Mexico City, Mexico – The Mexican Health Ministry took an important step on December 9, 2014 to ensure access to palliative care for people suffering from pain due to incurable illness - the release of the long-awaited guidelines to its health care system. The new guidelines will operationalize the provisions on end-of-life care outlined in Mexico’s 2009 health law.

"The publication of these guidelines is an important step toward ensuring that people who are dying in Mexico not only have a right to care in theory but also in practice," said Diederik Lohman, associate health director at Human Rights Watch. "Now Mexico’s progressive law can finally be put into operation."

In October Human Rights Watch, in a 122-page report titled Care When There Is No Cure: Ensuring the Right to Palliative Care in Mexico, highlighted the barriers faced by tens of thousands of patients who suffer unnecessarily from severe pain and other symptoms. Although the Health Ministry was supposed to issue the guidance within six months of the 2009 law coming into effect, it was held up for years, delaying the effect of the law.

Mexico’s health law offers extensive rights to people who are terminally ill and have six months or less to live. It states that all hospitals should offer palliative care to such patients, including in their homes, and that all health care workers should receive adequate training in palliative care.

The Human Rights Watch report found that, in practice, the availability of palliative care is uneven and limited throughout the country. Seven of Mexico’s 32 states did not have a single hospital that offered palliative care, and in another 17 states palliative care services only existed in capital cities. Estimates by the World Health Organization and the Worldwide Hospice and Palliative Care Alliance suggest that more than half of the 600,000 people who die every year in Mexico require palliative care.

The new guidelines provide detailed direction to hospitals and health care providers on when palliative care should be offered; the procedure for initiating it; and criteria for providing it in different settings, such as the patient’s home, outpatient clinics, or a hospital. The guidelines emphasize the importance of ensuring that patients can remain in their homes while receiving palliative care.

"This is a positive step, but the real challenge is to ensure that hospitals actually follow the guidelines and patients have access to the palliative care that the health law guarantees," Lohman said. "The government should set clear targets and hold the health care system to account."

In another key development, on December 5th, Mexico’s Public Health Council approved an agreement between government agencies on the development of palliative care. The agreement lays the foundation for critical reforms regarding the prescription of opioid analgesics (chemicals, such as morphine and hydrocodone, that suppress your perception of pain and calm your emotional response to pain by reducing the number of pain signals sent by the nervous system to the brain) and health care worker education.