©2001 Blackwell Science, Inc. VIEWPOINT  Degrading Landscapes: Lessons from Palliative Care Linda J. Kristjanson* and Richard J. Hobbs† *Faculty of Communications, Health and Science, Edith Cowan University, Churchlands, Western Australia; † School of Environmental Science, Murdoch University, Murdoch, Western Australia ABSTRACT INTRODUCTION Increasing interest is being shown in the concept of ecosystem health as an integrative framework for considering ecosystem and landscape manage- ment (Rapport 1995a,b,c; Rapport et al. 1998; Rapport & Whitford 1999). In doing this, oppor- tunities arise to transfer concepts and approaches from human health care to ecosystem and land- scape management. In this paper, we explore whether emerging health paradigms based on palliative care have relevance in the sphere of landscape management. In particular, can some degrading landscapes be viewed in some cases as being “terminally ill,” and if so, how can these landscapes be managed and how can the human communities dependent on these landscapes be assisted? To do this, we first explore the need for a shift in emphasis in health care away from techno- logical, reductionist approaches toward more ho- listic approaches including palliative care. This in turn necessitates a change in worldview that in- corporates recognition of death as a natural pro- cess. The principles that shape the modern world- view developed 300 years ago, and although this view has been greatly refined and modified in the years since, it has retained much of its early vision. The modern age is the Machine Age, comprising the postindustrial and information technology revolutions, where precision, speed, and accuracy are the premier values. This mechanical para- digm is simple, predictable, and above all, it has worked (Rifkin 1989). Modern health care, like almost every other activity in contemporary society, reflects this worldview. The mechanical approach to medicine has dominated the health care profession for 200 years. This “modern” worldview has dominated medical thinking but is increasingly challenged in the wake of pressing global issues, such as the Palliative care is the active total care of patients whose disease is not responsive to curative treatment. This pa- per presents a proposition that the principles of palliative care may offer a useful conceptual map that helps pro- mote understanding of the degradation of landscapes and the decline of rural communities from an ecosystem management perspective. Landscape reorganization by humans for food and other production requires consid- erable inputs of energy and effort. Current trends of landscape degradation indicate that human endeavors have resulted in the loss of functional landscapes with a concurrent decline in ecosystem services. The argument can be made that, in cases where ecosystem degrada- tion is extensive, the landscape may be terminally ill and in need of palliative care. The fundamental principles and components of palliative care are described and questions are posed regarding the extent to which pal- liative care principles and components challenge and ex- tend current land management philosophies and prac- tices. Address correspondence to: Linda J. Kristjanson, Professor, School of Nursing & Public Health, Edith Cowan University, Churchlands Campus, Pearson Street, Churchlands, Western Australia 6018.