Hospice Malta says improved palliative care must come before assisted suicide

Supporting palliative care is the most ethical and humane way to care for those at the end of life, Hospice Malta has said.

“Rather than the introduction of processes to end life, the emphasis should be on the advocacy for greater investment in crucial services that protect life and uphold the dignity of each person,” they said on Friday.

Last week, the Maltese government launched a public consultation on voluntary assisted dying, proposing a tightly regulated framework limited to mentally competent adults suffering from a terminal illness expected to lead to death within six months.

The consultation document makes clear that euthanasia will not be available to individuals with disabilities, mental health conditions, age-related illnesses such as dementia, or those experiencing social isolation in care homes. Patients must be over 18, have been residents in Malta for at least 12 months, and must personally request assisted dying. Doctors will be prohibited from suggesting the option to patients.

The organisation says this is a sensitive topic which affects people on an individual, community and national level, and believes the country should be strengthening the right to live well until natural death, not legalising the right to die.

Hospice Malta highlighted four key principles of palliative care: it supports the whole person beyond their physical pain, helps them preserve dignity until natural death, involves and supports families through the grieving process, and does not conflict with ethical or religious values that affirm the sanctity of life.

The organisation strongly said it believes national efforts should focus on expanding 24/7 palliative care across the country. “All energy and resources should focus on developing and strengthening these types of services,” it said, adding this vision is in line with the National Strategy for Palliative Care published earlier this year.

“With the help of trained professionals, medication, and emotional support, many of these challenges can be eased.” Hospice Malta called for urgent improvements in services, including respite care, equipment access, hotlines, companionship, and immediate help during moments of crisis.

The group also warned that international examples show how, once euthanasia is introduced, investment in palliative care often drops. They stressed assisted death should not be seen as the solution to suffering that could otherwise be managed with the right support.

Hospice Malta also supported advance care planning, discussions with patients and their loved ones that help guide choices during serious illness, as opposed to legal directives like a living will. These conversations, they said, are central to upholding dignity without resorting to extraordinary or unnecessary treatment.

Moving forward, Hospice Malta is urging the country to treat palliative care as a national priority. This includes expanding the healthcare workforce, making medicines available in the community without delays, improving public understanding of care options, and building a society that shows compassion to its most vulnerable members.

The organisation said it is grateful for the ongoing support from the Ministry for Health and the Ministry for Social Policy and Children’s Rights, the public, and corporate donors. “However, further investment is needed to expand the palliative care workforce, provide necessary medications without delays, develop educational programmes, and work towards a more compassionate society.”

“We believe that Malta’s small size is an advantage,” Hospice Malta said, pointing out that people can be reached in their homes more easily than in larger countries. “This allows for care that is truly centred on the person at home, with the right support.”