Care That Never Gives Up: In Honour of World Hospice and Palliative Care Day 2025

Quoting the Father of Medicine, Hippocrates, himself: ‘To cure sometimes, to relieve often, to comfort always’, these timeless words echo deeply the realm of palliative care, reminding us that the heart of healthcare lies not only in curing disease but in easing suffering and preserving dignity.

The World Hospice and Palliative Care Day 2025 theme “Achieving the Promise: Universal Access to Palliative Care” calls to action for communities, healthcare systems and policymakers to ensure that palliative care is not a privilege but a universal right – accessible to every person, everywhere. It is a call to ensure that compassionate care is but a standard healthcare for all. In an era marked by medical advancement and increased life expectancy, the demand for holistic, compassionate care at the end of life has never been greater. Yet, despite its proven benefits, access to palliative care remains limited worldwide. The need for palliative care is urgent and growing, especially as populations age and chronic diseases become more prevalent. Palliative care is not limited to end-of-life care; it begins at the time of diagnosis and continues alongside curative treatment. It addresses the physical, emotional, social, and spiritual needs of patients and their families. Its goal is not to hasten or delay death, but to relieve suffering and ensure dignity in life and death: representing a human right to comfort, dignity, and support at every stage of life and death, including support for families (bereavement support) as part of the remit (Lippincott journals).

WHO (2002) defines Palliative care as “an approach that improves the quality of life of patients and their families facing problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification, impeccable assessment, and treatment of pain and other problems—physical, psychosocial, and spiritual.” In contrary to the myth, palliative care is not only for the dying, but for anyone with a life-limiting illness. It runs alongside disease-modifying or curative treatment, and continues through terminal phase and not only when curative options are exhausted. One of its core values is to maintain the dignity and respect for the patient’s autonomy and values. It neither hastens nor postpones death, but helps people live meaningfully until the end. The primary goal is effective control of pain and other distressing symptoms through impeccable assessment and treatment.

Robert Twycross, a pioneer of modern palliative medicine, defined palliative care as “the active total care of patients whose disease is not responsive to curative treatment.” His approach emphasises relief from suffering and enhancement of quality of life through compassionate, holistic care and help people live as well as possible until they die.

According to a comprehensive study carried out in 2024, one in five people will be older than 60 by the year 2050 in India. This demographic transition demands integration of geriatric and palliative care. The national-level burden of palliative and supportive care needs of the older population is largely unknown in India. This study estimates the burden of palliative care needs among the older population in India from a nationally representative survey - Longitudinal Ageing Study of India (LASI): 12.2% of Indian older adults have supportive and palliative care needs. Among Indian states, highest for West Bengal (17%), Madhya Pradesh (16.9%), and Bihar (16.3%), while lowest in Arunachal Pradesh (2.2%), Nagaland (2.4%), and Mizoram (3%). This is the first study in India that estimates the need for supportive and palliative care using a nationally representative sample. One among eight older adults in India has supportive and palliative care needs (BMC Palliat Care 2024 Nov 30;23(1):274).

Another report published in October 22, 2022 estimated that only 1-2% of population who need palliative care have access to it. It also shows that while India stands at number three in terms of cancer incidence, most States do not have enabling policy to integrate palliative care with treatment offered to patients. Non-communicable diseases such as cancer, heart failure, dementia, and diabetes are now leading causes of death worldwide. The rising burden of chronic diseases often requires long-term symptom management and psychosocial support—core areas of palliative care. Without adequate palliative care, families often shoulder the burden of caregiving alone, leading to emotional exhaustion and financial hardship.

Integrating palliative care into health systems can ease this strain through professional guidance and community support. Access to pain relief and comfort care is increasingly recognized as a basic human right. Denying patients relief from suffering is both a medical and moral failure. As we can clearly see, the need for palliative care is not a distant concern—it is a present and pressing issue. As societies face increasing rates of chronic illness and population aging, the focus of healthcare must expand beyond curing disease to include caring for the person as a whole. Investing in it now is both a moral duty and a practical necessity to ensure that no one suffers needlessly in the final chapters of life.

In India, the palliative care services are heavily concentrated in urban areas and tertiary care centres. Many rural or remote areas have little to no palliative care services. Kerala is often cited as having the most developed infrastructure for palliative care. The National Programme for Palliative Care (NPPC) was launched in 2012 and while palliative care is mentioned in several national health policies, many states do not have enabling policies or regulations to enforce or expand palliative care services. Only a few states like Kerala, Karnataka, and Maharashtra have state‐level palliative care policies (The Hindu). Nagaland is in the nascent stages of developing palliative care services. There are some dedicated centres and services, but coverage remains patchy and mostly around urban or semi-urban centres like Dimapur, Kohima, Mokokchung (Palliumindia.org) and Chumoukedima. The St. Joseph Pain and Palliative Care Centre in Chumoukedima, inaugurated in 24th April 2022 remains the only full-fledged Palliative Care Centre in the state.

The Indian Association of Palliative Care (IAPC), established in 1994, is a national organisation committed to promoting and advancing palliative care in India. They are committed to ensure that palliative care is accessible and affordable to those who need it and to improve the delivery of quality palliative care across India through education and training of healthcare professionals, amongst others. More information on IAPC’s initiatives, memberships and resources can be found at www.palliativecare.in.

As the world observes the WHPCD today on 11th October 2025, let us take a moment to pause and reflect on the profound essence of the words by Cicely Saunders, one of the pioneering founders of modern hospice and palliative care:  “We may not be able to add days to life, but we can add life to days” . By bridging the gaps in access, strengthening healthcare systems and embracing dignity in care, we can help ensure that no one faces serious illness or end of life in pain or in isolation.

…..‘to cure sometimes, to relieve often, to comfort always’ – Hippocrates.

Dr Victoria Seb                      

MBBS (Gwl, MP) PGDFM (CMC Vellore) FIPM (IPM Calicut)                                         

email: drvictoria210@gmail.com