Expansion of Palliative Care: Establish System that Enables People to Live out Their Lives Peacefully

Editorial

15:13 JST, November 7, 2025

As the population ages, more people may prioritize pain relief over treatment that puts a burden on the body when they become ill. It is hoped that everyone will be able to live out their lives peacefully.

The Health, Labor and Welfare Ministry has indicated a policy to expand the scope of palliative care, which has been provided primarily to cancer patients, to include patients with renal failure.

Palliative care refers to medical treatment and care that is supportive of patients with serious illnesses and their families to alleviate physical and mental suffering and improve their quality of life. Specific measures include pain control using medication.

Currently, only cancer and AIDS patients are eligible for medical treatment fees paid to medical institutions when they receive comprehensive care in hospital palliative care units. Consequently, even if renal failure patients wish to be admitted to a palliative care unit, the reality is that this is often not possible.

Going forward, the health ministry intends to discuss expanding the scope of medical treatment fees to include patients with renal failure at the Central Social Insurance Medical Council.

Fundamentally, cancer patients are not the only ones who require palliative care. Expanding the scope of eligibility is understandable. For the sake of patients and families who desire palliative care, it is hoped that the ministry will work swiftly to realize this.

Even with renal failure, patients can maintain their daily lives while undergoing treatment to remove waste products from the body through artificial dialysis. About 340,000 patients in Japan currently receive artificial dialysis.

However, as their condition worsens, some patients can no longer continue artificial dialysis. Many patients experience distressing symptoms such as respiratory distress and severe pain in their final days, yet most of them cannot receive treatment to alleviate their suffering.

Regarding renal failure, writer Keiko Horikawa, who supported her husband through his fight against illness, revealed the harsh realities in her book “Toseki o Tometa Hi” (The day we stopped dialysis), which has drawn a significant response.

If pain could be alleviated, patients would be able to spend their remaining time in a state of physical and mental peace.

Three medical societies, including the Japanese Society for Dialysis Therapy, have already established guidelines for health care professionals when they provide palliative care to renal failure patients.

There is an urgent need to train personnel capable of providing palliative care based on the nature of the disease. Hopefully, the number of personnel with specialized knowledge will be increased by making these guidelines well known to the field and creating training opportunities for medical workers. The central government should also support such efforts.

When patients are struggling with disease while enduring pain, it is tough not only on them but also on their families. Considering this, in the future, anyone with any illness, whether in a hospital or at home, should be able to choose palliative care when needed. Everyone should see this as an issue that affects them personally.

(From The Yomiuri Shimbun, Nov. 7, 2025)