The Prague Charter: Urging governments to relieve suffering and ensure the right to palliative care

1. Lukas Radbruch
   1. Department of Palliative Medicine, University of Bonn, Bonn, Germany; European Association for Palliative Care (EAPC), Milano, Italy
2. Liliana de Lima
   1. International Association for Hospice and Palliative Care (IAHPC), Houston, TX, USA
3. Diederik Lohmann
   1. Human Rights Watch (HRW) New York, USA
4. Elizabeth Gwyther
   1. Worldwide Palliative Care Alliance, London, UK; Division of Family Medicine, School of Public Health, University of Cape Town, Cape Town, South Africa
5. Sheila Payne
   1. European Association for Palliative Care (EAPC), Milano, Italy; Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK

1. Lukas Radbruch Klinik für Palliativmedizin des, Universitätsklinikums Bonn, Sigmund Freud Str. 25, 53127 Bonn, Germany. Email: lukas.radbruch@malteser.org

The European Association for Palliative Care (EAPC), the International Association for Hospice and Palliative Care (IAHPC), the Worldwide Palliative Care Alliance (WPCA), and Human Rights Watch (HRW) are working together to advocate access to palliative care as a human right.

A right for palliative care

National governments and health authorities have an obligation to integrate palliative care in the health-care system. In order to do so, they may have to change policies and allocate resources in order to reduce unnecessary suffering of patients with life-limiting diseases.

The need for change

From a total of 57 million deaths in 2008 (world population 6860 million), 36 million people died from noncommunicable diseases, such as cancer or cardiovascular disease.² Whereas noncommunicable diseases are responsible for the majority of deaths in developed countries, infectious diseases such as HIV/AIDS (1.8 million deaths), malaria (0.8 million deaths), and tuberculosis (1.0 million deaths among HIV-negative people) account for a large percentage of deaths in developing countries.²

The vast majority of patients with life-threatening diseases will suffer from pain, dyspnea, and other physical symptoms or will require support with psychosocial or spiritual problems with the progression of their disease. Palliative care is an essential …

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