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José Miguel Carrasco, Sociologist and Doctor in Public Health. ATLANTES Program, Institute for Culture and Society

Necessary care for all

Sat, 10 Oct 2015 13:47:00 +0000 Published in Heraldo de Aragón, Hoy (Cáceres and Badajoz eds.), El Norte de Castilla and Diari de Tarragona.

The World Health Organization (WHO) estimates that about 40 million people worldwide need palliative care each year, but that less than 15% of them receive it. WHO defines palliative care as all care aimed at improving the quality of life of people facing a life-threatening illness.

Its goal is to alleviate the suffering of patients and their close environment (family members, caregivers, etc.) with a holistic perspective, that is, treating their physical pain, but also addressing other problems of a psychological, social and spiritual nature.

Palliative care is not intended to lengthen or shorten life, but to reaffirm its importance by providing the support that facilitates it, while trying to normalize death as a process inherent to the human being.

It might be thought that the most economically and socially developed countries are at the forefront in the provision of palliative care, but in Europe, for example, there are notable differences between countries in relation to the development of palliative care services. While countries such as the United Kingdom and Germany have an important network of health services aimed at promote a good quality of life for patients in advanced stages of disease, others are still in the very early stages of development. In Spain, according to data of the European Palliative Care association , palliative care coverage, both in home and hospital care, does not even cover 50% of the population's needs.

In the coming years, a gradual aging of the population is expected in our environment, which could mean that, by 2050, a quarter of our population will be over 65 years of age. If we add to this the epidemiological forecasts that point to an increase in the prevalence of diseases with long periods of advanced disease, such as cancer or neurodegenerative diseases, it seems clear that we will be facing a major public health problem that, as a society, we will have to address in the future and prepare for it in the present.

Although palliative care is not a single solution to the health and social problems we face, it can help to address them. From a healthcare point of view there are numerous programs of study and reports that show its benefits in terms of costs, since it reduces unnecessary hospitalizations and inefficient treatments, and can be provided both in specialized centers and in home care.

From the patient's point of view, there is abundant scientific evidence that sample the benefits in terms of quality of life and satisfaction of those who have access to them. From a social point of view, there are experiences of community interventions in which end-of-life care is assumed collectively, which have been shown to be effective in promoting social participation and the principle of solidarity.

knowledge Socially, palliative care is not yet integrated into our collective imagination, nor is it assumed within the health and social services that we demand from our providers, although it is true that it is being presented more and more frequently in the media and is part of social debates that contribute to increasing the population's awareness of its role and the benefits that it can provide. Culturally, the end of life is surrounded by taboos and fears that are an obstacle that hinders the development of the necessary care to face it in the best possible conditions.

Today we have the knowledge, the drugs and the technical advances necessary to provide patients in advanced disease with the best possible well-being. As a society we have an obligation and a responsibility to provide our citizens not only with the best health and social services, but we also have a responsibility to develop the appropriate social dynamics that promote the collective care of sick people. The development of palliative care services, their implementation, the dissemination of their existence and the benefits they can bring, are steps towards promote in our society a good end of life, with the hope of receiving appropriate care that minimizes unnecessary suffering.