Charters are not enough: We need tools for immediate action

Steven Vanderstichelen, Leena Pelttari and Ros Scott, members of the European Association for Palliative Care (EAPC) Volunteering Task Force, reflect on the evaluation of the EAPC Madrid Charter on Volunteering in Hospice and Palliative Care.

Left to right: Steven Vanderstichelen, Ros Scott and Leena Pelttari.

The EAPC Madrid Charter on Volunteering in Hospice and Palliative Care (HPC) was launched in 2017 to advocate for the support, recognition, promotion and development of volunteering in HPC. The Charter was promoted heavily in the years following its launch and was translated into 14 languages (Dutch, Danish, Finnish, Flemish, French, German, Hungarian, Italian, Norwegian, Polish, Portuguese, Serbian, Spanish and Russian) and can be found here. It has been signed digitally and physically by almost 4,000 people from 50 countries and correspondence from a hospice in New Zealand indicates that it inspired them to develop their own local charter to guide the development of their service.

This enthusiasm for the Charter was rewarding and we had a feeling that it resonated with many volunteers, volunteer coordinators, clinicians and researchers. However, we had no way of knowing what kind of impact the Charter had really made in practice. Declarations of intent, such as charters, have become quite prominent in the field of palliative care; however, the fact that they are rarely evaluated, and that their impact is often assumed a priori is problematic.1 If charters should not be made for their own sake and their goal is to effect change and improve practice, then evaluation of whether they achieve this goal is essential. For this reason, we set up an online survey to assess the impact of the Madrid Charter, in terms of awareness, reach, and use, and to evaluate its perceived usefulness.

We found that the Charter was used mainly in policy-oriented contexts. Additionally, many participants highlighted the potential of the Charter as an advocacy tool in a range of areas including national and local funding and policy negotiations and in promoting the development of HPC volunteering. This stresses the relevance and value of the Charter in advocating for volunteering. However, results also highlighted the lack of immediate use of the Charter to develop practice. While the Charter’s third aim was a call to action, this suggests that more efforts may be needed on that front.

Charters may be useful as policy tools for long-term change but may lack value as practical tools for immediate change. Promoting HPC volunteering may, therefore, require a two-pronged approach. This may entail the development of a toolkit aimed at both decision makers and practitioners, encompassing the spectrum of volunteering from informal to formal, linking key areas of the Charter to existing country resources, illustrated by case studies.

The aspirational statements within a Charter are not enough in themselves and a multilayered approach may be necessary, with accompanying practical tools and examples. If we are to be effective in promoting and supporting the unique resource that is hospice and palliative care volunteering, we should offer volunteers and volunteer coordinators practical means by which they can improve their immediate circumstances in the short term.

Download a copy of our longer article published in ‘Progress in Palliative Care’…

The paper has been set to open access for one year and can be read here.2

The EAPC Task Force on Volunteering recently concluded its second term. However, there are plans to continue this important work. Expect to hear more about our plans in the near future! View more posts relating to Hospice and Palliative Care Volunteering on the EAPC blog, including a special tribute to the work of the EAPC Volunteering Task Force.


  1. Inbadas, H., Zaman, S., Whitelaw, A., & Clark, D. (2016). Palliative Care Declarations: Mapping a New Form of Intervention. Journal of Pain and Symptom Management, 52(3), e7–e15.
  2. Vanderstichelen, S., Pelttari, L., & Scott, R. (2021). Evaluating the EAPC Madrid Charter on volunteering in hospice and palliative care: Reflections on impact. Progress in Palliative Care, 1–8.

Links and resources


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