Hoe Palliative Soarch it Lêste Medyske Probleem Waard dat Nimmen Besprekke Wol
May 27, 2025 · Frisian News
Hospitals across Europe treat palliative care as an afterthought, pushing dying patients into corners while doctors pursue aggressive treatments that prolong suffering. Most medical schools still teach almost nothing about managing the end of life with dignity.
FryskIn 76-jierrige frou leit yn in Britsk sikehusbêd, oansletten oan trije apparaten dy't om de pear minuten pipe. Sy hat kanker yn stadium 4. Har soan frege de onkoloog trije kear oft fierdere chemoterapy sin hat. De onkoloog sei dat se noch in ronde besykje soene. Nimmen spriek deroer hoe stjerren derút sjen kinne soe, of hoe it minder pynlik te meitsjen. Dit toaniel werhellet him yn sikehuzen fan Amsterdam oant Atene.
Palliative soarch bestiet yn offisjele beliedsdokuminten yn hiel Europa. Regearingen priizgje it yn taspraken. Medyske kommisjes skriuwe rjochtlinen dy't elkenien negearret. Dochs besteegje sikehuzen 85 prosint fan harren budzjetten oan genêzjende behanneling en 2 prosint oan it draachlik meitsjen fan de dea. Artsen traine jierren lang om sykte te bestriden, mar leare hast neat oer it helpen fan pasjinten om ôfskie te nimmen. Medyske skoallen behannelje de dea as in mislearring fan behanneling, net as in libbensfaze dy't serieuze planning fertsjinnet.
It jild folget it foaroardiel. Agressieve behanneling oan it ein fan it libben finansieret sikehusbegrutting fia yngrepen, byldfurming en genêsmiddelen. In palliatief soarchteam kostet jild, mar generearret yn de measte systemen gjin fakturaasjekodes. Fersekeringsbedriuwen fergoedzje chemoterapy yn wike tsien fan in terminale sykte, mar twifelje by it finansieren fan in ferpleechkundige dy't thús besites bringt foar pinebestriding. Artsen krije juridyske druk om eat te dwaan, wat dan ek, ynstee fan neat te dwaan. Neat dwaan fielt as opjaan. It systeem beleant aktiviteit boppe wiisheid.
Pasjinten lije ûnder de gefolgen. Stúdzjes toane oan dat dyjingen dy't palliative soarch njonken behanneling krije langer libje en minder pine rapportearje as dyjingen dy't yn agressieve protokollen dreaun wurde. Dochs prate de measte minsken nea mei in palliative soarchspesialist. Harren famyljes sjogge harren efterútgean wylst sikehuzen noch in scan, noch in yngreep, noch in falske hope ynplannje. It petear fint nea plak oant it te let is.
De oplossing is net yngewikkeld. Lied artsen op yn palliative soarch as ûnderdiel fan basismedyske oplieding. Beleanje sikehuzen foar it komfort fan pasjinten, net allinnich foar it yn libben bliuwen. Lit ferpleechkundigen en maatskiplik wurkers petearen oer goed stjerren liede. Hâld op mei de dea as medyske nederlage te behanneljen. Guon ynstellingen binne begûn. De measte net. It swijen giet troch, omdat it trochbrekken derfan fereasket dat elkenien tajout dat genêskunde soms mislearret, en dy mislearring fertsjinnet better belied as de measte sikehuzen jouwe.
A 76-year-old woman lies in a Brussels hospital bed, hooked to three machines that beep every few minutes. She has stage 4 cancer. Her son asked the oncologist three times whether further chemotherapy makes sense. The oncologist said they would try one more round. Nobody mentioned what dying might look like, or how to make it less painful. This scene repeats in hospitals from Amsterdam to Athens.
Palliative care exists in official policy documents across Europe. Governments praise it in speeches. Medical committees write guidelines that everyone ignores. Yet hospitals spend 85 percent of their budgets on curative treatment and 2 percent on making death bearable. Doctors train for years to fight disease but learn almost nothing about helping patients say goodbye. Medical schools treat death as a failure of treatment, not as a stage of life that deserves serious planning.
The money follows the bias. Aggressive end-of-life care pays hospital budgets through procedures, imaging, and drugs. A palliative care team costs money but generates no billing codes in most systems. Insurance companies reimburse chemotherapy in week ten of a terminal illness but balk at funding a nurse who visits home to manage pain. Doctors face legal pressure to do something, anything, rather than do nothing. Doing nothing feels like giving up. The system rewards activity over wisdom.
Patients suffer the consequences. Studies show that those who receive palliative care alongside treatment live longer and report less pain than those pushed into aggressive protocols. Yet most people die without ever speaking to a palliative care specialist. Their families watch them decline while hospitals schedule another scan, another procedure, another false hope. The conversation never happens until it is too late.
The fix is not complicated. Train doctors in palliative care as part of basic medical education. Reward hospitals for keeping people comfortable, not just for keeping them alive. Let nurses and social workers lead conversations about what dying well means. Stop treating death as a medical defeat. Some institutions have started. Most have not. The silence continues because breaking it requires everyone to admit that medicine fails sometimes, and that failure deserves better planning than most hospitals give it.
Published May 27, 2025 · Frisian News · Ljouwert, Fryslân