I would like to welcome all who are participating in this International Conference, \u201cPalliative Care:\u00a0 Everywhere and by Everyone.\u00a0 Palliative Care in Every Region.\u00a0 Palliative Care in Every Religion or Belief.\u201d\u00a0 The Pontifical Academy for Life is pleased to sponsor our Conference as part of its PAL-LIFE Project, whose goal is the spread and development of palliative care in the several areas of our planet.<\/p>\n
\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Dispelling a misunderstanding: \u201cpalliative\u201d is not the same as \u201cineffective.\u201d<\/em><\/p>\n The Pontifical Academy for Life has studied this question in the past; but, precisely because of its importance, we felt it necessary to follow up with a further reflective and creative exercise.\u00a0 We are convinced that a real change of perspective is needed to overcome a widespread conceptual and linguistic misunderstanding that affects the expression \u201cpalliative care.\u201d\u00a0 The phrase needs to be put into better focus within the larger world of medicine, which today has powerful and effective tools to combat a wide range of diseases and significantly improve health conditions worldwide.\u00a0 Notable advances in scientific knowledge have led contemporary medicine to consider physical healing its sole purpose, and to risk paying more attention to its own struggle against disease than to the patient and his or her needs as a whole person.\u00a0 We must never forget that every therapeutic effort (\u201ccure\u201d) has meaning only in the context of that deep personal relationship that is an integral part of \u201ccaring for\u201d the sick.\u00a0 Thus, it is a mistake to consider that medicine has necessarily failed when a patient does not recover.\u00a0 Among the many errors that result from that approach is a reliance on treatments that are excessive or not indicated and that result in disproportionate suffering.\u00a0 In short, doing everything<\/em> possible (if this means using all available modalities always and no matter what) can mean doing too much <\/em>(that is, an excess that harms the patient).\u00a0 Doing more does not always mean doing better.<\/p>\n There is another risk that must be avoided:\u00a0 abandoning the patient as soon as a cure is no longer possible.\u00a0 Even if we can not cure, we can still alleviate pain and suffering and continue to care for the patient. The \u201cincurable\u201d patient is never \u201cbeyond care.\u201d\u00a0 Without this conviction, the medical profession can easily fall into \u201ctherapeutic abandonment\u201d (\u201csince no cure is available, there is nothing worth doing\u201d) or in a slide toward euthanasia (\u201cbetter to end it all\u201d).\u00a0 Palliative care, in opposing these two risks, helps the medical profession rediscover its humanistic vocation, which is\u00a0 to defend the dignity of every person in whatever condition that person might be in.\u00a0 Experience confirms that behind every request for euthanasia or assisted suicide there are always two fears: fear of abandonment and fear of pain.\u00a0 Here it is important to dispel a misunderstanding, present in certain languages, that considers \u201cpalliative care\u201d a euphemism for \u201ceuthanasia.\u201d\u00a0 In reality, euthanasia and assisted suicide form no part palliative care.<\/p>\n On the contrary, palliative care is a way to reduce the number of requests for euthanasia, and to show how medical personnel, family and friends are united in providing the patient with accompaniment that is a loving consolation.\u00a0 And we must make it clear that, contrary to popular opinion, palliative care does not cease when no cure is possible.\u00a0 In fact, there is always room for palliative care, at least at the level of principle and technique.\u00a0 Think, for example, of the combination of pain management and therapeutically powerful personal accompaniment.\u00a0 We need a new medical culture, one that sees medical interventions and palliative care as two sides of the same coin.\u00a0 Cure and palliative care should be integrated with each other and collaborative.\u00a0 The notion that governs both is, as I mentioned earlier, \u201ctaking care of\u201d the patient, even in a home environment.\u00a0 This is how to fight the fairly widespread misunderstanding that “palliative” means “useless” and “ineffective.”\u00a0 Unfortunately, the persistence of this confusion explains the resistance to palliative care in public opinion, even when its importance is recognized.\u00a0 There might even be appropriate laws that govern the question, but that, because of this ambiguity are unknown or not enforced. Greater public awareness of palliative care is needed urgently, in political as well as medical contexts, and I believe that further research into the palliative care dimension of medical science is needed as well.<\/p>\n \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Palliative care as a collaborative effort<\/em><\/p>\n I am convinced, in fact, that medicine, in the sense of “taking care” of the patient needs a new cultural perspective that highlights the centrality of the human person in the face of the great challenges posed by the development of science and technology.\u00a0 Every man, every woman, in whatever condition they find themselves, have a right to be cared for in their need.\u00a0 And each of us needs to rediscover our duty of reciprocal attention, with the consequent obligation to care for one another\u2014in body and in spirit.\u00a0 Hence the urgency of promoting a culture of accompaniment that alone is able to counteract the individualistic narcissism that is increasingly weakening, and even corrupting, the fabric of our societies.