CELEBRATING WORLD HOSPICE AND PALLIATIVE CARE DAY 2021. THIS YEAR’S THEME IS LEAVE NO ONE BEHIND – EQUITY IN ACCESS TO PALLIATIVE CARE
In a special series, EAPC task forces and reference groups that work on behalf of vulnerable communities explain what they are doing to enable equity in access to palliative care. Today’s Guest Writers are Mary Turner and Aline Chassagne, Co-Chairs of the European Association for Palliative Care (EAPC) Task Force on Mapping Palliative Care for Prisoners in Europe.
The theme of this year’s World Hospice and Palliative Care Day is: ‘Leave no-one behind – equity in access to palliative care’, and there can be few groups that experience more challenges in accessing equitable palliative care than people in prison. Like populations around the world, prison populations are ageing and in some countries this means that increasing numbers of people are growing old and facing the end of life in prison. They often experience multiple and complex health problems in the last months and years of life, which place enormous strain on prison systems and staff, and present many challenges in terms of environments and facilities, equipment, medications, social care and palliative care.
The EAPC Task Force on Mapping Palliative Care Provision for Prisoners in Europe was set up in May 2017 with the purpose of examining the provision of palliative care in prisons in a small number of European countries, to make comparisons and facilitate learning between countries. A second purpose of the task force was to create an international network to bring together health and social care practitioners, researchers and prison staff interested in palliative care in prison, to share knowledge and potentially form new collaborations. The network, which started with a small handful of people, now has around 80 members from 20 different countries.
The task force has now completed the first part of the mapping work, a survey of prison systems in seven European countries (Belgium, Czech Republic, England & Wales, France, Scotland and Slovakia) and Australia.  In each country, a researcher completed the survey by searching the internet for publicly available data. Survey findings highlighted rising numbers of older prisoners in the four countries that have the highest prison populations (England & Wales, France, Australia and Czech Republic), and increasing numbers of deaths from natural causes, indicating a growing need for palliative care services in the foreseeable future. In only one country (England & Wales), could any evidence of current palliative care provision be found, and that was only available in a small number of prisons. Most countries have policies around early release on compassionate grounds (ERCG) but, contrary to popular belief, very few people are actually released, even when very close to the end of life, because of the stringent conditions around ERCG and the complexity of application processes. This means that, in most countries, prisoners who are approaching the end of life remain in custody until death. The exception to this is France, where very sick and dying prisoners are almost always moved to a secure hospital, where their needs can be better met. The International Association for Hospice and Palliative Care has called for all prisoners who are terminally ill to be considered for ERCG.  It is clear that solutions need to be found if prisons around the world are to cope with continually rising numbers of prisoners with palliative care needs, and ERCG for prisoners who no longer pose a risk to the public would seem to be a good place to start. There is still a long way to go before prisoners across the world have equitable access to palliative care.
For further information about the EAPC Task Force, or to join the network, please see: Prisoners palliative care – European Association for Palliative Care, EAPC (eapcnet.eu) or email Dr Mary Turner.
- Turner M, Chassagne A, Capelas ML, Chambaere K, Panozzo S, Teves C, Riegler E. (2021) Mapping palliative care provision in European prisons: An EAPC Task Force Survey. BMJ Supportive & Palliative Care. Available from: http://spcare.bmj.com/cgi/content/full/bmjspcare-2020-002701?ijkey=YI4jvFSiafvC2Bb&keytype=ref Published online 23 April 2021.
- IAHPC Policy Brief: Compassionate Release: A Practical, Human Rights-Based Response to the Aging Prisoner Crisis. Available from: Microsoft Word – Compassionate Release policy brief.docx (hospicecare.com) Accessed 23 September 2021.
Links and resources
- EAPC Task Force on Mapping Palliative Care Provision for Prisoners in Europe.
- View an earlier post from Aline Chassagne and Aurélie Godard Marceau on the EAPC blog: Is palliative care possible in prison? A national PARME study about inmates with terminal illness in France.
- Backgrounder to End of Life Care in the Prison Environment. A selection of journal abstracts, many with links to the full-text article, on hospice and palliative care in the prison environment from 2017 to 2021, compiled by Barry Ashpole.
- Find out more about World Hospice and Palliative Care Day 2021 here. Enter your own event and download the toolkit.
- Follow the hashtags #LeaveNoOneBehind21 & #WHPCD21
- Read the World Hospice and Palliative Care Day series on the EAPC blog.
BE PART OF THE EAPC 12TH WORLD RESEARCH CONGRESS ONLINE – ABSTRACT SUBMISSION EXTENDED ‘TIL 31 OCTOBER
#EAPC2022 – A world congress that offers new avenues for international collaborative research in palliative care. Make sure you are part of it – find out more and submit your abstract here: https://eapccongress.eu/2022/abstract-submission/