A valence issue or a transformational definition: is palliative care no more, no less than high-quality care?

According to the World Health Organization, palliative care is an approach that improves the quality of life of patients and their families when facing a life-threatening disease, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems. This type of care has been developed to promote the patient's well-being and dignity, even within the presence of a chronic, advanced and progressive disease. Despite this definition and others provided by international associations, the need to clarify some aspects and to achieve a definition consensus rises. Several initiatives have been conducted to establish a common definition for palliative care worldwide, as well as for other concepts such as progressive, terminal, end-of-life, supportive, respite and hospice care. This conceptual consensus would allow more effective cross-national and cross-cultural comparisons of health care systems, which may also contribute to the improvement of palliative care services. A good clarification of what palliative care is (e.g., is palliative care merely an approach or is it a specialized field within health care systems?) is needed. According to Sir Raymond Hoffenberg,1 'palliative medicine is no more, no less than the quality of care we should be offering all our patients every day - care tailored to their needs, skilled, compassionate'. Indeed, the core elements of palliative care should be present in all other health care settings since they are the essential features of good care. If so, another question arises: Is palliative care really no more, no less than high-quality care? By exploring the definitions of palliative care and related concepts, it is our aim to discuss this question and paradox as well as the slippery slope of introducing so many different concepts and sub-specialized areas within the field of palliative care.