What do we need to develop any kind of care? First and foremost, it is a regulatory and legal framework, infrastructure, personnel and a source of financing. <…> The concept of palliative care has emerged only 2011, and the primary legal and regulatory base only in 2015. We only have 200 geriatrists in the whole country. Today we have the capacity for about 12 thousand palliative care patients, whereas in 2011 we literally had only a few — Tatyana Yakovleva, First Deputy Minister of Healthcare of the Russian Federation..
When we train medical personnel, part of this training is that they distance themselves from the value of compassion and become just a cog in this medical machine that is focused on making money — Robert Twycross, Founder member, European Association for Palliative Care.
There are four issues to address before palliative care reaches everyone in need at the end of life. First of all, personnel training. <…> The fundamental principle of palliative care is exactly that – care! Nurses are unskilled. <…> The second issue is the lack of access to anaesthesia. <…> The answer to this issue lies not in funding or the drugs themselves, but in the angst of the medical community of the Article No.228.2 of the Criminal Code, and in the unbelievable stigma of morphine in the patient’s community. <…> The third issue is the lack of protocols and standards. And last but not least, it is the lack of infrastructure — Nyuta Federmesser, Head, Moscow Multidisciplinary Center for Palliative Care of the Moscow City Health Department.