\u00a0 I believe that palliative care\u2014by reason of the way it unites medical personnel from different fields, family and friends around the patient\u2014performs a greatly humanitarian service but at the same time assists in rebuilding a culture of solidarity that renders globalization truly human.\u00a0 For this reason, I am hoping for a broad alliance among men and women of different cultures and faiths that will promote united, bold and creative action in order to spread the acceptance of palliative care throughout the world.\u00a0 This is the purpose of our meeting.\u00a0 In this context, as a Christian, I see in the Gospel parable of the Good Samaritan an ideal icon that describes the vocation of palliative care very well.\u00a0 In the parable it is the strength of compassion that pushes the Samaritan to stop beside that half-dead man, give him first aid, load him on his donkey, take him to the inn, entrust him to the innkeeper, and guarantee the payment of his expenses.\u00a0 It is a story from the Gospel, but its meaning is universal.\u00a0 It challenges every indifference, breaks down every barrier, rediscovers the radical fraternity that unites us, beyond all our differences.\u00a0 I believe that the call for fraternity in this parable is universal.\u00a0 It makes us all responsible for the weakest, for those who have the most need for accompaniment.\u00a0 Likewise, the palliative care movement is a part of this movement of compassion and of accompaniment.\u00a0 It makes us rediscover that human fraternity that is called upon particularly when we are facing the last moments of earthly life.<\/p>\n I ask you\u2014still speaking as a Christian, but in a way that I am sure resonates with other religious and humanistic perspectives\u2014whether we should give a new name to the seventh Corporal Work of Mercy.\u00a0 The first six, as we know, are an invitation to give food, drink, dress those who are naked, welcome those who are foreigners, visit the sick and prisoners.\u00a0 The last invites us to \u201cbury the dead.\u201d\u00a0 Should we not change the phrase to \u201caccompany the dying\u201d?\u00a0 The example of Saint Teresa of Calcutta is particularly authoritative, and palliative care is a central part of her same religious and humanistic tradition.<\/p>\n The PAL-LIFE Project<\/em><\/p>\n In closing, permit me a word about the PAL-LIFE Project.\u00a0 During the Audience granted to the participants in the XXII General Assembly of the Pontifical Academy for Life, in the context of which the workshop “Assisting the Elderly and Palliative Care” was organized, Pope Francis said the following: \u201cI appreciate your scientific and cultural commitment\u00a0 to ensuring that palliative care can be available to all who need it.\u00a0 I encourage professionals and students to specialize in this form of assistance, which has no less value for the fact that it does not save lives.\u00a0 Palliative care creates something equally important: it gives dignity to the person. I urge all who, in various capacities, are involved in palliative care to put this commitment into practice by keeping intact a spirit of service and remembering that all medical knowledge is truly a science, in its noblest sense of the word, only if it promotes human good, a good that is never achieved \u2018against\u2019 human life and dignity.\u00a0 It is the capacity for service to the life and dignity of the sick, the elderly, that measures the true progress of medicine and of society as a whole.\u00a0 I repeat the appeal of St. John Paul II: “Respect, defend, love and serve life, every human life!\u00a0 Only on this path will you find justice, development, true freedom, peace and happiness!\u2019\u201d<\/p>\n Desiring to follow the words of the Holy Father, in March, 2017, the Pontifical Academy for Life launched the PAL-LIFE Project, establishing an international Study Group to promote the development and spread of palliative care around the world and to promote a culture of accompaniment of the weak and of those who are facing the last days of their earthly lives.\u00a0 Through this project, the Academy hopes to promote a greater sensitivity in Christian communities and civil society to the development of palliative care everywhere.\u00a0 The Academy\u2019s wish is to interact with other academic institutions and scientific organizations to promote palliative care and to work with the various stakeholders to carry out concrete initiatives.\u00a0 From March, 2017 until today several activities have been brought to completion, including cooperation with the “Pallium India” Association (currently headed by Dr. M.R. Rajagopal) and the Catholic Health Association of India. Our entire Group of Experts has also worked on the drafting of a “White Paper for Global Palliative Care Advocacy,” which I would like to present officially at the end of this Conference.\u00a0 We would also hope to participate in the work of international bodies, in particular the United Nations, working closely with Liliana De Lima and Katherine Pettus of the International Association of Hospice and Palliative Care.\u00a0 We also want to start other Working Groups concerned with deepening spiritual care in the context of palliative care, and a seminar on this subject was held last August with the guidance of Prof. Christina Puchalski.\u00a0 Finally, of particular importance was the Conference on End of Life issues organized last November in partnership with the European Region of the World Medical Association.\u00a0 In the light of the shared humanist roots that nourish our work, I am sure that during these days we will work together effectively, growing in our shared knowledge, and I wish all of you a very productive experience.<\/p>\n