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Palliative care in different countries varies significantly based on socioeconomic conditions. Some of the basic issues are the concepts of chronic and terminal illness that should be managed as comfort and quality of life versus curative attempts (De Lima, 2004). The variations also involve the different cultural beliefs and levels of education of the patients and the healthcare professionals. The communication styles affect the implementation of palliative care. The funding of healthcare systems in the individual countries also has a strong impact on the availability of palliative care (Bruera & Sweeney, 2002).
In a publicly funded healthcare system such as the one found in Canada the funding and legislation is shared between federal and provincial governments. Within this setting in 1997, the Canadian Palliative Care Association listed 600 palliative care services, which is a significant increase since 1981 when they listed only 116 programs. Even with this increase, only a few patients are able to access these programs, and the majority of terminally ill individuals continue to die in critical care units (Bruera & Sweeney, 2002).
In Spain, the healthcare system is publicly financed providing universal coverage for its population. In 1998, there were 143 palliative care teams, which was an increase since 1986. The teams consist of home care programs, programs for hospitalized individuals, and integral systems, which provide an integration of resources between critical care units and home support teams. The development of these ideas has not consistently advanced; therefore advisory teams continue to facilitate inpatient palliative care beds. The inability to control pain decreases the success of home palliative care. Educational programs continue to be developed to facilitate the growth of these programs (Bruera & Sweeney, 2002; James, 1993).
The context of this presentation will compare and contrast Palliative Care abilities in different countries.