LGBT+ Inclusive Palliative & End-of-Life Care

Protection against discrimination based on sexual orientation, gender identity and/or gender history is widely variable across the world and attention is required to get this right for the significant populations who identify as LGBT+. Research in some countries has shown that even where such protections are written in law, lesbian, gay, bisexual and/or trans (LGBT) people may not receive the palliative and end of life care they need from health and social care professionals.

In countries where inequality is legally or culturally sanctioned, LGBT+ people face barriers accessing basic healthcare and palliative care. Evidence demonstrates that LGBT people are at increased risk of certain life-limiting illnesses and life-threatening diseases, and at higher risk of mental health linked to discrimination. It is therefore important to ensure that health and social care is inclusive.However, empirical studies led by academics at the Cicely Saunders Institute, King’s College London and University of Hertfordshire, found that in the context of advanced illness LGBT+ people reported multiple barriers to accessing care, at service level and during interactions with health and social care professionals.

The Task Force is chaired by Richard Harding, Professor of Palliative Care & Rehabilitation, King’s College London, UK and Katherine Bristowe, Lecturer, Kings College London, UK.

A legacy of institutional and historical barriers can also cause invisible stress for LGBT+ people. A systematic review involving the same research team found that LGBT people may face additional stressors during bereavement, such as failure of others in acknowledging their significant relationships, homophobia, and additional legal and financial barriers.

Inclusive, non-discriminatory care is vital for all, and attention is required to get this right for the significant populations who identify as LGBT+. This Task Force will begin seeking to respond to these shortcomings, in order to improve palliative and end of life care for LGBT+ people experiencing life-limiting and advanced illness, and the support provided for their partners and those close to them.

Providing LGBT+ Inclusive Palliative & End-of-Life Care

These recommendations have been developed using resources collated by members of the EAPC Task Force.

LGBT+ is an acronym to include lesbian, gay, bisexual, and trans people, and anyone who considers themselves to have a minority sexual orientation, gender identity or gender history (the relationship between gender identity and sex assigned at birth).

The recommendations bring together evidence and examples of good practice suggested by members and utilised within our countries. This guidance was developed in English in collaboration with task force members from 15 countries. Member countries are responsible for translation and ensuring the guidance is culturally appropriate.

The legal context for LGBT+ inclusion will vary in each country, as well as any requirements from bodies governing health care provision. As such, attention should be given to how recommendations fit with local law and guidance. Special attention is needed for any recommendations that may conflict with local law.

You can download the full document here.

Download the Swedish translation of the recommendations here.