The Role of Palliative Medicine in Poor and Rich Countries

The WHO guidelines for tumor pain therapy recommend a medicinal, preferably oral pain therapy after careful anamnesis, examination, and determination of the pain diagnosis. These recommendations were confirmed by the Drug Commission of the German Medical Association (WHO 1996). In 1960, Cicely Saunders formulated the first principle papers for the establishment of a hospice. On July 14, 1967, the St. Christopher’s Hospice in London with a research department was opened. In 1969, Saunders set up an outpatient hospice service. This chapter describes palliative medical measures for treating clinical symptoms of seriously ill patients, such as pain, shortness of breath, and fever. In addition, the principles of palliative medicine are described and their different applications in poor and rich countries are highlighted. Oncological therapies are not opposed to palliative medicine, but palliative care and chemotherapy complement each other! “The unword ‘therapeutically exhausted’ has ‘served its purpose’!” In the treatment of seriously ill, especially older patients, the patient’s wish must be followed and the family and social environment must be taken into account, worldwide!