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    28 february, 2019

    Palliative care no longer defined as an exclusively medical service

    Author: Alexander Tkachenko, no comments

    The State Duma adopted in the third reading legislative amendments to Federal Law 323-FZ on the Foundations of Healthcare of Citizens in the Russian Federation, concerning palliative care. It is these amendments to the current law that have been discussed in the media, including social media, and have become known as the Law on Palliative Care.

    By the time of the third reading this legislative initiative had passed through many serious public hearings and reflects more precisely the opinion of the expert community and public organizations than the initial version. “Zero” hearings were held in the Civic Chamber and discussions were held in the regions. Participants in the meetings of medical experts and representatives of patients’ organizations discussed issues related to expanding the very definition of palliative care, accessible pain relief and different aspects of support for palliative patients at home.

    The main point is that the definition of palliative care as an exclusively medical service is finally obsolete. Bringing together medical, psychological, social and spiritual help should make cooperation between healthcare centers and social protection institutions possible and even mandatory. This will substantially improve quality of life for patients with even the gravest illnesses.

    The law opens up opportunities for effective pain relief. This is very important. Much will still have to be updated and regulated but I hope the scandals that rocked palliative care just five years ago will become a thing of the past.

    I hope it will be easier for state institutions to help not only patients but also their whole families. After all, when someone close to you falls seriously ill, it is one of the worst ordeals in life, and sometimes relatives need help as much as the patient.

    I am sure that the adopted law will act as a catalyst for the development of palliative care in the regions where it has been inaccessible so far.

    That said, I’m still skeptical to some extent. In my experience legislative changes should not be perceived with euphoria as a real breakthrough, a new era in palliative care. A new era will dawn when every person with a serious illness is guaranteed a decent quality of life until his last breath. And so there is still a lot of work ahead.

    I think these legislative innovations should be followed by a change in the practice of caring for seriously ill people in every region, the allocation of funds for this purpose and the introduction of changes to other regulatory acts.

    These changes should affect the legislative foundation not only in healthcare but also in social protection, state procurement and rules on equipping institutions.

    We will have to develop and propose plans for structuring interdepartmental cooperation in every municipality. This work should be focused on the needs of palliative patients rather than departmental instructions and the views of officials.

    I will repeat the words I spoke during consideration of the legislation in the State Duma. We find ourselves at a unique moment of opportunity, when amendments to the law have significant public backing. But it is up to each of us to determine the extent to which we seize this opportunity created by the attention of the government and the President himself to this issue.

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