Declaration and Call-to-Action on Palliative Care & COVID-19

Witnessing, with the rest of the world, the overwhelming physical, social, emotional and spiritual suffering COVID-19 is inflicting on infected persons and their families globally;

Recognizing that palliative care is aimed at prevention and management of serious health-related suffering[1];

Observing with great concern that the persons infected with COVID-19 are isolated from their families, and may never see them again;

Deeply concerned that the families of those who die from the disease typically may be permitted only one last look at the person’s body from some distance, and are deprived of the comfort of one last touch;

Recalling the World Health Assembly Resolution 73/1 of 19 May 2020[2] which calls upon member states to include palliative care in their COVID-19 response;

Noting with satisfaction that the WHO “Interim Guidance for Clinical Management of COVID-19[3]” includes the statement that “basic palliative care, including relief of dyspnea or other symptoms and social support, should be practiced by all doctors, nurses, social workers and others caring for persons affected by COVID-19,” lays out the ethical principles for optimum care, and includes the “Essential Package of Palliative Care Medicines” in the Appendix;

Relieved that all essential modalities for integration of palliative care with COVID-19 management are inexpensive to produce;

Dismayed that health systems around the world seem to have done little to integrate palliative care in their response to date, and hoping they will implement the measures advised in such guidance.

 

We call on

All healthcare systems to:

  • accept the ethical and moral responsibility to treat COVID-19-related suffering by integrating basic palliative care, including for vulnerable groups such as children (neonates to adolescents); refugees, internally displaced persons and migrants; older persons; persons with disabilities; prisoners; LBGTQI and the homeless;
  • immediately provide online palliative care curricula (that include principles of humanitarian health response) to all healthcare providers involved in management of COVID-19;
  • ensure access to essential medicines for providing palliative care to people with COVID-19 including controlled medicines;
  • study the consequences of grief among the bereaved and generation of care systems aimed at the above; and
  • mandate a strategy for integration of palliative care in all COVID-19 management across all ages and in all settings.

 

Authors: Board of the Elisabeth Kübler-Ross Foundation

Rajagopal MR ; Connor S; Gray D; Luz R; Marston J; Ross K; Rothwieler B.

[1] Knaul FM, Farmer PE, Krakeur EL et al. Alleviating the access abyss in palliative care and pain relief—an imperative of universal health coverage: the Lancet Commission report. The Lancet 2017; The Lancet, 391:10128 http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32513-8/fulltext

[2] World Health Organization. 73rd World Health Assembly. 19 May 2020.

[3] World Health Organization. Clinical Management of Covid-19. Interim Guidance. 27 May 2020. P 46-47.