–004842

Boratyńska, M. (2013). Informacja i swobodny dostęp do genetycznych badań prenatalnych a klauzula sumienia i przywilej terapeutyczny. Etyka, 47, 34–49. https://doi.org/10.14394/ETYKA.536

Boratyńska, M. (n.d.). Praktyczne problemy informacyjne uzyskiwania świadomej zgody pacjenta. Publikacje.pan.pl. Retrieved 31 August 2023, from http://publikacje.pan.pl/Content/119380/PDF/5 Boratynska.pdf

Borowska, M., Augustynowicz, A., Olszewski, P., & Religioni, U. (2023). Respecting the patient’s right to information in hospital wards in Poland: Socio-economic determinants of patients’ opinions. Patient Preference and Adherence, 17, 2311–2323. https://doi.org/10.2147/PPA.S421336

Borski, M. (2023). The model of palliative care in Poland from the perspective of people at the end of life and their carers: Preliminary issues. Białostockie Studia Prawnicze, 28(3), 33–52. https://doi.org/10.15290/BSP.2023.28.03.02

Critoph, D.J., Cable, M., Farmer, J., Hatcher, H.M., Kuhn, I., Taylor, R.M., & Smith, L.A.M. (2024). Is there scope to do better? Clinical communication with adolescents and young adults with cancer: A scoping review. Psycho-Oncology, 33(4). https://doi.org/10.1002/PON.6317

Critoph, D.J., Taylor, R.M., Spathis, A., Duschinsky, R., Hatcher, H., Clyne, E., Kuhn, I., & Smith, L.A.M. (2024). Triadic communication with teenagers and young adults with cancer: A systematic literature review – ‘make me feel like I’m not the third person’. BMJ Open, 14(2), 80024. https://doi.org/10.1136/BMJOPEN-2023–080024

Drozdowska, U. (2021). Zadośćuczynienie w razie naruszenia prawa pacjenta do informacji o alternatywnej metodzie wykonania zabiegu operacyjnego. Gdańskie Studia Prawnicze, 49(1), 167–179.

Dukiet-Nagórska, T. (2008). Autonomia pacjenta a polskie prawo karne. Oficyna a Wolters Kluwer business.

Grądalski, T. (2022). Medical referral criteria for palliative care in adults: A scoping review. Polish Archives of Internal Medicine, 132(3). https://doi.org/10.20452/PAMW.16223

Grądalski, T., Wesolek, E., & Kleja, J. (2012). Terminal cancer patients’ informed consent for palliative care admission and their quality of life. Journal of Palliative Medicine, 15(8), 847. https://doi.org/10.1089/JPM.2012.0055

Grądalski, T., Kochan, K., Wesołek, E., & Kleja, J. (2010). Zgoda chorego na leczenie u kresu życia. Palliative Medicine in Practice, 4(3), 119–124. https://journals.viamedica.pl/palliative_medicine_in_practice/article/view/28540

Hajdukiewicz, D. (2023). Przywilej terapeutyczny – wątpliwy relikt paternalizmu czy istotny element leczniczy? Prawo i Medycyna, 15(3–4), 57–67. https://prawoimedycyna-archiwum.com/wp-content/uploads/2019/04/PiM_nr_52_53_3–4_2013.pdf

Jakubów, P., Niedźwiecka, K., Kondracka, J., Turczynowicz, A., Kocańda, S., & Malarewicz-Jakubów, A. (2023). Legal and medical aspects of the end of human life from the perspective of palliative medicine related to cardiac surgery. Białostockie Studia Prawnicze, 28(3), 53–70. https://doi.org/10.15290/BSP.2023.28.03.03

Janiszewska, B. (2020). Protection of patient confidentiality from a civil law perspective. Białostockie Studia Prawnicze, 25(2), 11–29. https://doi.org/10.15290/BSP.2020.25.02.01

Jarosz, M. (2013). Disclosure of unfavorable information in clinical practice. Oncology in Clinical Practice, 9(6), 225–229. https://journals.viamedica.pl/oncology_in_clinical_practice/article/view/36078

Kaminska, W., Chittajallu, S., & Davis, T. (2022). The social stigma of hospice care in the context of cancer. Przegląd Socjologiczny, 71(2), 193–213. https://doi.org/10.26485/PS/2022/71.2/8

Kania, A. (2019). Przesłanki i konsekwencje odpowiedzialności zawodowej lekarzy – wybrane problemy w świetle przepisów ustawy o izbach lekarskich. Roczniki Nauk Prawnych, 29(2), 7–30.

Karcz-Kaczmarek, M., & Maciejewski, M. (2015). Samorządy zawodowe i zakres ich samodzielności, w świetle doktryny oraz orzecznictwa. Studia Prawno-Ekonomiczne, 45(95), 57–76.

Krakowiak, P., Skrzypińska, K., Damps-Konstańska, I., & Jassem, E. (2016). Walls and barriers. Polish achievements and the challenges of transformation: Building a hospice movement in Poland. Journal of Pain and Symptom Management, 52(4), 600–604. https://doi.org/10.1016/j.jpainsymman.2016.07.009

Kubiak, R. (2017). Przywilej terapeutyczny. Medycyna Paliatywna, 9(1), 12–20. https://www.termedia.pl/Przywilej-terapeutyczny,59,30133,1,0.html

Leppert, W., Sesiuk, A., & Kotlińska-Lemieszek, A. (2022). Current status of academic palliative medicine in Poland: A nationwide study. BMC Palliative Care, 21(1). https://doi.org/10.1186/S12904–022-00983–8

