**5. Conceptualization**

To the scholar mind, a multi-faceted approach is prerequisite to adequately conceive PC from the conceptual, semantic and meaning, anthropological, philosophical and political angles without forgetting that of *actively caring for others*´ wellbeing and assisting them. There could be different ways to unveil its intrinsic philosophy by seeking what imprints character to a movement which began well before Medicine itself was considered an entity, from the medieval hospitium [39] (pl hospitia) hɒˈspɪtɪə Greek: ξενία, xenia, προξενία and positions the scholar in front of is the ancient Greco-Roman concept of hospitality as a divine right of the guest and a divine duty of the host. An archaic place of shelter for travelers, especially one kept by a monastic order, that we are trying nowadays to adapt to a very different society with unmet needs.

There are interesting efforts to establish useful, replicable models. Some are orientated to [41] building digital domain ontologies, incredibly interesting and potentially game changing in niche areas used across the world. However, the model chosen to conceptualize is one by Flores Talavera G. [42] for reasons relating

Professor Talavera's process guides the investigator to initiate conceptualization by undertaking documentary research on the meaning of the key terms; including a review of the meanings and clarification of semantic confusions, looking at the appropriate dictionaries to contextualize it and learn about the possible conceptual evolution of the term. She then suggests consultation of Thesauruses in which the terms are described in the way they are used by scientists followed by accounting for the definitions of the term from a specific perspective. - In specialized dictionaries (Philosophy, Psychology, Sociology, and Physicians and Education) and conceptual essays, definitions located in sources to broaden the search horizon to

It is then possible to compare related terms using three processes: defining each one of them, establishing similarities and then establishing differences. This would then facilitate term characterization by establishing its most important characteristics, not of the word but of the complex reality that the term tries to elucidate. To consider types and uses of the object (term) of study from its conceptual definition and expand the understanding of the meaning and reality intended to be

Conceptual purity of words used in the palliative field could facilitate its extension and promotion by examining its intrinsic philosophy understanding *what* it is that imprints character to a movement that began from the medieval hospitium and

Applying the chosen methodology to the conceptualization and semantics of the original Palliative Care entails an interesting linguistic and geographical *iter* that could decisively contribute to the dissolution of the original *karos* philosophy observed in some situations. There should have been a process of content-rich implementation, in its place this is truncated by a less nuanced implementation marked by external and constant pressure to achieve tangible and quantitatively

The number of terms that could be analyzed in order to be conceptualized could might be thought to be huge. This is not the case as there are a handful of terms, key

However, there is a number of them that deserve immediate attention as they are used, maybe even abused, too frequently. An appropriate conceptualization of these is urgent due to their weight in planning, policy – making and the delivery of

Although it is a very specialized subject and deserves a full piece of work with

To begin with, and following the first two process points from guideline, we can start from the top of the organizational and planification pyramid from which all policy flows to inform health and social care, there are two vocables that could be

*5.2.1 Representative terms and words used in international palliative care*

to its clarity, teaching dimension and the fact that she writes in Spanish.

*The Challenges Facing Palliative Care Advocacy: What Is in a Name?*

*DOI: http://dx.doi.org/10.5772/intechopen.97367*

find the "sense" of the term.

explained, it is useful to identify the key ones.

**5.2 Palliative care conceptualization**

has foundational Judeo- Christian roots.

to impulse palliative programs (**Table 2**).

more specialist direction, we present a first attempt here.

used better to achieve the sought-after results.

relevant results.

excellent *Palliative Care.*

**307**

The encounter with the ancient vocables that give name to this *caring* movement whets the scholar's appetite to learn more about the semantic and semiotic correspondence of the most commonly used words in PC in order to fully understand the impact of language and its own development in its evolution.

A straightforward methodology pathway leads us to study the roots of the discipline key words, analyzing their semantic transformation over time to witnessing their morphological evolution and conceptual spirit of each vocable. Grounded on a careful conceptual description of those words used in the palliative field could facilitate its extension and promotion which should benefit more people.

#### **5.1 Language and conceptualization**

Linguistics is a science which object of study is language. Its analysis places language in context, as it takes into consideration social, cultural, historical, and political factors influencing language.

Conceptualization consists of processes observing language production. It takes language-specific perspectives and event understanding.

Such process is still little understood by the experts [40] in the field. At the same time, we find ourselves at a point in the history of the Modern Hospice movement when it seems to be imperious to start a rigorous process around strong, concise and unambiguous definitions. This is due to the expansion of the discipline throughout the different countries with their cultures and languages which need to adapt to a new way of formalized compassion. Within PC, too many words are translated almost literally from the English language, resulting in numerous concepts with multiple scopes or dimensions, often inaccurate. This is confusing and makes it hard to transmit the science to others outside the field as they are incapable of conceiving its objective without further clarification. Existing PC definitions are being currently contested, probably because concepts are neither tangible nor concrete. Characterizations of our field based on abstract concepts make for confusion needing an effort to interpret conceptually by act or process of forming a general notion or idea.

