Session 21

End of life, end of autonomy?

Examining the reality of the current end-of-life paradigm

Organised by the Le Centre National pour la Fin de Vie et les Soins Palliatifs and the European Observatory on Health Systems and Policies

Session format: Fishbowl

End-of-life care embodies the social contract at its most fundamental level, as meeting people’s needs during this vulnerable life stage rests primarily with government services. Yet, across Europe, access to end-of-life services in full respect of the wishes and rights of patients remains uneven. This is partly because some of these services, like assisted dying, are - where legal - shaped by socioeconomic disparities, policy gaps, and polarised views among health professionals. As solidarity in health is increasingly challenged across Europe, how can we ensure that end-of-life care remains a shared governmental and societal responsibility, that is adequately resourced, and not over-medicalised despite strained health budgets and competing political priorities?   

The session presents the key issues of debate in end-of-life and supportive care in the context of the broader social contract. It aims to underline the need for strengthened partnerships to foster fair and inclusive end-of-life care, with people’s emotional and spiritual needs, equally relevant as their medical ones, at the centre. This session will underline the responsibility of governments within the social contract to provide clarity in policies that uphold dignity and quality of life during the end-of-life period.