title: Routinization and medicalization of palliative care: losses, gains and challenges.
abstract: This article investigates some of the criticisms that have been directed at the hospice movement in the process of interaction with the traditional Western healthcare system, such as those relative to its routinization and medicalization. It also aims to review some of the consequences of this process of institutionalisation for the field of end-of-life care: surveillance and control over the process of dying, at the expense of decisions preferably based on the patient and that patient's ability to decide how to die, with the loss of wider objectives originally established by the movement, such as unconditional reception for the patient. Based on these criticisms, some considerations are made regarding the moral implications and risks related to this specific mode of action, the hospice way of care.
authors.affiliation: Bioethics Council, Brazilian National Cancer Institute, Rio de Janeiro, Brazil.
authors.forename: Ciro Augusto
authors.initials: CA
authors.lastname: Floriani
authors.affiliation: Bioethics Council, Brazilian National Cancer Institute, Rio de Janeiro, Brazil.
authors.forename: Fermin Rolland
authors.initials: FR
authors.lastname: Schramm
mesh_terms: D001293:Attitude to Death; D017051:Hospice Care / Q000379:methods* / Q000592:standards; D006801:Humans; D010166:Palliative Care / Q000379:methods* / Q000592:standards