In May 2013 the EAPC Congress take place in Prague. The member of organizing committee in Czech Republic, Martina Špinková, asked Lukas Radbruch, Chair of the Scientific Committee, several questions on this topic.
The Congress in Prague emphasizes human rights. For what countries in the world are you personally concerned about this topic most?
I am concerned about the access to palliative care as a human right for most of the countries in Africa, Asia and Latin America. However, this human right is in danger not only in regions that are far away, but also in quite a number of European countries. When I visited Albania in the summer, I saw how the few palliative care services struggle to provide palliative care to at least a few patients, but the vast majority of patients are not able to access palliative care when they need it. The Human Rights Watch has published a report on Ukraine recently, describing how patients suffer from pain because they do not have access to opioids or palliative care. Many of the countries that collaborate in the ATOME project (Access to Opioid Medications in Europe) describe a lot of barriers and problems which make it difficult to access opioid treatment.
That is true – unfortunately we know it only too well from our own patients even though opioids are available in the Czech Republic: physicians are afraid and do not use them…
I know from my own experience, how encouraging (and even comforting) is meeting people working in the same field from all over the world. I hope lot of people will come back home from Prague encouraged? The EAPC congresses provide a unique opportunity to meet colleagues from all over the world and discuss common problems and new ideas, and to get inspiration from others who have managed to overcome problems and barriers. And you can listen to renowned experts in the field lecturing about their top-actual research work.
And what about you personally– is there anything special you are looking forward to this time?
There is a number of EAPC workgroups, task force meetings and other groups that will carry out their work, and procure guidance on various aspects of palliative care. I am looking forward to that outcome of the congress. I also am looking forward to meeting some professional friends from all regions of the world, and to listen to a broad scope of speakers and topics. We also have launched the Prague Charter recently, urging governments to acknowledge palliative care as a human right, and this Charter will be one of the main focus points of the Prague congress.
The Prague Charter is very important. We are pleased, that Congress takes place in Prague, even though we know palliative care in our country is wide of real quality state… Do you expect this event could help not only encourage caregivers, but also induce officials and decision makers to both understand the problem and solve it?
I am happy that the congress is in Prague as we hope that this will promote and foster the development of palliative care in Czech Republic by two means: allowing Czech physicians and nurses participate and learn more about palliative care from international experts, and to show politicians and other decision makers that palliative care is an important issue and is worthwhile to have!
Perhaps some of them will read this interview: what would you recommend them to do first?
Promote and develop a national strategy for palliative care, which describes how palliative care can be provided to all those who need it, who will provide it and how it is going to be financed.
Such a common thing: dying well. And in spite of it so much lectures, congresses, persuading people…If you’d have magic wand and could make something in the world better, what would you do?
I would convince decision makers all over the world that opioids are not dangerous if used correctly for pain management and palliative care, and that they should remove barriers and obstacles until all patients in their country that need opioids get them.
And is there something special in the field of palliative care in last years you are happy about, proud of?
There is a lot to be proud of. The most recent thing: two international palliative care associations, the IAHPC and the WPCA have become official partners of the WHO, which also means that they have a much stronger voice in the global health care development.
Do you see the future of palliative care more in the palliative care teams offering professional care at patient’s home (or elderly homes) or in the inpatient hospices?
There seems to be a consensus all over Europe that staying at home is preferred by most patients, and that home care teams should be the major pathway. Inpatient hospices are needed for a minority of patients, where complex problems and lack of care givers from the family prevent home care.
And one bold question at the end about the end: even we “palliative people” are approaching death. Do you have any wish – expectations about the last time of your life?
Yes, that I want to be very old when it happens J. And that I will be content and happy to look back a full life.
Lukas, thank you very much for interview!