The recent presentation of Malta's National Palliative Care Strategy 2025-2035 - incidentally just days before a national consultation exercise on a form of euthanasia was launched - marks a pivotal moment in the country's approach to end-of-life care. As outlined by Health Minister Abela, the strategy represents a comprehensive and compassionate reimagining of how Malta supports individuals facing life-limiting illnesses.
It focuses not only on strengthening healthcare infrastructure but also on preserving patient dignity and integrating services into community and home settings. This decade-long roadmap demonstrates a commitment to ensure that palliative care is not a privilege, but a fundamental right.
At the core of the strategy is the recognition of palliative care as an integrated and essential component of Malta's healthcare system. Historically, palliative care has often been confined to hospital settings or specialised facilities, limiting its reach and accessibility. By emphasising its incorporation into primary healthcare, the strategy aims to decentralise services, making them more accessible to patients. This approach reflects a shift from reactive to proactive care, allowing symptoms to be managed before they become severe and ensuring ongoing support through the progression of illness.
A particularly forward-looking element of the strategy is its focus on community and home-based care. Minister Abela underscored the importance of enabling individuals to spend their final moments at home if they so choose. This aligns with a global trend recognising that many patients prefer to pass away in the familiarity and comfort of their own homes, surrounded by loved ones.
However, for this to be a viable option, a robust support system must be in place. The strategy's commitment to expanding human resources to provide consistent, high-quality care in personal residences is both practical and compassionate. It signals a move toward truly person-centred care, tailored to individual needs and preferences.
Equally important is the strategy's emphasis on coordination and flexibility in service delivery. Palliative care needs can change rapidly and unpredictably. As such, services must be adaptable, with systems in place to respond swiftly to emerging symptoms or changing patient wishes. The inclusion of stakeholder discussions and collaboration with NGOs and private entities ensures a multidisciplinary approach, drawing on a wide range of expertise and resources.
Another commendable aspect of the strategy is its intent to raise public awareness about palliative care. Despite its vital role, palliative care remains misunderstood by many, often associated solely with end-of-life moments. The strategy acknowledges the need to educate the public and healthcare professionals alike about the holistic nature of palliative care - addressing physical, emotional, psychological, and spiritual suffering.
Chronic and terminal conditions can often lead to a loss of autonomy and identity. By ensuring that care is tailored to individual values and wishes, the strategy seeks to uphold a person's sense of self until the very end. This is the essence of dignity in care - recognising the person beyond the illness.
Malta's National Palliative Care Strategy 2025-2035 is a timely initiative. By embedding palliative care into the fabric of the healthcare system, extending it into communities, and committing to continuous improvement and inclusivity, the strategy not only enhances quality of life but also reaffirms a societal commitment to empathy, respect, and human dignity.
If effectively implemented, this strategy has the potential to transform the experience of illness and dying in Malta for generations to come. If, then, the government will proceed with the idea to legislate a form of euthanasia, it must ensure that the palliative care available is continuously being upgraded and improved so as to lay greater emphasis on dignified end-of-life care.