Policymakers, key professionals, providers, and funders of health services are recognizing the advantages of palliative care and the right of patients with life-threatening illnesses to receive this care along with regular medical treatment.
MJB’s studies have highlighted the contribution of palliative care to improved patient well-being and health system cost savings. Yet despite the fact that as early as 2009 Israel’s Ministry of Health issued guidelines obligating the national health plans to offer palliative care and to train staff accordingly, the provision of palliative care in Israel remains low.
Palliative Care Education
One reason for the low levels of care is the shortage of specialists and trained personnel with knowledge and skills in palliative care. Compounding the challenge is an inconsistency in palliative care educational programs. A 2017 study by MJB found, for example, enormous variance among programs, with little similarity in how professionals even understand and define what palliative care education should encompass.
Physicians and Palliative Care
The challenges also extend to physicians who have already been trained in palliative care. A 2016 study found that, while 70% of physicians surveyed said that they had the skill to treat patients according to palliative principles, the rate of those actually using these principles is much lower. The physicians blamed the gap on a shortage of palliative services, a lack of guidelines on appropriate timing for referral, and the fact that many available services are exclusive to cancer patients.
Patients and Palliative Care
The same study also found that public attitudes toward end-of-life care are similarly complex and not always consistent. More than 80% of people surveyed said that quality of life is more important than length of life, and that they would like to choose their type of care and have their preferences taken seriously. But almost half the general public had never heard of palliative care or of treatments to ease end-of-life suffering and improve the quality of life in the end-of-life period. And at the same time, 60% said that in the case of an incurable illness, they would want everything done to save their lives, and 53% believed that advance care planning is unnecessary.