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Textbook of Palliative Care pp 1621–1637Cite as

Attending to the Suffering Other: A Case Study of Teleconsultation in Palliative Care at Home

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Abstract

Although this chapter has its origins in the Dutch practice of palliative care at home, its message is relevant to all countries in which a considerable percentage of the population prefers to die at home. These people usually depend to a great extent on general practitioners to realize such a death at home. Although there are exceptions, many generalists lack experience with and/or knowledge of palliative care. These limitations show themselves most in complex cases and often result in the patient being hospitalized. This chapter provides a perspective on a potential (part of the) solution to integrate generalist and specialist palliative care at the patient’s home: teleconsultation. It describes how to empirically and ethically study such a complex, technological intervention within a particular care practice, with a focus on the fit of the technology. Teleconsultation technology should be considered non-neutral. It mediates the relationships between patients and their accompanying professionals, while also coshaping experiences of virtual proximity and real-time autonomy. It can also be a constant reminder of an approaching death. Teleconsultation appears to provide opportunities for professionals to experience responsibility for a patient’s suffering and to address it adequately, although its scripts do not fill the need for meaningful moments of silence. In the end, this chapter claims that teleconsultation can be of value to the practice of palliative homecare, if special consideration has been given to its careful use by professionals. Teleconsultation requires an open and humble attitude toward both patients and colleagues, as well as sensitivity for privacy issues.

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Disclaimer

This chapter is an adaptation of three unpublished chapters from the PhD dissertation “Teleconsultation: enhancing personalized palliative care at home. An empirical-ethical analysis.” A PDF of this PhD dissertation is hosted at the Radboud Repository of the Radboud University Nijmegen.

Author information

Authors and Affiliations

  1. IQ healthcare/Ethics of healthcare, Radboud University Medical Center, Nijmegen, The Netherlands

    Jelle van Gurp

  2. Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands

    Jeroen Hasselaar & Kris Vissers

  3. Professor Emeritus of IQ healthcare/Ethics of healthcare, Radboud University Medical Center, Nijmegen, The Netherlands

    Evert van Leeuwen

  4. Amsterdam School of Communication Research, University of Amsterdam, Amsterdam, The Netherlands

    Martine van Selm

Authors
  1. Jelle van Gurp
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  2. Jeroen Hasselaar
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  3. Evert van Leeuwen
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  4. Martine van Selm
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  5. Kris Vissers
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Corresponding author

Correspondence to Jelle van Gurp .

Editor information

Editors and Affiliations

  1. School of Medicine,Palliative Care, HammondCare, The University of Sydney School of Medicine, Sydney, Australia

    Roderick Duncan MacLeod

  2. VUB-UGhent End-of-Life Care Research Group, Department of Family Medicine and Chronic Care and Department of Clinical Sciences, Vrije Universiteit Brussel (VUB), Brussels, Belgium

    Lieve Van den Block

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van Gurp, J., Hasselaar, J., van Leeuwen, E., van Selm, M., Vissers, K. (2019). Attending to the Suffering Other: A Case Study of Teleconsultation in Palliative Care at Home. In: MacLeod, R., Van den Block, L. (eds) Textbook of Palliative Care. Springer, Cham. https://doi.org/10.1007/978-3-319-77740-5_119

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