Rethinking care toward the end of life: Outcomes from a Salzburg Global Seminar

Sixty invited international delegates met in December 2016 to consider global opportunities and challenges in palliative care. They gathered at the Schloss Leopoldskron (some scenes from ‘The Sound of Music’ were filmed here) to discuss and debate seven key questions:

How do we engage patients and families to ensure that end of life care honours what matters most to them, with respect for culture and for context at the level of the individual and the population?
What are the relative contributions of health care and community-based social care in different contexts? How can they best be joined up to maintain function, independence, and agency for people for whom death is near?
How can healthcare systems better support families, caregivers and community members in caring for people of all ages for whom death is near?
How are robust processes established and implemented for arriving at decisions when patients can no longer express their own preferences? What role does public engagement and government have in this?
Which are the most promising evidence-based and cost-effective innovations in care towards the end of life? What yields the greatest value to patients, especially in low- resource settings?
What can we learn from the systems failures in high-income countries with regard to supporting patients, families and caregivers with palliative care?
How can palliative care best be undertaken in the context of societal deprivation or conflict?

Salzburg Global (SG) was founded in 1947 with the aim of encouraging intellectual dialogue in post-war Europe. SG aims to challenge leaders to help solve important global issues and, since its establishment, SG has been a catalyst for global engagement on critical issues in education, health, environment, economics, governance, peace-building and more. SG achieves this by designing, facilitating and hosting international strategic programmes (seminars). Uniquely, Salzburg Global builds connections with and between people from a broad range of expertise, cultures and professional backgrounds. Over the duration of the seminars, government officials, institutions and individuals at all stages of their professional development and from all sectors are asked to rethink their relationships and identify shared interests, goals and outcomes.

A key outcome of the session was aimed to be the development of ‘A Salzburg Statement of key principles guiding care towards the end of life’. It was a testament to the freethinking and originality of the participants that for the first time in the history of SG, the outcome was not a statement, but instead, a set of nine questions. The questions are designed to highlight challenges facing the global community and will be linked to international ‘days’. Each of the nine questions will be explained more fully in EAPC blogs over the coming year.

There was snow and plenty of hard work, interspersed with some time to socialise and make the most of the beautiful location and, of course, there was schnitzel, Glühwein and a Christmas market.