Clinical practice guidelines for the management of psychosocial distress at the end of life.

Algorithm-based clinical practice guidelines relating to psychiatric, psychosocial, and spiritual domains can effect a major improvement in end-of-life care by defining a gold standard for clinicians in an area not previously subjected to such a level of scrutiny. This article outlines the status of these guidelines and offers recommendations for policy development relative to doctor-patient communication and management of distress (psychological, social, existential, spiritual) and psychiatric disorders. The arching principle of these standards and guidelines is the recognition that the physical and the psychosocial are interrelated and overlapping in end-of-life care, and that patients should receive their total care as a seamless integration of physical and supportive services.