Therapeutic ratio and defined phases: proposal of ethical framework for palliative care.

The everyday practice of oncology and palliative care raises complex issues. Examples include: When should radical curative treatment be -- or rejected from the outset as an option? Do measures for the of symptoms shorten life? When should active drug treatments -- for, antibiotics and steroids -- be stopped? (Similar questions can be about support of physiological systems: blood transfusion, ventilation, dialysis, intravenous hydration and nutrition.) What steps should be when food and drink can no longer be taken by mouth? How should we deal differences of opinion about management arising among patient, family, carers? What is the relation between euthanasia and palliative care? We to examine these questions in a framework that divides the therapeutic into three phases or modes: curative, palliative, and.