Taking a palliative care approach to psychiatry’s toughest cases


While palliative care approaches to care are intended to improve quality of life for a variety of patients experiencing severe illnesses, they have not traditionally been used to treat patients with mental illness.

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As an emerging field, palliative psychiatry deserves clinical and ethical attention in responding to the vulnerabilities and needs of those patients with conditions such as treatment-resistant depression and persistent suicidality. The September issue AMA Journal of Ethics® (@JournalofEthics) features numerous ethical perspectives on palliative approaches to psychiatry.

This month’s issue of AMA Journal of Ethics includes the following articles.

  1. Palliative Approaches to Psychiatry.” 

    1. This note from the editor outlines how the issue explores palliative psychiatry as one response to pharmacological futility that reinvigorates core philosophy of medicine investigations into what health care is for.

  2. How Palliation Can Improve Care of Patients With Severe and Enduring Anorexia Nervosa.”

    1. This commentary on a case considers the ethical feasibility of palliative psychiatry in the care of patients with severe and enduring anorexia nervosa.


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  3. How Should Long-Term Psychotherapy Address Ethical Questions During the Palliative Care of a Patient With Serious and Persistent Mental Illness?” 

    1. This commentary on a case considers the course of a palliative approach to care of a patient with a serious and persistent mental illness.

  4. Is There a Case for Palliative Care Addiction Psychiatry?” 

    1. Palliative psychiatry can facilitate compassionate resolution of ethical conflicts in end-of-life care decision-making with patients who have substance-use disorders.  

In the journal’s September podcast, Amy Johnson, DO, a key clinical educator in hospice and palliative care, discusses clinical end-of-life skills that psychiatrists need to have to care well for patients with terminal psychiatric illnesses. The September issue also features four author-interview podcasts. Listen to previous episodes of the podcast, “Ethics Talk,” or subscribe in iTunes or other services.

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Submissions for the 2023 Conley Contests are being accepted through Sept. 22. U.S. MD and DO students, resident physicians or fellows in programs accredited by the ACGME or AOA are eligible to submit entries. The winning prize for the best essay and artwork, respectively, is $5,000.

Learn more about the Ethics Essay Contest and the Art of Medicine Contest.

Upcoming issues of the journal will focus on geriatric psychiatry and health and loneliness. The November issue will feature an interview with U.S. Surgeon General Vivek Murthy, MD. Sign up to receive email alerts when new issues are published.