Bioethics and palliative care for patients with Parkinson’s disease

This study discusses the relationship between bioethics and palliative care in the care of patients with Parkinson’s disease. It is a theoretical reflection based on World Health Organization documents, Brazilian regulations on palliative care and advance directives, a national palliative care manual and studies on the needs of patients with advanced Parkinson’s disease. The disease goes beyond motor symptoms and involves pain, dysphagia, cognitive changes, mood disorders, progressive loss of autonomy and family burden. Palliative care, when introduced early and integrated with neurological treatment, contributes to symptom control, honest communication, advance care planning and caregiver support. The principles of autonomy, beneficence, non-maleficence and justice, together with therapeutic proportionality and clinical prudence, guide difficult end-of-life decisions such as artificial feeding, intensive care admission and palliative sedation. It is concluded that caring for people with Parkinson’s disease requires an ethics of presence that respects human dignity and ensures equitable access to quality palliative care.