Interest in this matter comes from personal experience of palliation in both the Anglo-Saxon and Iberian cultures and language and observing the inadequate adoption of terminology without the right notions behind. We defend the proposition that it is important to know what notions different authors might use to refer to PC and establish which of those most faithfully represent its most intimate nature.

#### *The Challenges Facing Palliative Care Advocacy: What Is in a Name? DOI: http://dx.doi.org/10.5772/intechopen.97367*

**5. Conceptualization**

society with unmet needs.

**5.1 Language and conceptualization**

political factors influencing language.

language-specific perspectives and event understanding.

evolution.

more people.

notion or idea.

intimate nature.

**306**

To the scholar mind, a multi-faceted approach is prerequisite to adequately conceive PC from the conceptual, semantic and meaning, anthropological, philosophical and political angles without forgetting that of *actively caring for others*´ wellbeing and assisting them. There could be different ways to unveil its intrinsic philosophy by seeking what imprints character to a movement which began well before Medicine itself was considered an entity, from the medieval hospitium [39] (pl hospitia) hɒˈspɪtɪə Greek: ξενία, xenia, προξενία and positions the scholar in front of is the ancient Greco-Roman concept of hospitality as a divine right of the guest and a divine duty of the host. An archaic place of shelter for travelers, especially one kept by a monastic order, that we are trying nowadays to adapt to a very different

*Suggestions for Addressing Clinical and Non-Clinical Issues in Palliative Care*

The encounter with the ancient vocables that give name to this *caring* movement whets the scholar's appetite to learn more about the semantic and semiotic correspondence of the most commonly used words in PC in order to fully understand the impact of language and its own development in its

A straightforward methodology pathway leads us to study the roots of the discipline key words, analyzing their semantic transformation over time to witnessing their morphological evolution and conceptual spirit of each vocable. Grounded on a careful conceptual description of those words used in the palliative field could facilitate its extension and promotion which should benefit

Linguistics is a science which object of study is language. Its analysis places language in context, as it takes into consideration social, cultural, historical, and

Conceptualization consists of processes observing language production. It takes

Such process is still little understood by the experts [40] in the field. At the same time, we find ourselves at a point in the history of the Modern Hospice movement when it seems to be imperious to start a rigorous process around strong, concise and unambiguous definitions. This is due to the expansion of the discipline throughout the different countries with their cultures and languages which need to adapt to a new way of formalized compassion. Within PC, too many words are translated almost literally from the English language, resulting in numerous concepts with multiple scopes or dimensions, often inaccurate. This is confusing and makes it hard to transmit the science to others outside the field as they are incapable of conceiving

its objective without further clarification. Existing PC definitions are being currently contested, probably because concepts are neither tangible nor concrete. Characterizations of our field based on abstract concepts make for confusion needing an effort to interpret conceptually by act or process of forming a general

Interest in this matter comes from personal experience of palliation in both the

Anglo-Saxon and Iberian cultures and language and observing the inadequate adoption of terminology without the right notions behind. We defend the

proposition that it is important to know what notions different authors might use to refer to PC and establish which of those most faithfully represent its most

There are interesting efforts to establish useful, replicable models. Some are orientated to [41] building digital domain ontologies, incredibly interesting and potentially game changing in niche areas used across the world. However, the model chosen to conceptualize is one by Flores Talavera G. [42] for reasons relating to its clarity, teaching dimension and the fact that she writes in Spanish.

Professor Talavera's process guides the investigator to initiate conceptualization by undertaking documentary research on the meaning of the key terms; including a review of the meanings and clarification of semantic confusions, looking at the appropriate dictionaries to contextualize it and learn about the possible conceptual evolution of the term. She then suggests consultation of Thesauruses in which the terms are described in the way they are used by scientists followed by accounting for the definitions of the term from a specific perspective. - In specialized dictionaries (Philosophy, Psychology, Sociology, and Physicians and Education) and conceptual essays, definitions located in sources to broaden the search horizon to find the "sense" of the term.

It is then possible to compare related terms using three processes: defining each one of them, establishing similarities and then establishing differences. This would then facilitate term characterization by establishing its most important characteristics, not of the word but of the complex reality that the term tries to elucidate.

To consider types and uses of the object (term) of study from its conceptual definition and expand the understanding of the meaning and reality intended to be explained, it is useful to identify the key ones.

