A new collection of articles on current topics from PACED

Key Issues in Home-Based Pediatric Palliative Care:  According to WHO and ICPCN estimates, about 21 million children worldwide need paediatric palliative care. Thanks to medical advances, more children with life-limiting or life-threatening conditions are living longer and increasingly require long-term, comprehensive, and adaptable care.

The authors of this article explore families’ experiences with receiving palliative care at home—a model many countries consider preferable. However, access and quality vary greatly depending on healthcare system capacity and the level of service coordination.

Parents identified three main challenges: a lack of understanding of their family’s needs by healthcare providers, limited access to professionals who can be reached quickly in crises, and the absence of an integrated medical record system that would enable information sharing and give families a sense of control.

The authors conclude that developing home-based paediatric palliative care demands not only resources but also systemic changes, including better coordination, interdisciplinary teamwork, and recognising the family as a full member of the care team.

Read the article: https://bmcpalliatcare.biomedcentral.com/articles/10.1186/s12904-025-01881-5

Caring for the Caregivers

Palliative care relies heavily on nurses—those who stand beside patients daily and keep health systems running. But they also need care.

The Lancet Global Health article emphasises that when nurses coordinate palliative care, patients see tangible benefits: better symptom control, increased psychological resilience, and improved adherence to treatment.

The authors highlight troubling data from the International Council of Nurses, revealing a global nursing crisis: chronic staff shortages, unsafe working conditions, low pay, and minimal mental health support. Caring for nurses is not optional—it’s essential. Without a supported and sustainable nursing workforce, delivering quality palliative care remains out of reach.

Read the article: https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(25)00195-0/fulltext

Palliative Care for Individuals and Healthcare Systems

This article adds to the growing evidence that palliative care benefits not only patients and their families but also entire health systems.

The authors present international data showing that a large part of healthcare costs are incurred in the last year of life.

Patients with advanced illness often undergo aggressive treatments that do not improve their prognosis but increase suffering and financial strain on families. For instance, in India, nearly half of children with cancer received chemotherapy in the final week of life; in Ireland, 10% of people at the end of life account for over 60% of total health and social care costs.

In this context, palliative care is both compassionate and cost-effective: it decreases hospital admissions and unnecessary interventions while providing care that aligns with patients’ values and preferences. Incorporating palliative care into health systems is not only an act of compassion but also a wise policy decision, making care more sustainable and truly centred on the person.

Read the article: https://www.sciencedirect.com/science/article/pii/S088539242500836X

Rescue Fantasy as a Source of Meaning

This article explores the inner conflict faced by palliative care professionals—between the medical instinct to preserve life and the reality of a field where saving life is often impossible.

In medicine, the ‘rescue fantasy’ describes a caregiver’s strong desire to restore health, to bring the patient back to life, and to overcome illness. In palliative care, this urge inevitably conflicts with other priorities: alleviating pain, maintaining dignity, supporting families, and helping patients find meaning.

The study shows that palliative care professionals do not abandon the rescue fantasy—instead, they transform it. Rather than trying to ‘save life’, they aim to improve its quality by providing comfort, relieving suffering, and helping patients stay true to themselves until the end.

The same change applies to supporting families: helping them cope with emotional pain becomes another meaningful form of ‘rescue’. The authors argue that such fantasies should not be suppressed but understood as a constructive source of professional purpose and resilience—helping clinicians stay engaged and compassionate in their daily encounters with death.

Read the article: https://www.tandfonline.com/doi/full/10.1080/07481187.2025.2510480#abstract

Nurses as a Guide for Artificial Intelligence

The authors call for a new professional mandate: ‘Every nurse—an AI nurse’. Artificial intelligence already impacts healthcare—from predictive models that warn of patient deterioration to chatbots supporting mental health. However, most nursing programmes still lack formal education on AI, and nurses are often viewed as users rather than contributors to innovation.

The article argues that nurses—being professionals most closely connected to patients—must be involved in designing and managing AI tools to ensure these technologies uphold the core nursing values of compassion and person-centred care. For palliative care specialists, this discussion feels particularly relevant: it’s about safeguarding humanity in an increasingly digital healthcare environment.

Read the article: https://journals.sagepub.com/doi/full/10.1177/20552076251377939