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Resolution 2249 (2018)
The provision of palliative care in Europe
1. The Parliamentary Assembly recognises
that palliative care is fundamental to human dignity and a component
of the human right to health.
2. Building on the definition given by the World Health Organization,
the Assembly notes that palliative care focuses on preventing and
relieving suffering associated with a life-threatening or life-limiting
condition through a holistic approach addressing physical, psychosocial
and spiritual problems. The goal of palliative care is to improve
the quality of life for patients and their families, and to uphold
their dignity, by alleviating suffering in all its forms.
3. Echoing its Resolution
1649 (2009) “Palliative care: a model for innovative
health and social policies”, the Assembly stresses that palliative
care should be available not just to the terminally ill, but also
to those who are chronically ill and to persons requiring high levels
of individual care who would benefit from the palliative care approach.
With an ageing population, living longer and with more years of
chronic illness and pain, a substantial increase in palliative care
needs can be anticipated over the coming years.
4. The Assembly deeply regrets that fifteen years after the adoption
of Committee of Ministers Recommendation Rec(2003)24 on the organisation
of palliative care, hundreds of thousands of people in Europe still
do not have access to appropriate palliative-care services. The
Assembly is particularly concerned about the lack of access to appropriate
pain relief, leading to situations in which patients suffer for
months and even years, and die in pain that could be prevented.
5. The Assembly notes that the lack of appropriate palliative-care
services not only increases suffering for patients and families,
but also involves higher costs for the health-care system, as it
leads to unnecessary hospital admissions, as well as inappropriate
recourse to expensive emergency services and treatments. Consequently,
it is of utmost importance to identify palliative-care needs as
early as possible and to provide palliative-care services at all
levels of care. This should include, in particular, palliative-care
services at community level and home-based care, which can be provided
at a lower cost and through which people with limited access to
medical facilities can be reached.
6. The Assembly pays tribute to the millions of informal caregivers
– spouses, partners, relatives and friends – who provide care to
loved ones suffering from a chronic illness, disability or other
long-lasting health affliction. It recognises the crucial and irreplaceable
role which informal caregivers play in the provision of palliative
care and stresses the importance of adequately supporting these
caregivers. Bearing in mind that most patients prefer to stay, and
eventually die, at home, the Assembly notes that the need for informal caregiving
can only grow in the coming years.
7. In view of the above, the Assembly calls on the Council of
Europe member States to take the following measures with a view
to strengthening palliative-care services and to ensuring access
to quality palliative care for both adults and children who need
it:
7.1. recognise palliative care
as a human right, define it as part of the health-care system and
dedicate the necessary resources to it;
7.2. integrate palliative care into all services and settings
of the health-care system, in particular extend palliative-care
services to all patients with life-threatening or life-limiting
chronic conditions;
7.3. ensure access to pain treatment and management as a crucial
component of palliative care, in particular:
7.3.1. remove
legal and regulatory obstacles that restrict access to pain-relieving
medication in the context of palliative care;
7.3.2. address educational and attitudinal barriers by raising
awareness of appropriate and effective pain management, including
opioid-based treatments, among health-care professionals and the
general public;
7.4. provide comprehensive support for informal caregivers,
and in particular:
7.4.1. offer them respite services and
bereavement support, and protect them against financial losses;
7.4.2. remove any barriers that prevent men and women from identifying,
sharing, determining and playing their role in informal caregiving,
having regard to their particular situation and needs;
7.5. ensure adequate training on palliative care for health-care
professionals, in particular:
7.5.1. include basic palliative-care
training in medical and nursing schools, and ensure continuing professional
education on palliative care;
7.5.2. recognise palliative care as a medical speciality;
7.6. systematically provide psychological, emotional and spiritual
support for patients and families;
7.7. improve public awareness of palliative care via media
and information campaigns;
7.8. take measures to foster a partnership between government
and civil society in the provision of palliative-care services;
7.9. consult people living with life-threatening or life-limiting
conditions, as well as their carers and health professionals, on
the development of palliative care-related policies and services.
8. Finally, the Assembly invites the World Health Organization
to pay particular attention to palliative care when following the
implementation of target 3.8 of the Sustainable Development Goals
on achieving universal health coverage.