In a healthcare system under increasing pressure, can a palliative care commission drive meaningful change?

Dear Editor,
This commentary by Higginson is relevant to health systems in low-, middle- and high-income countries. Comprehensive palliative care that is available in a timely way for people with a life-limiting illness (but not limited only to the terminal stages of that illness) does improve the quality of care while reducing the resources used. Indeed, the opportunity of low- and middle-income countries is to learn from the poor decisions made in high-income countries when providing care in the last year of life and not replicate the mistakes that have been made.

Timely recognition that a person is at high risk of an 'expected death' in the coming months or years should be a flag for clinicians to plan the care with that person and their family and friends. We have robust ways of identifying many such people, but do little with that knowledge.

The benefits of palliative care outlined in the commentary to date have not included the wellbeing and health of carers in the years after the person's death, but evidence suggests that palliative care is associated with improvements that need to be quantified in detail.

At its most fundamental level, there is untold suffering that needs to be relieved with a systematic and well-funded approach as evidence of a humane society that values every person, even when they do not have a voice.