Palliative care in Portugal and Europe: different concepts and organizational models, different levels of development, different needs and (potential for) further development

Diverse international organizations have been defining palliative care in different ways. As an example, while the World Health Organisation defines palliative care as an approach that improves the quality of life of patients and their families when facing a life-threatening disease, other associations, as the European Association for Palliative Care, have been defining palliative care as an active type of care provided to a patient whose disease is not responsive to curative treatment. Although complementary and with similarities, these definitions have been influencing the way palliative care has been developed and implemented across different countries in Europe. Moreover, the development of palliative care in Europe is heterogeneous. This points out to the existence of different levels of development, indicating inequalities in the availability and accessibility of this type of care among European citizens. The objectives of this presentation are: (1) to reflect on how different concepts may influence the organization of palliative care resulting in diverse levels of development, and (2) to highlight the need and potential for further developments of palliative care in Portugal to make it accessible to all citizens who are in need of such type of care. Three country-cases will be presented and analyzed with regard to three diverse levels of development: Germany (advanced integration of palliative care), the Netherlands (preliminary integration of palliative care) and Portugal (generalized provision). Questions will be raised on why these three countries present diverse levels of development. In addition, a set of inequalities in the access to palliative care in Portugal will be enounced: geographic, financial, diagnose-related, and age-related. Based on the right of all citizens to palliative care, the intrinsic potential for further developments of this type of care in Portugal will be highlighted.