#### **5.2 Palliative care conceptualization**

Conceptual purity of words used in the palliative field could facilitate its extension and promotion by examining its intrinsic philosophy understanding *what* it is that imprints character to a movement that began from the medieval hospitium and has foundational Judeo- Christian roots.

Applying the chosen methodology to the conceptualization and semantics of the original Palliative Care entails an interesting linguistic and geographical *iter* that could decisively contribute to the dissolution of the original *karos* philosophy observed in some situations. There should have been a process of content-rich implementation, in its place this is truncated by a less nuanced implementation marked by external and constant pressure to achieve tangible and quantitatively relevant results.

#### *5.2.1 Representative terms and words used in international palliative care*

The number of terms that could be analyzed in order to be conceptualized could might be thought to be huge. This is not the case as there are a handful of terms, key to impulse palliative programs (**Table 2**).

However, there is a number of them that deserve immediate attention as they are used, maybe even abused, too frequently. An appropriate conceptualization of these is urgent due to their weight in planning, policy – making and the delivery of excellent *Palliative Care.*

Although it is a very specialized subject and deserves a full piece of work with more specialist direction, we present a first attempt here.

To begin with, and following the first two process points from guideline, we can start from the top of the organizational and planification pyramid from which all policy flows to inform health and social care, there are two vocables that could be used better to achieve the sought-after results.


graft

**309**

1941 as "action of implanting,"

from implant

"to plant in" abstractly, of ideas,

emotions, etc.

"to plant", literally "plant in," from assimilated

"into, in, on, upon".

–

Implementing

 a Palliative Care Program speaks of

"working at it" and "being

*DOI: http://dx.doi.org/10.5772/intechopen.97367*

IMPLEMENT

The difference between the notions conceived through these two verbs is very important.

/IMPLANT

part of the

Something that needs to be taken into account by politicians,

PALLIATIVE

Early 15c.,

"serving to mitigate or alleviate" (a

wound, illness, etc.); other

meanings "cloak, cover,

concealing;"

"under cloak, covert," from Latin

*pallium* "a cloak"

*'to cloak',* *´to protect´* ´to conceal,"

 from

Dates from 1724.

*ADJ.*

*PALLIATIF*

As a verb, used since

*PALLIATUS*

1779.

*VERB*

*NOUN*

*PALLIATIVUS*

*VERB*

LATIN

*PALLIARE*

CARE

circa. 1400

a. the provision of what is

Old English *caru*, *cearu*

anxiety, grief," also "burdens of

mind; serious mental attention"

Late Old English "concern, anxiety

caused by the weight of many burdens,"

Proto-Germanic

grief, care"

Source also of Old Saxon *kara* "sorrow;". The primary sense is

 \**karō* "lament;

apprehension

 of evil or

"sorrow,

C."charge, oversight, attention or

Of all the different meanings of

Care, only used in Spanish. There is a

reluctance to Attend, Assist, have

regard for etc..

*Cuidados*

& *Cura are*

heed with a view to safety or

protection"

The sense in *care o*f in addressing

(used from 1840).

 is attested from;

necessary for the health, welfare,

maintenance,

someone or something.

keeping, supervision,

charge, b. serious attention or

consideration

something correctly or to avoid

damage or risk. (caution,

carefulness,

heedfulness,heed)

D. Meaning "object or matter of

wariness,awareness,

that of inward grief, and the word

is not connected, either in sense or

form, with L. cura, care, of which

 applied to doing

protection,keeping)

 (safe

 custody,

 and protection of

Circa 1580. Circa 1520s- 1550s

*Noun*

*Verb*

development".

 While implanting a Palliative Care Program talks about "having something new to deal with or to put up with".

 managers, et as it might mean the difference between people being engaged or not.

*Adj.* French

Late Latin from past participle of Late Latin

*palliare* "cover with a cloak,

conceal,"

*Noun.* Medieval Latin

*Verb.*

Medieval Latin *palliare*

*palliativus*

*Palliatus*

"cloaked,"

or favorable which mitigates or

Used by politicians and journalists

to express strong actions or will.

representation".

 "that

*The Challenges Facing Palliative Care Advocacy: What Is in a Name?*

extenuates,".

*Palliatif,*

"serving to extenuate by Excuses

 form of in-


Dates from

**308**

Hospice

*late 17th*

*century.*1818.

