The government on Thursday launched a consultation on palliative care with a focus on providing support to people who choose to die at home.

The draft document setting the strategy for the next 10 years is up for discussion until March 17, with the final document planned for publication by May. 

Launching the consultation on Thursday, Health Minister Chris Fearne said the consultative document focused on palliative care at home and in the community, as the best way to die was in a familiar environment.

“This means we need to have the services and resources available to put patients' and relatives’ minds at rest that they can still receive the necessary treatment at home that they would otherwise receive at hospital.”

Statistics show that only 12% of deaths occur in private residences. Of these, a substantial number are people with terminal illnesses who would have chosen to keep on living at home till the end, receiving palliative care at home.

The minister on Thursday said that as a medical professional, he knew that while it was not always possible to cure everyone, it was always possible to improve everyone’s journey towards their death.

The biggest satisfaction for medics, he said, was to help cure people, and they could not look the other way when they were faced with an illness and condition for which there was no longer a cure. 

Also addressing the launch, consultant on public health Analise Borg said the strategy addressed the stigma surrounding palliative care and the fear of having a relative die at home. It also aimed at enhancing the palliative care workforce. 

From the National Palliative Care Strategy for Malta 2023 - 2033 document

Does the strategy include euthanasia? 

Last year PL promised a national discussion on the introduction of euthanasia. 

In January of 2021 prime minister Robert Abela had also heavily hinted at looking to legislate on the matter, telling party supporters how he had agonised over the subject when a friend of his had been diagnosed with an illness. 

However, the strategy proposed on Thursday does not discuss euthanasia. 

"The strategy abides by the definition of palliative care provided by WHO and EAPC, both of which stipulate that palliative care is an approach that improves the quality of life of patients and their families dealing with life-threatening illness, through the prevention and relief of suffering by means of early identification, assessment and treatment of pain, of other symptoms, and of social, psychological and spiritual problems," the document argues.

"Furthermore, palliative care affirms life and regards dying as a normal process - it neither hastens nor postpones death and sets out to preserve the best possible quality of life until death. Therefore euthanasia and physician-assisted suicide are not considered part of the provision of palliative care. In accordance with these definitions, euthanasia and physician-assisted suicide are therefore not included as part of the scope of this strategy. "

Some recommendations:

• - Encourage people to plan ahead and talk with their loved ones and health professionals about end-of-life care
• - Review the undergraduate curricula on palliative care knowledge
• - Address the acute shortage of palliative care medical professionals
• - Enhance respite services for informal caregivers
• - Identify a bereavement service coordinator
• - Consider developing a plan to empower and incentivise local GPs to identify palliative care needs as early as possible
• - Ensure an established Do Not Attempt Resuscitation policy across all health care settings
• - Establish protocols for the relocation of patients nearing their end of life to quieter wards or single rooms

Hospice complex to start receiving outpatients by June 

St Michael's hospice palliative care complex (former Cini institute) will start providing outpatient services by June and inpatient services by September.

The premises, which were handed over to Hospice Malta by the Church in 2016, will host a ward with 16 beds for inpatients, catering for around 600 people a year. 

The complex, Chief Medical Officer Walter Busuttil said, would not be turned into a residential home, but rather, a place where patients and their relatives learnt about palliative care so that they could continue it at home.

The inpatient ward will cost approximately €1.719 million a year, with the government covering the costs. 

Feedback can be submitted by March 17 on consultations.health@gov.mt or by post at Palliative Care Strategy Consultation, Department for Policy in Health, Ministry for Health 15, Merchants Street, Valletta VLT 1171.