Dr Marta Ximena León, Associate Professor, School of Medicine, Universidad de la Sabana, Bogota, Colombia, explains how a committed group of people has worked tirelessly to make palliative care a legal right in Colombia.
Many years ago, my father was diagnosed with advanced cancer and that made me search for ways to alleviate his suffering. I had heard about palliative care, had completed a palliative care fellowship at the National Cancer Institute and since then I have been working in this field.
In 2008 the Colombian Association of Palliative Care, with the advice of international experts such as Liliana De Lima, started working with a senator and her team to draft a palliative care law. We worked with patient associations, and delegates from the Ministry of Health, Ministry of Finance, National Competent Authority of Control Medications and the Ministry of Justice.
During this time, I have had the opportunity to participate in two programmes: the International Pain and Palliative Care Fellowship at the Pain and Policy Studies Group in Madison, Wisconsin, and the International Leadership Program at Ohio Health in Columbus (US). Both programmes enabled me to learn and better understand the complexities of healthcare systems, the palliative care public health perspective and the issues regarding availability of opioids. And they gave me the tools and resources to work with authorities and government representatives.
The palliative care law in Colombia went through the House and the Senate several times before passing both in 2010. Unfortunately, the President did not approve – the Minister of Finance argued that the country did not have the funds to support palliative care services and rejected it on a legal technicality. The Supreme Court debated this, found that the argument from the executive branch was not valid but requested the House to modify some of the language.
The proposed law went through some additional changes, and finally, on 7 September 2014, the Minister of Health signed the new law. The Palliative Care Law “regulates the right of patients with terminal, chronic, degenerative and irreversible conditions to palliative care services, to improve the quality of life of the patients and families through an integrated treatment of pain and other physical, emotional, social and spiritual symptoms, according to clinical guidelines establish by the Ministry of Health.”
The Law establishes rights of the patients: access to palliative care services, accurate information regarding diagnosis and prognosis, a second opinion and having an advance directive. It also outlines the obligations of the health system and the government:
- to offer palliative care services with equity and quality in all levels of care throughout the country;
- to educate health professionals; and
- to ensure availability of opioid medication 24 hours/ 7 days of the week.
Patients with palliative care needs and their families will benefit from the Law, by ensuring access to services, medications, and adequately trained professionals. The task now is to work on its implementation.
- Click here to read a series of posts on palliative care in Colombia published on the EAPC blog earlier this year.
- The Pain & Policy Studies Group, Wisconsin.
- International Leadership Program at Ohio Health.
Last call for nominations to EAPC Early Researcher Award – 30 November 2014
You have the chance to nominate an outstanding early career researcher or clinician to be one of the three next EAPC Early Researcher Award winners. Supervisors/mentors can nominate someone or candidates can also nominate themselves. The award aims to highlight their personal career development and their potential for the future. The winner of the first place will be invited to present his/her work to an international audience by giving a lecture at the 14th World Congress of the EAPC. Applications deadline: 30 November 2014. More information including submission link and criteria can be found here.