title: [Palliative medicine].
abstract: BACKGROUND
  This paper investigates the qualitative and quantitative situation of palliative care medicine in Germany. The challenge of palliative care is the improvement of the quality of life of patients who are expected to die within months. In head and neck surgery most of these patients are suffering from cancer. Palliative care may incorporate symptom control and may support self-determination, including psychological, social and spiritual aspects. Treatment is not intended to cure the patients. Palliative care focuses on care of the patient and family rather than on the underlying disease.
  
  
  METHODS
  A databank search was performed using key words such as palliative medicine, palliative care, hospice, AAPV, SAPV and PCT.
  
  
  RESULTS
  The search demonstrates the restoration of quality of life as a guiding principle of palliative care in Germany. This may be achieved by symptom control and support of self-determination as well as psychosocial or spiritual support. Furthermore, relatives including children receive emotional support. A further principle is the proactive coordination of palliative procedures.
  
  
  CONCLUSIONS
  Improved legal conditions for realistic specialized ambulatory palliative care (spezialisierte ambulante Palliativversorgung, SAPV) as well as strengthening of general palliative care (allgemeine ambulante Palliativversorgung, AAPV) should be encouraged so that a sustainable palliative care net with cooperation of SAPV and AASP can be developed throughout Germany.
authors.affiliation: Universitäts-HNO-Klinik, Universität Tübingen, Elfriede-Aulhorn-Str. 5, 72070 Tübingen, Germany. zenner@uni-tuebingen.de
authors.forename: H P
authors.initials: HP
authors.lastname: Zenner
mesh_terms: D015897:Comorbidity; D003863:Depression / Q000401:mortality / Q000517:prevention & control* / Q000523:psychology*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D009369:Neoplasms / Q000401:mortality / Q000451:nursing* / Q000523:psychology*; D010146:Pain / Q000401:mortality / Q000517:prevention & control* / Q000523:psychology*; D010166:Palliative Care / Q000523:psychology* / Q000706:statistics & numerical data; D011788:Quality of Life / Q000523:psychology; D013727:Terminal Care / Q000523:psychology / Q000706:statistics & numerical data