Just tenth of approved palliative care medicine available, professor says

Terminally ill patients in Malta have access to only 10% of palliative care medicines approved by the World Health Organisation for use in the European Union, Fr Emanuel Agius, a professor of moral philosophy and moral theology, said.

He noted that one in five – 20% – of essential palliative drugs can only be accessed through private channels, meaning patients have to pay for them or rely on funding.

Agius was speaking during a seminar, titled ‘Rethinking Death and Dignity’, organised by the Association of Child and Adolescent Mental Health and the Malta Association of Psychiatry Trainees.

The event addressed the subject of euthanasia after the government launched a document for consultation that has largely divided the public, with some calling for the introduction of assisted dying and others lobbying for improved palliative care instead.

Agius contrasted Malta’s “rushed” two-month consultation on euthanasia with France’s years of extensive discussions prior to enacting similar legislation.

He criticised the term “assisted voluntary euthanasia” used in the consultation document as misleading, saying it blurred the critical distinction between physician-assisted suicide and euthanasia. Under the current proposal, euthanasia would have to be self-administered by terminally ill people who are given six months or less to live.

Agius strongly advocated for increased investment in palliative care, to ensure the preservation of human dignity until natural death occurs.

He echoed the words of retired medical professor Joseph Azzopardi, who said that palliative care patients require access to a wide range of care and medications to treat symptoms such as severe pain and depression, yet, current bureaucratic hurdles often restrict the availability of strong, effective treatment.

Azzopardi called for the creation of a dedicated department of palliative care within the department of health, a separate palliative care module in the Medical School and an increase in consultants, trainees and specialised nurses in terminal care.

A specialist in internal medicine, diabetes and endocrinology, Azzopardi highlighted significant gaps in Malta’s palliative care system.

While healthcare professionals strive to relieve suffering and ensure comfort, certain medications commonly used in other EU countries remain unavailable or difficult to access in Malta, he said.

This applies not only to pain relief but to other supportive treatments as well. The process of acquiring essential equipment, such as syringe pumps, can be complicated, often leaving patients without what they need to pass away comfortably at home, he said.

Many of his points align with Malta’s newly launched palliative care strategy, which outlines a 10-year plan to enhance care for individuals with life-threatening illnesses.

The strategy acknowledges that delays and burdensome procedures to access medications and equipment are inappropriate for patients with limited life expectancy and should be minimized.

The strategy also notes that availability of essential home care equipment, such as appropriate beds and pressure-relieving devices, is limited and obtaining permits is often a bureaucratic challenge.