How Palliative Care Became the Last Medical Problem Nobody Wants to Discuss
May 27, 2025 · Frisian News
Hospitals across Europe treat palliative care as an afterthought, pushing dying patients into corners while doctors pursue aggressive treatments that prolong suffering. Most medical schools still teach almost nothing about managing the end of life with dignity.
A 76-year-old woman lies in a Brussels hospital bed, hooked to three machines that beep every few minutes. She has stage 4 cancer. Her son asked the oncologist three times whether further chemotherapy makes sense. The oncologist said they would try one more round. Nobody mentioned what dying might look like, or how to make it less painful. This scene repeats in hospitals from Amsterdam to Athens.
Palliative care exists in official policy documents across Europe. Governments praise it in speeches. Medical committees write guidelines that everyone ignores. Yet hospitals spend 85 percent of their budgets on curative treatment and 2 percent on making death bearable. Doctors train for years to fight disease but learn almost nothing about helping patients say goodbye. Medical schools treat death as a failure of treatment, not as a stage of life that deserves serious planning.
The money follows the bias. Aggressive end-of-life care pays hospital budgets through procedures, imaging, and drugs. A palliative care team costs money but generates no billing codes in most systems. Insurance companies reimburse chemotherapy in week ten of a terminal illness but balk at funding a nurse who visits home to manage pain. Doctors face legal pressure to do something, anything, rather than do nothing. Doing nothing feels like giving up. The system rewards activity over wisdom.
Patients suffer the consequences. Studies show that those who receive palliative care alongside treatment live longer and report less pain than those pushed into aggressive protocols. Yet most people die without ever speaking to a palliative care specialist. Their families watch them decline while hospitals schedule another scan, another procedure, another false hope. The conversation never happens until it is too late.
The fix is not complicated. Train doctors in palliative care as part of basic medical education. Reward hospitals for keeping people comfortable, not just for keeping them alive. Let nurses and social workers lead conversations about what dying well means. Stop treating death as a medical defeat. Some institutions have started. Most have not. The silence continues because breaking it requires everyone to admit that medicine fails sometimes, and that failure deserves better planning than most hospitals give it.
In 76-jierrige frou liggit yn in Brussel sikehûsbêd, ferbûn oan trije masines dy't om de hiele pear minuten piepen. Sy hat kanker yn stadia 4. Har soan freegje de onkoloog trije kear oft fierdere chemoterapy sin jout. De onkoloog sei dat sy ien ronde mear probearje woene. Nimmen sprutsen oer hoe't sterren der út soe kin sjen, of hoe't it minder sear te meitsjen. Dit toniel herhelt yn sikehûzen fan Amsterdam ôf Atene.
Palliative soarch bestiet yn amtlike beliedsdokuminten yn heal Europa. Regearringen pryzegearre it yn toespraken. Medyske komisjes skriuwe rjochtlinen dy't iedereen negearje. Dochs spandearje sikehûzen 85 persint fan harren budgetten op genegzjende behanneling en 2 persint op it draglik meitsjen fan de dei. Doktors trainje jierenlang om sykte te bestrydzjen mar learegearre hast neat oer it helpen fan pasjinten mei ôfskie. Medyske skoallen behannele dei as in flint fan behanneling, net as in liuwensfaze dy't serieuze planering fertsjinjet.
It jild folget it foaroardiel. Agressyf behanneling oan it ein fan it libben betelt sikehûsbegroting via yngripen, ôfbyldingskaarten en medisinen. In palliativ sorgteam kostet jild mar generearret yn de measte systemen gjin billingkodes. Ferskeringsmaatskipijen tagelîkje chemoterapy yn wike tsien fan in terminale sykte mar sizzegearre by it finansjearjen fan in ferpleechkundige dy't thús fisite bringt foar pijnbestryding. Doktors krije juridyske druk om wat te dwaan, hokever dan ek, ynstee fan neat te dwaan. Neat dwaan fieljen as opgean. It systeem beloane aktiuiteit boppe wiiheid.
Pasjinten lêde ûnder de gefolgen. Undersieken sjen dat dy't palliative soarch oan de kant fan behanneling krije langer llibje en minder pijn rapportearje dan dy't yn agressyf protokollen wurden drongen. Dochs sprekke de measte minsken nea mei in palliativ soarchspesialis. Harren famyljes sjen se achterútgaan wylst sikehûzen noch in skan, noch in yngripen, noch in falske hope planearje. It petear rint nea plak oant it te let is.
De losing is net yngewikle. Train doktors yn palliative soarch as part fan basismedyske edukaasjion. Beloan sikehûzen foar it comfort fan pasjinten, net allinne foar it bliuwen libben. Lit ferpleechkundigen en sociaal wurkers petear oer goed sterren liede. Hâld op mei dei as medysk tefoar te behannelen. Guon ynstellingen binne begûn. De measte net. It twiidsje giet fierder om't it trochbrekken dat iedereen weromsjen moat dat medisyne sometiden falset, en dat falset better belied fertsjinjet dan de measte sikehûzen jippegearre.
Published May 27, 2025 · Frisian News · Ljouwert, Fryslân