Teleconsultation: enhancing personalized palliative care at home. An emperical-ethical analysis

Abstract

Contains fulltext : 150185.pdf (publisher's version ) (Open Access)The Dutch government aims to transfer care for chronically ill people to the home as much as possible. In an ageing society, this means that primary care physician, homecare agencies, and proxies increasingly become responsible for the chronically ill. How can patients, who are in the last phase of life, and their proxies still receive specialist palliative care at home, if necessary? One potential solution, video consultation, was investigated in this thesis. Eighteen patients with advanced cancer or COPD were followed over time, while regularly having video consultations with hospital-based palliative care specialists. For these patients, that meant receiving extra care and attention at home, where they felt more comfortable and in control. Teleconsultation technology invites to hyperfocus on conversation partners, thus easily causing virtual proximity. If well-protected, this proximity enables intimacy, consolation, and reassurance. It appears that human suffering can be recognized and acknowledged through modern communication technologies. However, a silent ‘being-with’ patients remained impossible to realize through technology, as was physical consolation. This thesis shows what requirements should be met to realize high-quality multidisciplinary or interdisciplinary care via video consultation that results in distance personalized care.Radboud Universiteit Nijmegen, 21 januari 2016Promotores : Vissers, K.C.P., Leeuwen, E. van Co-promotores : Hasselaar, J.G.J., Selm, M. va