Dr. Jose Pereira, from the University of Ottawa (Canada), gave an international course called "Decision-Making at the end of life" organized by the Faculty of Medicine at the University of Navarra Museum. For the expert, "One of the keys is that palliative care is not something unique to the end of life; it can help a lot during different stages of a disease."

In his view, palliative care is "absolutely essential" in health practice because "it is a vehicle for many other skills. A good doctor should have a holistic view of patients, who have their own story and are individuals, rather than just a tumor or a set of diagnostic tests. They are human, and as such, we must try to understand them to improve the care provided." Dr. Pereira encourages students to ask questions like why do people lose weight? or Why do they feel pain? "We must try to understand them and to do that we must communicate with them, understand their psychological and spiritual needs," as Dr. Periera noted.

He further remarked, "When a person realizes that he is approaching the end of his life, very emotional responses emerge. Sometimes patients show happiness, a kind of celebration of life, but they can also be shattered and very sad. These emotions and feelings lead to decisions and if people are not properly counseled about why they feel one way or another, they can be erroneous."

The issues that confront us at the end of life have a strong ethical component, thus this course aims to be very comprehensive. "We are talking about people caring for other people, human beings. They have to understand how people respond to certain situations. For example, if someone has advanced cancer and chemotherapy is not helping, it is easier to give a patient false hope than to tell the truth, but is not right," as Dr. Periera argued.

The end of life and euthanasia

In the expert's opinion, "euthanasia is not part of palliative care; it is something else," while he laments so "much hype and misinformation about this issue." As a society, we do not see people die, "on the whole, we believe that death is a failure, but it is not. Death is an indispensable part of life. And there is a myth that every death is accompanied by suffering, hence the need for a quick and easy solution to avoid it," he explains.

He also laments that there is so much confusion about the concept of euthanasia: "When someone is going to die, when he is dependent on a machine to continue living and has no hope of recovery or of having a certain quality of life, disconnecting the machine is not euthanasia. We need more information, more dialogue," he stresses.

In addition to Dr. Pereira, Professors Carlos Centeno, José Miguel Carrasco and Nunciata Comoretto taught sessions. All of these researchers form part of the ATLANTES project of the Institute for Culture and Society at the University of Navarra and are experts in palliative medicine.