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Unusual perceptions at the end of life: limitations to the diagnosis of hallucinations in palliative medicine
Kellehear, Allan
Kellehear, Allan
Publication Date
2017
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2016-01-13
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Abstract
The diagnosis of hallucination for unusual
perceptions such as deathbed visions, near-death
experiences, or visions of the bereaved, is
unhelpful in palliative medicine both
academically and clinically. This paper reviews the
broad prevalence data about unusual
perceptions in the general population as
to identifying the more narrow
epidemiological source from which the much
smaller focus on hallucinations seem to emerge.
Major debates and limitations of current
hallucination research are reviewed to show that
current academic and clinical certainties are
largely confined to unusual perceptions that can
be readily linked to psychopathology, quite
specific organic disease states and psychoactive
drug use. Current state-of-the-art in hallucination
studies does not warrant broad or uncritical use
of this type of diagnosis in end-of-life care.
Conclusions from interdisciplinary (as opposed to
single discipline) hallucination studies suggest
that the way forward for clinical and research
work in palliative medicine may lie in a more
biographical and cultural approach to unusual
perceptions at the end of life.
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Kellehear A (2017) Unusual perceptions at the end of life: limitations to the diagnosis of
hallucinations in palliative medicine. BMJ Supportive & Palliative Care. 7(3): 238-246.
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