The Minister of Health, Alexandru Rafila, said that at the beginning of next month he will launch a public debate on the topic of the transfer of terminally ill patients from ATI to a palliative care area.
Alexandru Rafila, Minister of Health PHOTO: Archive
He was asked about how the problems related to the transfer of a patient from ATI, in a terminal stage, to the palliative care area were resolved.
“We really have a problem, (…) there were a lot of discussions in Romania and no conclusion was reached, that’s why we don’t have them either, because there are many problems of a cultural and social nature, that is, it’s not just about medical decision. It is something that must be explained very well publicly, that we are not discussing euthanasia, that must be clear to everyone, but the acceptance of this interruption of treatment at ATI and its continuation in palliation does not exist at the moment because no one over time it has not reached the point of social acceptance of this”, said Alexandru Rafila, on Thursday, at Digi24, writes Agerpres.
He stated that in his opinion, as a doctor, this debate must take place, specifying that he will launch it “as soon as possible, probably at the beginning of next month”.
“And I tell you who the actors should be, I will provoke this public debate as Minister of Health, it should be the professional societies, it should be the patient organizations and it should also be the Church. You started this discussion starting from the issue of transfer and not from the issue of euthanasia. It is good for the Church to be part of this discussion, precisely to avoid the public interpretations that will appear, related to such a situation. that is, to be able to have the widest possible representation of society and to understand that we are discussing a patient who no longer has the resources to recover and we are not discussing euthanasia. Euthanasia in Romania, from my point of view, must be taken out of the discussion, because social acceptance in Romania for such a thing certainly does not exist”said Rafila.
The minister stated that following the international audit requested after the situation at the Saint Pantelimon Hospital, a model of good practice in the field could also appear.
“We requested an international audit… we need examples of good practice from other countries. (…) And, following this audit, if you want, which will examine the existing procedures in Romania, maybe what happened at Pantelimon, let’s also come up with the model of good practice that exists in other countries, so that we choose it knowingly and with everyone, so that we don’t have tensions that cast a shadow on patient safety in a public hospital”. Rafila stated.
The minister also explained what he means by palliation.
“By palliation it means that you take care of a patient whose therapeutic resources for healing are exhausted and you have to offer him support, so that he can live with dignity, that is, to do the pain therapy, first of all to eliminate the pain, and to ensure conditions , including psychological counseling, because you know, many of the patients in palliation, we do not mean… palliation is of many kinds, it is not only intensive care palliation, there are many other ailments that in the terminal stage patients need of a certain kind of care”said Rafila.
The Minister of Health stated that following the discussions held recently with the Head of the Executive, one of the measures presented to the Prime Minister refers to the creation of a palliation department within emergency hospitals in Romania, connected to the Intensive Care Department.
“And this can also decongest the Intensive Care Units, so that they receive more patients”Rafila explained.
The minister stated, related to the existing palliation centers in Romania, that at the national level there are 3,000 palliation beds.
“The estimated need, at the end of a project that we concluded at the end of last year, a project with Norwegian funds, was around 4,000 beds, which would be the need at the national level. (…) We currently have 3,000, are also contracted by the health insurance companies. And we want to do it, so that we can increase this number of beds, to do these compartments in emergency hospitalsand the payment per service for this type of patient should be higher, now it is around 200, 200 and something lei per day. And we must also come with the public sector, balance, because out of the 3,000 that are functional, contracted, 2,000 beds are in the area of NGOs, the Church. The Church has many palliation centers, churches of various denominations, not only the Orthodox Church, and 1,000 are in the public area“, said Rafila.