Leppert, W., Grądalski, T., Kotlińska-Lemieszek, A., Kaptacz, I., Białoń-Janusz, A., & Pawłowski, L. (2022). Organizational standards for specialist palliative care for adult patients: Recommendations of the Expert Group of National Consultants in Palliative Medicine and Palliative Care Nursing. Palliative Medicine in Practice, 16(1), 7–26. https://doi.org/10.5603/PMPI.2021.0035

Lis, W. (2020). Zgoda pacjenta na czynność medyczną w polskim porządku prawnym. Zeszyty Naukowe Katolickiego Uniwersytetu Lubelskiego Jana Pawła II, 61(3), 39–58. https://czasopisma.kul.pl/znkul/article/view/11087

Luciani, F., Veneziani, G., Giraldi, E., Campedelli, V., Galli, F., & Lai, C. (2025). To be aware or not to be aware of the prognosis in the terminal stage of cancer? A systematic review of the associations between prognostic awareness with anxiety, depression, and quality of life according to cancer stage. Clinical Psychology Review, 116, 102544. https://doi.org/10.1016/J.CPR.2025.102544

Miller, E.M., Porter, J.E., & Barbagallo, M.S. (2022). The experiences of health professionals, patients, and families with truth disclosure when breaking bad news in palliative care: A qualitative meta-synthesis. Palliative & Supportive Care, 20(3), 433–444. https://doi.org/10.1017/S1478951521001243

Nesterowicz, M. (2021). Prawo pacjenta do informacji medycznych (w świetle orzecznictwa). Gdańskie Studia Prawnicze, 49(1), 9–28. https://doi.org/10.26881/GSP.2021.1.01

Pawłowski, L., Modlińska, A., & Lichodziejewska-Niemierko, M. (2019). Selected aspects of advance care planning according to Polish legal regulations: Physician’s requirements. Palliative Medicine in Practice, 13(4), 197–203. https://doi.org/10.5603/PMPI.2019.0023

Payne, S., Harding, A., Williams, T., Ling, J., & Ostgathe, C. (2022). Revised recommendations on standards and norms for palliative care in Europe from the European Association for Palliative Care (EAPC): A Delphi study. Palliative Medicine, 36(4), 680–697. https://doi.org/10.1177/02692163221074547

Polish Ministry of Health. (2022). Regulation of the Minister of Health of 29 October 2013 on Guaranteed Benefits in the Field of Palliative and Hospice Care (consolidated text: Journal of Laws of 2022, item 262).

Radbruch, L., De Lima, L., Knaul, F., Wenk, R., Ali, Z., Bhatnaghar, S., Blanchard, C., Bruera, E., Buitrago, R., Burla, C., Callaway, M., Munyoro, E.C., Centeno, C., Cleary, J., Connor, S., Davaasuren, O., Downing, J., Foley, K., Goh, C., […] Pastrana, T. (2020). Redefining palliative care: A new consensus-based definition. Journal of Pain and Symptom Management, 60(4), 754–764. https://doi.org/10.1016/j.jpainsymman.2020.04.027

Rietjens, J.A.C., Sudore, R.L., Connolly, M., van Delden, J.J., Drickamer, M.A., Droger, M., van der Heide, A., Heyland, D.K., Houttekier, D., Janssen, D.J.A., Orsi, L., Payne, S., Seymour, J., Jox, R.J., & Korfage, I.J. (2017). Definition and recommendations for advance care planning: An international consensus supported by the European Association for Palliative Care. The Lancet Oncology, 18(9), e543–e551. https://doi.org/10.1016/S1470–2045(17)30582–X

Sejm of Poland. (1996). Law of 5 December 1996 on the Professions of Physician and Dentist (Journal of Laws of 2022, item 1731, as amended).

Sejm of Poland. (2021). Law of 2 December 2009 on Medical Chambers (Journal of Laws 2021, item 1342, as amended).

Sejm of Poland. (2022a). Law of 27 August 2004 on Healthcare Services Financed from Public Funds (consolidated text: Journal of Laws of 2022, item 2561, as amended).

Sejm of Poland. (2022b). Law of 15 July 2011 on the Professions of Nurse and Midwife (consolidated text: Journal of Laws of 2022, item 2702, as amended).

Sejm of Poland. (2022c). Law or 6 November 2008 on Patients’ Rights and the Patients’ Ombudsman (Journal of Laws 2022, item 1876, as amended).

Sejm of Poland. (2023). Law of 25 September 2015 on the Profession of Physiotherapist (Journal of Laws 2023, item 1213, as amended).

Sutherland, R. (2019). Dying well-informed: The need for better clinical education surrounding facilitating end-of-life conversations. The Yale Journal of Biology and Medicine, 92(4), 757–764. https://pmc.ncbi.nlm.nih.gov/articles/PMC6913833/

Szafran, D. (2016). Przesłanki ograniczenia prawa do informacji o stanie zdrowia w polskim prawie medycznym. Internetowy Przegląd Prawniczy TBSP UJ, 3, 28–40. http://www.tbsp.wpia.uj.edu.pl/documents/4137545/134032088/6.+Szafran_3_2016.pdf

van der Velden, N.C.A., Meijers, M.C., Han, P.K.J., van Laarhoven, H.W.M., Smets, E.M.A., & Henselmans, I. (2020). The effect of prognostic communication on patient outcomes in palliative cancer care: A systematic review. Current Treatment Options in Oncology, 21(5), 40. https://doi.org/10.1007/S11864–020-00742-Y

World Health Organization. (2023). Palliative care. https://www.who.int/europe/news-room/fact-sheets/item/palliative-care

Zimmermann, A., Mędrzycka-Dąbrowska, W., & Zagłoba, M. (2018). Patient’s right to pain treatment. Palliative Medicine in Practice, 12(1), 21–29. https://journals.viamedica.pl/palliative_medicine_in_practice/article/view/57057

Pobrania

Opublikowane

2025-06-27