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  HOME | Latin America (Click here for more)

Latin America Lacks Palliative Care Plan for the Terminally Ill

MEXICO CITY – The inclusion of palliative care for the terminally ill – also known as comfort care – is a big unresolved issue in Latin American healthcare systems, Felicia Marie Knaul, director of the University of Miami Institute for the Advanced Study of the Americas, told EFE in an interview.

“If we’re able to work on the prevention of illnesses and the access to treatment, we can also work on providing palliative care” that eases patients’ physical, psychological, social and spiritual suffering, said Knaul, who has dedicated the last three years to studying that problem.

The Harvard graduate with a Ph.D. in economics has just delivered the final manuscript of a world report on the subject that The Lancet medical journal will publish in October, and which will review 15 symptoms associated with diseases that tend to be terminal.

“It can be chronic pain, severe pain, breathing difficulties, severe itch, fatigue and insomnia,” among others.

Knaul defines palliative care treatments as those reserved “for the end of life” and are administered to people who have been “diagnosed with a disease or condition that can significantly shorten life.”

According to the expert, these terminal illnesses and the care required to mitigate the pain should be considered for all of the region’s healthcare systems, among other reasons because it could be useful from an economic point of view.

“We’re talking about a reduction of between 25 and 35 percent of hospitalizations. But only if patients can get help outside of hospitals,” she said.

The best-case scenario would be to “integrate all these patients into a search for universal healthcare coverage,” which is “a very real proposal,” according to the specialist, who in 2013-2014 contributed to a series of articles in The Lancet on universal healthcare coverage in Latin America.

Knaul said the region faces enormous problems if it doesn’t take action quickly.

Among the chief targets is cancer, the second cause of death in South America and the Caribbean and the third in Mexico.

Although palliative care is not exclusively for cancer, that is one of the leading diseases in terms of demand, said the former chair of the Pan American Health Organization Task Force on Universal Health Coverage

Knaul believes the regulatory framework of the region needs changes in order to deal with such taboos as access to morphine and to overcome the obstacles to implementing national healthcare plans that include palliative care among their priorities.

“There are archaic laws and restrictions plus international control over what countries can do. I’m talking about integrating palliative care into the different levels of healthcare systems, starting with the first level of attention,” she said.

 

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