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Croatian Declaration on Palliative Care [Новость добавлена - 01.06.2008]

 
Croatian Declaration on Palliative Care
 
We have one and only life, every human being has the right to die with dignity. This is something that the modern hospice movement strives to achieve by providing palliative care for terminally ill patients. For many governments the financing and development of health care activities involving both curative and palliative care is an imperative. 
 
Palliative care, as part of health care,  is a fundamental human right as set out in the Canadian Declaration of 1992 and 2000, the 2003 Cape Town Declaration, the 2003 Recommendations of the European Council, the 2004 European School of Oncology, the 2005 Barcelona Declaration on Palliative Care, the 2005 Korean Declaration, the 2006 Venice Declaration, and 2007 statement made by Pope Benedict XVI.

The addendum to the 2003 Recommendations of the Commission of Ministers of the European Council addressed to state members and relating to the organization of palliative care says the following, «palliative care is a vital, integral part of health care services and it aims to achieve and maintain the best possible quality of life of seriously ill patients. To ensure this, a proper and just level of funding must be provided. It is recommended that countries should devote special attention to public education on the appropriate forms of palliative care.
 
In Croatia, the 2003 Health Care Act mentioned the notion of palliative care (articles 16, 25,  69 and 71). The Act envisages the founding of an institution of palliative care at the level of primary health care. The institution of palliative care is described in paragraph 5 of article 81 as «a health care institution with a palliative interdisciplinary team for home visits (physician, nurse, physical therapist, social worker, specially trained to care for the dying), with a medical pain and palliative care outpatient clinic and a day hospital».  However, so far, not a single institute for palliative care has been set up.
In the programme of the Croatian government for the period 2008 -2011 (Chaper 17 – health, hospital treatment) there is a paragraph that reads: «Palliative care and hospices are to be included in the health care system (network and referral centre), the deadline being December 2008.
Palliative care is for the first time introduced into the RH state budget. For Palliative care project were aforded  65.988 Kn ( about 9.426 Eu).
Chapter 19 of the Report to EU comissions says: „that Croatia  has the obligation to report to the EU on  the availability, quality and sustainability of palliative care in Croatia and  the possibility of its evaluation».
Unfortunately, within the Croatian health system  there is not a single modern institution for palliative care, nor is there a developed palliative care system at any level whatsoever.

 

In view of the above, we believe that :
- palliative care, as part of health care,  is one of the fundamental human rights;
- palliative care must be included in the Croatian health policy in keeping with WHO recommendations;
- palliative care must be based on the principles of equal accessibility, regardless of race, ethnic origin, sex, social status and the ability to pay for the services;
- health professionals must be properly educated in palliative medecine;
- members of the family and non medical volunteers, as important factors in providing palliative care, must be recognized and supported by government policy.

 

We agree that, by the end of 2008, the competent state bodies must:
- set up an Institution of palliative care in Zagreb with the aim of developing the first referral centre of palliative care, which will be part of the regular health care system and the centre of educational and research activities in this area;
- develop a clear plan for setting up a network of palliative care at all levels, in keeping with the international recommendations and Croatian legislation (palliative medecine in primary health care, palliative teams, palliative care institutions, palliative units in general hospitals, clinics, and clinical hospital centres, hospices, etc.);
- adopt the Croatian Act on Palliative Care;
- approve the proposal to amend the Compulsory Health Insurance Act and ensure leave and remuneration for those providing care for a dying family member, like in the case of parents with seriously ill children.

 

We support:
- the Second Congress of Palliative Care  entitled «Hospices and palliative care – a fundamental human right» , to be held in Zagreb, Croatia ,10-11 October 2008.
- promoting the propaganda action  «... and good by !?», aimed at raising funds for furnishing and equiping the Institution;
- developing  curricula in the field of palliative care at all levels (undergraduate and postgraduate  education for physicians, special training for nurses, social workers, volunteers, etc.).

 

 

Zagreb, May 2008

 

Steering Committee:
Marijana Braš, Rudolf Gregurek, Anice Jušić, Stjepan Krajačić, Zoran Lončar, Julijana Franinović Marković, Gordana Poljar

 

Hrvatski liječnički zbor - Croatian Medical Association
Hrvatsko društvo za hospicij/palijativnu skrb,HLZ
Croatian Society for Hospice /Palliative Care, CMA
©ubićeva 9, 10000 Zagreb, RH; MB 3271676
®iro-račun: 2360000-1101214818 poziv na br. 02 268129
Tel:++ 385 1 48 56775, e-mail :
 Zagreb, May, 2008
The Palliative Care in Central and Eastern Europe and Former Soviet Union Countries Monthly Email Newsletter Vol.IV. No.5. May 2008