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Palliative care for all? How can Brazil develop a palliative care service founded on principles of equity and access for all?

Corrêa, Santiago Rodrígueza,b; Abel, Julianc,d

Current Opinion in Supportive and Palliative Care: December 2018 - Volume 12 - Issue 4 - p 504–509
doi: 10.1097/SPC.0000000000000394
END OF LIFE MANAGEMENT: Edited by Gustavo De Simone and Bridget Johnston

Purpose of review Despite the historical international development of palliative care over the last 50 years, provision of equity of care and access to appropriate medication remains a major problem in many countries across the world. Interest in the public health approach to end-of-life care has grown over the last 20 years. Models of palliative care, which are affordable and provide equity of care are changing through these new concepts. We describe an existing model of practice in a primary care setting in Rio Grande in Brazil, which could act as a template for redesign of palliative care services.

Recent findings Traditional models of palliative care have focussed on the physical, social, psychological and spiritual domains. Abel and Kellehear have proposed a new model, uniting specialist and generalist palliative care with compassionate communities and the civic component encapsulated in the compassionate city charter. This model is more comprehensive, emphasizing both harm reduction and health and well being promotion, and is currently being rolled out within the Family Health Strategy in Rio Grande in Brazil.

Summary An existing model of palliative care, which includes the public health approach in Rio Grande be used as a basis for more equitable palliative care in Brazil, to meet a large unmet need.

aMedical Sciences University of São Paulo (USP), Project Estar ao Seu Lado-Cuidados Paliativos na Atenção Primária, Rio Grande, Brazil

bSchool of Interdisciplinary Studies, University of Glasgow, Scotland

cCompassionate Communities

dUniversity of Bradford, Bradford, UK

Correspondence to Santiago Rodríguez Corrêa, MSc, Family Physician, Master Degree on Medical Sciences. Founder of Project Estar ao Seu Lado-Cuidados Paliativos na Atenção Primária, Capitão Antonio Bento dos Santos N° 02, Unidade Básica de Saúde da Estratégia da Saúde da Família-Ciro Lopes Castelo Branco, Rio Grande, RS, Brazil. E-mail:

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