Beyond symptom management: the ethics and psychiatry of palliative medicine
The September 2025 issue of Annals of Palliative Medicine featured 2 Editorials, 4 Original Articles, 3 Review Articles, 2 Case Reports, and 1 Editorial Commentary. Both of the two Editorial articles serve as the introductory articles to Special Series article collections for Annals of Palliative Medicine.
The first, an introduction to the Special Series on supportive care after breast cancer (1), has previously been discussed in a prior Message from the Editor-in-Chief (2). With breast cancer being the most common non-cutaneous malignancy among women worldwide (3), and with survival for breast cancer having improved through advancements in detection, treatment, and supportive care, there is an increasing population of breast cancer survivors living with complications from their cancer and their cancer treatment (4). That Special Series details a comprehensive and up-to-date report of the pertinent issues, challenges, opportunities, and latest developments in breast cancer survivorship care and research.
This Message from the Editor-in-Chief focuses on the second Editorial and the Special Series that it introduces. Co-Guest Editors Dr. Jan Gärtner and Dr. Manuel Trachsel, both from University Hospital Basel (USB) in Switzerland, led a Special Series entitled, “Ethics and Psychiatry Meet Palliative Medicine” (5).
There are ethical and psychological challenges when caring for patients with life-limiting illnesses. This journal has recently reported on the myriad of definitions of palliative care and palliative medicine (6). The interdisciplinary need to care for patients is consistently stressed. While that pertains to the multidisciplinary management of a patient’s physical symptoms, addressing the distress that patients experience in additional ways beyond the physical is critical to optimizing their quality of life and supportive needs. This Special Series brings together the views and expertise from the fields of palliative medicine, psychiatry, and medical ethics to discuss existential suffering, patient autonomy, and caring for patients with complex needs.
The Special Series includes five impactful articles on ethics and psychiatry in palliative medicine. The first is an expert consensus on the research, clinical, and educational priorities for palliative psychiatry. Next is a narrative review article on rethinking existential suffering. Third is a review article on clinical-ethical arguments and recommendations for assisted suicide in patients with mental disorders. Then is a scoping review on end-of-life care for patients with anorexia nervosa. The final article is a case report on palliative psychiatry for a patient with treatment-refractory schizophrenia and severe chronic malignant catatonia.
This Special Series collection of articles is an excellent and enlightening read that provides insights and reflections into what are some of the most challenging patient encounters that palliative care and affiliated providers face. Dr. Jan Gärtner and Dr. Manuel Trachsel should be commended for recruiting leading experts to contribute these articles that serve as a great foundation for practitioners to develop more patient-centered care for patients and their significant others, and to reduce the severity of conflicts and moral distress among teams caring for these challenging patients.
Acknowledgments
None.
Footnote
Provenance and Peer Review: This article was commissioned by the editorial office, Annals of Palliative Medicine. The article did not undergo external peer review.
Funding: None.
Conflicts of Interest: The author has completed the ICMJE uniform disclosure form (available at https://apm.amegroups.com/article/view/10.21037/apm-2025-04/coif). C.B.S. serves as the co-Editor-in-Chief of Annals of Palliative Medicine from April 2014 to April 2027. The author has no other conflicts of interest to declare.
Ethical Statement: The author is accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.
References
- Alkhaifi M, Simone CB 2nd, Lustberg M, et al. Introduction to supportive care after breast cancer: challenges and opportunities. Ann Palliat Med 2025;14:423-5. [Crossref] [PubMed]
- Simone CB 2nd. Supportive care after breast cancer. Ann Palliat Med 2024;13:1556-8. [Crossref] [PubMed]
- Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2024;74:229-63. [Crossref] [PubMed]
- Miller KD, Nogueira L, Devasia T, et al. Cancer treatment and survivorship statistics, 2022. CA Cancer J Clin 2022;72:409-36. [Crossref] [PubMed]
- Gaertner J, Trachsel M. The intersection of ethics, psychiatry, and palliative medicine-reflections on a complex relationship. Ann Palliat Med 2025;14:426-9. [Crossref] [PubMed]
- Zhang K, Shang B, Kellehear A, et al. Scope of Annals of Palliative Medicine based on a review of the disciplinary development and evolving definition of palliative medicine. Ann Palliat Med 2023;12:1125-31. [Crossref] [PubMed]
