Palliative care: Progress, needs, and challenges

This is a commentary on http://www.ijhpr.org/content/1/1/9/ webciteThe important paper by Bentur et al. [1] captures the range of challenges to the inclusion of palliative care in medicine. Various clinical, economic, cultural, and institutionalized systems and practices all impinge on the ability of Israel and other countries to bring about this needed component. Moreover, the effort to accomplish that goal occurs in the context of simultaneous efforts by other groups to deal with the same problems that are targeted by the Palliative Care medical subspecialty.This brief Commentary touches on: (1) palliative care terminology and its extent world-wide, (2) ethical and human rights perspectives, and (3) potential collaborations and other means of reaching palliative care goals.The term "palliative care" literally means palliation or comfort provided to the ill. The article to which this Commentary responds gives the definition as "... palliation for anyone who needs it, no matter their prognosis." However, despite this statement and effort in the Palliative Care community to extend its purview to patients at all stages of illness, the internationally common use of the term refers to the relief of physical and emotional suffering among the terminally ill. Managing pain and other physical or emotional distress in patients under active treatment geared to remission or cure is commonly termed "symptom management" or "supportive care", rather than "palliative care". While it may seem reasonable to combine the two, doing so may lead to less than optimal results as the unique requirements of each may be left unmet.The World Health Organization (WHO) defines palliative care as the provision of "... relief from pain and other distressing symptoms that affirms life and regards dying as a normal process; (and) intends neither to hasten or postpone death..." [2].This definition of terms in the WHO document exemplifies the international focus on palliative care. Through numerous n