By Marta Koblańska, January 24, 2025 Photo: Dmitriy, Pixabay
Various civilizations approached differently to people who needed strong care differently due to their health status. Western civilization is claiming its supreme role in the gentle transition of humans to the end.
Palliative care is a new branch of medicine and has not been implemented in some countries, yet. Its major goal is to relieve the pain coming from an illness. There are several pain grades, dependent also on the type of illness, and there are many ways to alleviate it. Palliative care extends life if scheduled soon, which, anyway, should not necessarily result in the other treatment being cut off. However, the practice might be different due to the costs of a life for the society that the patient contributed to in the past. One or another, palliative care is placed at the top of modern civilization’s achievements as it helps in real, particularly when a family can not either afford or match the requirements of care for the impaired member. In Poland, which is among the top 10 countries throughout the world in advances of palliative care (number 7 in 2019, according to Aleksandra Ciałkowska-Rysz statement in line with the Atlas of Palliative Care), the catholic church holds its substantial share in the assessment. However, without volunteers, public money from the national health incumbent Narodowy Fundusz Zdrowia, having been increased since 2016/2017, private sponsors, and many people who just want to give their stake, the situation of patients in palliative care could have been much more difficult.
Blazing legal issues
The situation is not perfect anyway due to legal absurdities, making the end of life for some patients rather miserable than of good quality. This includes blood and its derivatives treatment rules, left to be solved by the former ruling coalition party. Blood transfusion can be performed only in a dedicated hospital unit, which generates both unnecessary suffering for patients being moved as well as costs of transport. Palliative care specialists, together with hematologists and transfusion experts, have been fighting to cancel the law to enable the treatment in the place where the patient stays. Polish upper-house of Parliament – Senate, as stated during the conference on palliative care in Warsaw, organized by Warsaw Medical University in cooperation with Łodź Medical University (Warszawski Uniwersytet Medyczny and Łódzki Uniwersytet Medyczny), and the Polish church charity Caritas has been scheduled to resolve the problem.
The most important issue to solve is thus feeding. There are many home-care units of palliative care in Poland, as well as dedicated hospital units, but eligibility to feed parenterally or directly to the gut has been granted to out-patient services. What’s interesting there is an obligation to go there with a caregiver. Usually, the condition of a patient who requires such service does not let for free walking. So either a specified transport unit is needed or a privately-run sophisticated service. How Polish public palliative care is responding to the problem is a mystery. However, during the conference, Prof. Aleksandra Ciałkowska- Rysz of Łódź Medical University emphasized that the situation must change.
Civilization burden
Due to a civilization shift, the demand for palliative care is expected to rise. More and more and more and more younger people have to face cancer. And despite cancer being transformed into a condition possible to live with for a certain amount of time, as long as a science-based cure is provided, many people need the care to relieve enormous suffering. In Poland, cancer patients constitute 88 percent of the total within palliative care.
As there are many emerging conditions that make humans impaired in a way impossible to fix to enable smooth functioning, the list with recognition of illnesses for palliative care needs to be widened. Another condition to be added in Poland is an end-stage failure of the kidneys. These organs are the key to the proper work of the whole body due to their role as a cleaner for an organism from undesired substances or substances in surplus gained outside. They are very often a gateway for the heart shape. The fundamental question is thus about the age of people with renal dysfunction to go for palliative care, as a ren may be transplanted.
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