 Rest house for travellers

noun

*Hospitium*

Meaning

Original language (s)

French *hospice*

almshouse"

Old French *ospice*

shelter," Latin 1. *hospitium*

reception, hospitality,

relationship

2.*hospes* (genitive *hospitis*) "guest; host," also "a stranger, foreigner"

Late Latin*:* 

filling up Made of two Latin vocables

In (towards the center) Plere (to fill up) (Greek polis,

many)

Partly from Medieval Latin

implementa

Partl from late Latin

Implementum

fulfilment',

implere 'fill up' (later

from in- 'in' + Latin plere 'fill'.

Old French

*Noun* Modern use

If you implant an idea or attitude

in people, you make it become

accepted or believed.

From 1886 Meaning "surgically implant

(something)

originally of teeth.

which is attested by 1981

short for breast implants (1976).

1890,

"thing implanted;"

 in the body",

*Emplanter*

French

*"to insert, engraft"*

Medieval Latin. In (towards the centre) Plant (see in, to plant, and

observe)

*Implantus*

Implant

16th Century 1540c

*Verb*

I.Transitive

1a: to fix or set securely or deeply

1b: to set consciousness

inculcate

2. to insert in living tissue

II.Intransitive

To undergo

*Noun*

implantation

 or habit patterns:

permanently

 in the

15th Century

*verb*

*Noun*

'employ'),

 both from Latin

'filling up,

 (plural

*implementum*;

 *implere*:

From it comes

use first recorded 1913.

implementation,

 its

*Suggestions for Addressing Clinical and Non-Clinical Issues in Palliative Care*

Implement

*Verb.* early 18th

Verb:

1.-To put (a decision, plan,

agreement,

2.- To start using a plan or system

3.- To complete, perform, carry

into effect,"

*Noun*

Used to refer to different artifacts:

furniture, gear, or dress'.

 etc.) into effect.

century. 1707

*Noun,* in late Middle

English.

verb

*implemere*

noun

*Implementum*

First used circa 1707c.

in Scottish English. Legal term meaning

"fulfilment,"

 of guest and host

 bonds of hospitality,

entertainment;

,"hospitality,"

 13c. "hospitable

"hospice,

"hospital,

1879.Sense of "home for the aged

and terminally ill "

1978is first attested as *hospice*

*movement*

Contemporary

 use

Of note The term repudiated in Spanish- Palliative

Care Unit is used instead

Used in the Netherlands

*Hospitium,* places for those who

don't want euthanasia and go there

for protection.

 as

"Hospice" is strongly


Attention

**311**

energies,"

*attentio*)

*ad* "to, toward" + *tendere*

b. Old French

"*atendre*"

"stretch,"

directed related to Cicely Saunders´s *"Active listening"*

"Mental heeding" "give heed to,"

literally "to stretch toward", "be

subject to" (now obsolete), "direct

one's mind or energies" (archaic),

from (

ASSIST

early 15c

14c

*Aspect of Care*

*Verb*

… )

*assisten* 'take one's stand'. stand by,

Origen from two Latin vocables

Related: Assisted; assisting gives

way to

*DOI: http://dx.doi.org/10.5772/intechopen.97367*

Medical assisted suicide attested

from 1884

Interesting use of *insist* tends to

*The Challenges Facing Palliative Care Advocacy: What Is in a Name?*

happen when patient´s symptoms

or family anguish are present.

Ad- to; + iuvare – "to help"

from *ad-* 'to, at' + *sistere*

Late Middle English, from

Old French Latin *assister* "

take a stand near, attend,"

to set, place, cause to stand,"

*assister* "to stand by, help, put,

place, assist"

to help someone, aid, collaborate,

cooperate, benefit

"take a stand, stand on, stand still;

French *insister*

Or

directly from Latin *insistere*

from root \*en "in") + *sistere*

follow, pursue; insist, press

vigorously,

from in- "upon" "take a stand," from PIE \*si-st-,

reduplicated

stand, make or be firm."

take one's stand by',

Late Middle English: from

Old French *assister*, from

Latin *assistere* 'from ad- 'to, at' +

sistere

from Old French

Medieval Latin

*assistentia*,

*assistance* and

'take one's stand'. "act of helping or aiding; help given, aid," from the respective

verbs

"to help, aid, give assistance or

support to in some undertaking

effort,"

"stand by, take a stand near,

attend,"

To take a stand; to set, place, cause

to stand"an act of assistance,"

assist" stand still.

> **Table 2.**

*Palliative care terminology:*

 *vocables evolution through time and languages*

 from

 or

Late Latin *adjuva*

Latin *assistere* from assimilated

*sistere*

 form of *ad* "to" +

ASSISTANCE

early 15c.,

1570s

& ASSIST Aspects of

Care

Noun*(s).*

 form of root \*sta- "to

 urge, dwell upon,"

INSIST

1580s

14c.

Aspect of Care

*Aspect of Care*

*Noun*

