“In light of the prevalence of suffering caused by HIV/AIDS and cancer and the difficulty and complexity of making treatment available to all who need it, palliative care has been proposed as a more achievable and affordable alternative to disease-modifying treatment for HIV/AIDS and cancer in poor settings […] However, should the response in any context ever be just palliative?”
The disproportionate suffering of the world’s poor from AIDS and cancer has generated efforts to promote palliative care as an affordable alternative to expensive disease-modifying therapies. These well-intentioned efforts stem from a wish to respond to the suffering of the poor as quickly and widely as possible and from the view that only inexpensive interventions are feasible in poor settings. Such efforts also may be informed by the cautious attitude of palliative care in rich countries toward disease-modifying treatments for patients with advanced life-threatening illnesses. Yet, acceptance of unequal access for the poor to life-saving medical services that are badly needed and potentially feasible is unjust. Although palliative interventions to relieve the disproportionate physical, psychological, and social suffering of the poor are essential, they should be integrated with preventive and disease-modifying interventions for major killers, such as acquired immunodeficiency syndrome and cancer.