Conditions pour le maintien d'un écosystème palliatif et l'émergence d'une « écologie palliative » ?

Palliative care should be considered as a global and ecologic system, not just as an end of life management utility. Working on developing stronger palliative care requires identification of all the conditions needed for its development. Determinants of what might be called palliative ecology depend on national and regional policies and the involvement of the local actor's community. At the national level palliative care must be redefined and enhanced in order to offer a clear and coherent vision of palliative care. The regional level is strategic, supporting the implementation of this policy, to provide staff and funds, to enhance actions flowing from this aim and to promote innovative solutions. At the local level, medical and non-medical workers are the key. They must develop a culture of cooperation on the basis of collegiality and work across the traditional divisions. As every ecologic system, these three levels are substantively interrelated and cannot be supported separately without disruption of the palliative care.