Do you know what palliative care is? Understand why the CPI used

The Brazilian Academy of Palliative Care (ANCP) issued a letter to senators from Covid’s Parliamentary Inquiry Commission (CPI) criticizing the misuse of the term “palliative care” or “palliative care”.

Prevent Senior users accuse the company of using palliative care as a tool to induce elderly covid-19 patients to die, as a way to reduce hospital stays and thus reduce costs. In the Senate, the members of the CPI alluded to such accusation without, however, correcting or explaining the use of the term “palliative treatment”.

::Prevent Senior in the CPI: fraud in death certificate, early treatment and parallel office::

The ANCP letter informs that this is far from the goal of palliative care. “We would not like to be associated with the bad practices that the CPI points out, with good intentions, but out of ignorance. Let them use whatever term they want: homicide, euthanasia, but that has nothing to do with palliative care.”


According to Juliana Dantas, journalist of the award-winning Finitude podcast, about death and mourning, Palliative Care (PC) has nothing to do with delaying or accelerating the process of death.

Rather, it is an approach that involves a series of specialists from different fields who work together to improve the quality of life of patients who have any type of life-threatening disease, such as covid.

“The entire team becomes horizontal and the priority is the patient and the family. There is a doctor, but, just as important, there are nurses, occupational therapists, speech therapists, physiotherapists, social workers, spiritual assistants, for example.”

In other words, it is the effort to enable death in natural time, with comfort and quality, dealing with physical pain and psychological, social, cultural, family problems, among others.

“Palliative care is the support for the person to have their own natural course of life and death. It has to do with death at the right time, orthothanasia”, which is different from euthanasia, the process of accelerating death, and dysthanasia, the artificial extension of this process.

“Often, when we are looking only for a cure, we forget that there is a human being there. If there is nothing else to do for the disease, how are we going to treat this human being who has discomfort, nausea, all physical, existential, social, family, spiritual symptoms, all of that?”, he exemplifies.

In this sense, those who promote palliative care always weigh the cost-benefit of the intervention in relation to the result that can be achieved. For example, if intubating a patient may generate little or no results, “why commit the violence of this intervention with this person?”.

Another point of confusion is who is the target of palliative care. As said by Dantas, the approach can be made available to patients who have any type of illness that is life threatening. That doesn’t mean it’s just for incurable illnesses or terminally ill patients. It can be, but not necessarily.

“In Brazil, people die very badly”

Unfortunately, palliative care is far from being a reality in Brazil. The country has only 191 palliative care services. For the size of the Brazilian population of 213 million, according to the Brazilian Institute of Geography and Statistics (IBGE), the number should be approximately 2,000 services, according to Dantas.

If, on the one hand, portions of the population with high financial condition try at all costs to postpone the process of death, bringing unnecessary suffering to patients, on the other hand, there is the opposite scenario: “when the patient dies, for example, in a queue, for lack of care, for medical negligence, which is the other end of a bad management of a situation, of a death without quality and dignity”.

Prevent Senior on the opposite hand

From the accusations against the Prevent Senior health care provider, if proven, it can be said that the implemented practices definitely cannot be classified as “palliative treatment”. Within the classifications, they would actually be close to processes to expedite wrongful death.

A different scenario is that of the Unified Health System (SUS). Palliative care is a right and, therefore, it is available in public health agencies. Of the 191 palliative care services existing in Brazil, 148 are from the SUS.

“The problem is that the fact that we are not aware of this right makes us not ask for it. Only with information can we have all the cards on the table to be able to make our decisions”, says Dantas. And therein lies the problem of the term being used incorrectly. There is a risk of increasing prejudice about a practice that is positive.

“It is very dangerous for us to put palliative care as a negligence, a euthanasia, which has absolutely nothing to do with it, as if it were only for terminal patients.”

“It’s a very fine tune. I say it’s almost witchcraft. Very personalized, always shared decisions. It is never a unilateral decision by the medical team and it is never something that goes unexplained. Just then, by the accusations against Prevent Senior, we get this average that it was absolutely not palliative care”, says Dantas.

Edition: Anelize Moreira

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