What happens when palliative care is neglected as a public health priority?

New series: Palliative Care and Public Health – where contributors will explore how we can make sure that palliative care becomes part of public health and a health care priority.

To launch the series, our guest writer Luc Deliens, Professor of Palliative Care Research and Chair of the EAPC Reference Group on Public Health and Palliative Care, explains what happens when palliative care is neglected as a public health priority.

Professor Luc Deliens. (Photograph phototonyphillips.com)

The Covid-19 pandemic has exposed and magnified many of the weaknesses of our healthcare systems, including the lack of access to palliative care for patients dying alone with Covid-19. It is striking how little we have heard in the general media about palliative care in this pandemic, a symptom of how it is under-valued as a public health priority in our societies.

Covid-19 has a major impact on people, not only physically, but also mentally. Once someone is ill, there is uncertainty about the course of the disease, the symptom burden and the treatment. If an infected person has the misfortune to need hospitalisation, and the good fortune to receive it, a terrible period follows on the ward or, worse, in intensive care. Patients don’t know if they will be able to see their families again and many thousands have died without ever doing so. The conditions for those bereaved become unbearable when they cannot say a proper goodbye. After such a death, family and friends are confronted with intense emotions of shock, pain, anger, guilt and loss.

The coronavirus has already caused many deaths in most countries, but the governments responsible for the management of the pandemic have given little attention to palliative care. In palliative care, dealing with end-of-life care for both the patient and those close to them is part of everyday work. How come it was not a priority in this pandemic? The answer is simple – palliative care is not considered part of public health and is not a health care priority.

Patients with Covid-19 may deteriorate rapidly. It is, therefore, all the more important that palliative care is called in promptly and efficiently. People expect medicine to cure people, and if that is not possible, to try to prolong lives. However, what we should always be able to expect from modern medicine is to provide as much comfort care as possible, aimed at preserving or increasing the quality of life. Many Covid-19 patients exhibit severe and distressing symptoms, including shortness of breath, agitation, coughing and extreme fatigue, the most common.

Palliative care should become a human right in all societies and systematic prevention of suffering should be a core task of public health systems. In this pandemic and in cases in which it had been possible, palliative care has certainly not always been guaranteed for Covid patients. Many died in undignified and horrendous circumstances, often separated from family and friends for days or weeks, or in touch only as a face on a screen.

Dying is first and foremost an existential and social experience, and the deprivation of loved ones cuts off all concerned from essential sources of quality of life. In hospitals, at home and in residential care homes, palliative care often had no place. Unless palliative care becomes a top priority for public health, equal to the prevention of illness or health promotion, it will never achieve priority from governments, as has been painfully demonstrated in this Covid-19 pandemic.

Join us at the 7th Public Health Palliative Care International Conference in beautiful Bruges in Belgium – submit your abstract!

We hope you will enjoy the new series and that you may also wish to join us at the 7th Public Health Palliative Care International Conference, which our EAPC Reference Group is jointly organising from 20 to 23 September 2022. And there is still time to play a part in the conference yourself by submitting an abstract! Abstract submission deadline: 31 January 2022, more information here.


Look out for the next post in this series when the guest writer will be: Dr John Rosenberg, President of Public Health Palliative Care International.


  • Free global launch of the Lancet Commission on the value of death – Tuesday 1 February at 1-3 pm GMT. Register here.
  • The Lancet Commission on the value of death in-person conference 

    at the Royal Society of Medicine, London, UK, on Tuesday 1 March 2022. Register here.


APPLY FOR EAPC Researcher Awards 2022. Submit your application by 31 January 2022.

This entry was posted in ADVOCACY & POLICY, Coronavirus and palliative care, EAPC Task Forces/Reference Groups, PATIENT & FAMILY CARE, public health palliative care and tagged . Bookmark the permalink.

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