Dr. José Pereira, from the University of Ottawa (Canada), has given the international course'Decision-Making at the end of life', organized by the School of Medicine at the Museum of the University of Navarra. For the expert,"one of the keys is that palliative care is not something specific to the end of life, but can be of great help during different stages of an illness".

In his opinion, palliative care is "absolutely essential" at internship healthcare, since "it is a vehicle for many other competencies: a good physician must have a holistic perspective of patients. They have their own history, they are individuals, more than just a tumor or a set of diagnostic tests. They are human, and as such, we have to try to understand them to improve care." Pereira encourages students to ask questions such as "Why do people lose weight?" or "Why do they feel pain?" "We must try to understand them, and for that we need to communicate with them, understand their spiritual, psychological needs...," he stresses.

"When a person realizes that he is nearing the end of his life, he activates very emotional responses. Sometimes they get happy, they celebrate life, but it can be very hard, sad. These emotions and feelings lead to decisions, and if we are not properly counseled about why we feel this way, they can be wrong," he remarks.

The questions we face at the end of life have a strong ethical component, which is why this course aims to be so comprehensive. "We are talking about people who care for other people, human beings. They need to understand how we respond to certain situations. For example, if someone has cancer at a very advanced stage and the chemotherapy is not working, it is easier to give them false hope than to tell them the truth, but it is not the right thing to do," Pereira explains.

End of life and euthanasia

In the expert's opinion,"euthanasia is not part of palliative care; it is something else," although he denounces that there is "a lot of sensationalism and misinformation surrounding this topic". As a society we do not see people dying, "as a whole we consider that death is a failure, but it is not so. Death is an indispensable part of life. And there is the myth that all death is accompanied by suffering, hence the need for an easy and quick solution to avoid it," he explains.

He also denounces that there is much confusion about the very concept of euthanasia: "When someone is going to die, when he depends on a machine to continue living and has no hope of recovery or of being able to have a certain quality of life, disconnecting the machine is not euthanasia. We need more information, more dialogue," he stresses.

In addition to Dr. Pereira, sessions will be given by Professors Carlos Centeno, José Miguel Carrasco and Nunciata Comoretto, all of them researchers of the ATLANTES program of the University of Navarra and experts in Palliative Medicine. Institute for Culture and Society of the University of Navarra and experts in Palliative Medicine.