Integrative Palliative Care: Enhancing the Natural Synergy Between Integrative Health and Palliative Medicine
The Journal of Alternative and Complementary Medicine
Shelley R. Adler, Lucille R. Marchand, and Nancy Heap. The Journal of Alternative and Complementary Medicine. Published Online: 13 March 2019.
Osher Collaborative Forum: Outlooks, Opinions and Opportunities
This is the fourth column of the JACM/Osher Collaborative partnership.
Shelley Adler, PhD, Osher Center for Integrative Medicine, University of California, San Francisco
Lucille Marchand, MD, Osher Center for Integrative Medicine, University of Washington
Nancy Heap,LCSW, Osher Center for Integrative Medicine, Northwestern University
The current biomedical health care system in the United States clearly is challenged by a host of pressing concerns. The complexity of the opioid crisis, the unmet needs of the aging population, and physician burnout are just a few examples of complicated problems that can only be solved with innovative, multifaceted strategies. As one model of an interprofessional approach that builds on existing discrete efforts, the authors propose an amplification of integrative palliative care—a hybrid of integrative health and palliative care—to enhance healing and reduce suffering.
At first glance, some may view integrative health, which focuses on wellness, as disparate from palliative care, which focuses on quality of life in serious illness. In fact, the two fields share core values and goals. Overlooking the synergy between the two health care disciplines misses a critical opportunity to provide truly transformative care for people with serious illness. The authors advocate here for a holistic, hybrid approach to living well across the life course; one that builds on the strengths and shared philosophies of integrative medicine and palliative care.
Serious illness, whether life-threatening or chronic, threatens the whole person—physically, psychologically, socially, and spiritually. Suffering encompasses more than just physical distress (1). As Frankl notably observed, an individual may have pain or other debilitating symptoms, but not suffer from them; conversely, a person may be free of physical symptoms, yet suffer enormously (2). Dame Cicely Saunders, the founder of the modern hospice movement, introduced the concept of “total pain,” which includes the physical, emotional, social, and spiritual dimensions of distress (3). Put another way, suffering is experienced by whole persons, not bodies (4). This central concept of holism—the recognition of the primacy of body/mind/spirit—is foundational to both integrative medicine and palliative care.