What began in the 1960s as an initiative of the founder of palliative and hospice work, Cicely Saunders, in England, quickly spread to many countries within and outside Europe and set important social and political impulses. In Germany, the hospice movement as a civic movement has also asserted itself against social opposition and has facilitated the provision of hospices, which we take for granted today, as well as the development of palliative medicine. More than 10,000 doctors with the additional title of palliative medicine practice in Germany today, and around 15 percent of our hospitals have palliative care wards. In addition, there is the steadily expanding network of specialised outpatient palliative care. Not all, but a lot of people want to die in dignity at home, and with us they can do so.

However, in terms of palliative care, there are big differences worldwide...

That’s true. While palliative care is generally very good in Europe, North America and Australia, things are quite different in Latin America, Asia or Africa. The legal framework conditions are partly lacking there and the question of financing is often unresolved. But Latin America is the region where palliative care is currently developing the fastest. And, for example, in Uganda, the situation for patients has already improved significantly. In many African countries, however, the lack of access to opioids and morphine is a major issue. Colleagues talk about 'worse than torture' when they describe the cancer pain of patients that they cannot adequately treat. All over the world, a culture-sensitive handling of the taboo topics of death and dying is important.

In your opinion, what are currently the most pressing issues?

Apart from further developing and expanding palliative care worldwide, the psychological support of many terminally ill patients is still insufficient - even in countries that have well-developed palliative care systems. In the case of cancer diagnoses, a psycho-oncologist is usually available right away - unfortunately, this is not always the case when it comes to patients with cardiovascular or neurological diseases. We need to make sure that we build strong networks with psychologists so that all seriously ill people have better access to psychological care.

Many people avoid the topic of palliative medicine. Why should it be important to them nevertheless?

Because it is a topic of increasing importance and there is a growing need. People are getting older and older. Although more of us are growing old while staying healthy, geriatrics and palliative care are the fastest-growing disciplines in medicine. By the way, it is a widespread misconception that palliative care is about terminal care. Rather, our goal is to improve the quality of life of terminally ill people, starting with the diagnosis. We sometimes support patients for many years. So I do not introduce myself by saying "Hello, I'm your doctor for dying," but rather, "Hello, I'm your quality of life physician". This helps a lot to remove the taboo.