Appropriate palliative care: when does it begin?

The transition between a curative and a palliative approach to the care of a patient with cancer may be filled with uncertainty for patients, their families and health care professionals. A conventional model of treating the patient with cancer through curative, palliative and terminal phases is examined. The boundaries between the phases of care are blurred. A model of care based on respect for patient autonomy ensures that the timing of the switch from curative to palliative care is appropriate.