In recent days, many media outlets have reported on a news story: the Basque health system had reprimanded a doctor for treating a girl at the end of her life “outside of official business hours.” This Bilbao pediatrician, Jesús Sánchez Etxaniz, along with his team of nurses and psychologists, was indeed treating children with palliative care needs mornings, afternoons, evenings, and on holidays. Because, as he said on Radio Nervión: “The death of children knows no business hours. We don’t think it’s very humane to restrict this service from Friday at 3 p.m. to Monday at 9 a.m. It has created unrest within the team, and I have decided to take a break for a while to recover.”

Beyond thanking Dr. Sánchez and his team for the work they have been doing for 13 years, at the cost of their personal and family lives, the question we can ask ourselves is whether a palliative care system based on the will, charity, and love of these teams for their young patients and their families can be sustained. Caring for people with an incurable chronic illness cannot fall solely on the shoulders of palliative care teams. They work beyond any professional ethics. If we want them to care for others, they must also take care of themselves, allowing them to rest so they can return with renewed strength to their work, which is none other than helping people die with dignity. As Dr. Sánchez commented on his social media: “I am angry, furious, and disappointed with my superiors, tired of banging my head against a wall.” Thank you, Dr. Sánchez; your ethics and professionalism have been your guiding light, above all protocols. We sincerely hope you return soon to care for and look after your little ones, because they need you.

The Spanish Society of Pediatric Palliative Care (PEDPAL) has long been calling on the Ministry of Health to enact a law that establishes the right to palliative care 24 hours a day, 7 days a week, and to provide the necessary resources to implement it.

Although there is no updated data on the pediatric palliative care rate in Spain, it is widely recognized that palliative care in general is lacking. According to the Atlas of Palliative Care in Europe 2025, a study prepared by the ATLANTES Global Observatory of the Institute for Culture and Society (ICS) of the University of Navarra in collaboration with the European Association for Palliative Care (EAPC), Spain has substantially increased the number of specialized teams, with a total of 450, representing 0.96 services per 100,000 inhabitants, compared to the 0.6 recorded in the previous analysis, conducted in 2019. These data place our country in 25th place out of the 53 analyzed, still far from the countries with the greatest resources, such as Austria, Switzerland, or Sweden, which have more than 2 specialized teams per 100,000 inhabitants, the standard recommended by the Spanish Society of Palliative Care (SECPAL).

Let us not depend on the humanity of our healthcare professionals; we need a palliative care law that addresses solutions and provides resources to support patients in the final stages of their lives.

Borja Castillo Lapetra – Founding Trustee, Board Member and Director – Dignia Foundation