Palliative Care NSW’s 2025 Professional Education Day in May opened with a session on access and equity in palliative care. The session asked the question: How do we provide palliative care for everyone? Framed by the principle that palliative care is a human right, the session explored what it means to deliver person-centred care to people at risk of being overlooked by mainstream services. This includes those experiencing homelessness, living in boarding houses or in custodial settings, from refugee or CALD backgrounds, Aboriginal and Torres Strait Islander people, and LGBTQIA+ communities.
This is not just a clinical concern, it’s a matter of social justice. The 2008 Joint Declaration on Palliative Care and Pain Treatment as Human Rights marked a global call to action, citing obligations under the UN’s Universal Declaration of Human Rights to ensure access to adequate care and relief from avoidable suffering.
Joan Ryan OAM opened the session with a powerful reflection on the concept of “dignity of risk”. Drawing on her decades of experience, Joan emphasised that everyone has the right to live and die on their own terms. Respecting a person’s choices throughout their care often involves taking considered risks, whether that means supporting someone to remain in the space of their choosing, or advocating for a model of care that prioritises dignity and choice over safety and control.
Joan’s emphasis was on prioritising autonomy whilst easing the burden on the individual and families, particularly for those in precarious or non-traditional living arrangements. Balancing risk with safety, Joan framed this work as a continuous act of listening, advocacy, and respect.
Speech pathologist, Hannah Bodrozic, shared her work within custodial health environments. Delivering palliative care to incarcerated patients underscores a profound paradox: offering comfort and choice in a strictly controlled setting. Incarcerated individuals, many of whom face compounding disadvantage and trauma, have the same rights to dignity and relief from suffering as the rest of the community.
Hannah highlighted the complexities of advocating for patient-centred care within a system not built to support it. Access to modifications (such as food modifications), privacy, and continuity of care is constrained by security concerns and institutional priorities. Yet, through collaboration with diverse multidisciplinary teams, clinicians like Hannah work to carve out spaces of compassion and support in order to deliver quality care in challenging environments. Hanna’s insights highlighted that advocacy is integral to this work, not just for individual patients, but for systemic recognition that patient-centred palliative care is for everyone.
Aboriginal Health Worker, Tanya Antaw, and Social Worker, Hannah Talty, gave a joint presentation on their work in paediatric palliative care. Their approach demonstrates how deep listening, cultural safety, and mutual respect enhance outcomes for children and their families. Working in tandem and alongside patients and their families, Tanya and Hannah draw on distinct but complementary skill sets to deliver holistic, patient-centred care.
Tanya described how Aboriginal Health Workers support families and children through culturally grounded care and spiritual connection, guided by trust and lived community experience. Hannah outlined the role of social workers in building rapport and assisting with the practical logistics of care planning and delivery. Together, their collaboration reflects a model where each professional’s strengths are recognised and interwoven.
In paediatric palliative care, where the patient’s voice can be difficult to centre independently from the family, Tanya and Hannah affirm the importance of being led by the patient and their context. By listening to both child and family, they create a care environment that is genuinely responsive and patient-centred. As Tanya put it, “It’s not about us, it’s about them.”
To close the morning session, a Q&A and panel discussion reinforced the key themes explored throughout the presentations. While each case study presented unique challenges, common threads emerged: the critical importance of collaboration, active listening to patients and families prioritising choice, and working across disciplines and systems. Providing palliative care that truly meets people where they are requires flexibility, cultural humility, and diverse teams capable of bridging gaps in trust, access, and understanding.
Panellists also reflected on broader systemic issues. Many communities continue to misunderstand what palliative care is, often viewing it solely as end-of-life care delivered in hospitals or aged care settings. For marginalised groups, distrust of services may be rooted in histories of trauma, exclusion, or systemic neglect. The discussion highlighted the need for trauma-informed care, stronger community education, and better integration with housing, justice, and disability support services.
The emotional weight of this work was also acknowledged, with panellists emphasising the importance of self-care for clinicians and volunteers. While some organisations have robust support structures in place, others lack the resources to sustain staff wellbeing, leaving individuals to carry this burden alone. Joan jokingly suggested that a session on self-care might be on the agenda for the next Professional Development Day — and judging by the audience reaction, this is definitely a topic Palliative Care NSW is looking at featuring in the future.
This enlightening session echoed the growing national and international movement to recognise palliative care as a human right — a right to dignity, to adequate pain relief, and to be seen and heard at the end of life, even by systems and societies that may deem some lives less worthy of care.
Although the session touched on just a few examples, the Australian Government’s 2019 policy paper on barriers to palliative care identifies nine marginalised groups who face multiple, overlapping disadvantages that limit equitable access to quality care.
Key barriers include the absence of culturally appropriate care, geographic isolation, exclusion from Medicare in custodial settings, trauma histories, and insufficient workforce diversity. Addressing these challenges requires deliberate collaboration between healthcare providers, community organisations, and those with lived experience.
Palliative Care NSW’s Education Day began with a question and ended with a call to action: to move beyond one-size-fits-all models and instead cultivate trust, relationships, and responsive care. It means recognising that risk is sometimes necessary to uphold dignity. It means drawing on the strength of multidisciplinary teams and community partnerships. And it means reaffirming that palliative care is not a privilege — it is a right, and it must be available to everyone.
Palliative Care NSW extends its sincere thanks to Joan Ryan OAM, Hanna Bodrozic, Tanya Antaw, Hannah Talty, and all panellists for generously sharing their insights and experiences. Their contributions not only informed the day, but challenged us all to continue striving for a palliative care system that is inclusive, collaborative, and grounded in dignity for every person.
Many of you will be looking ahead to the Oceanic Palliative Care Conference (OPCC) in September with the conference theme Connecting Systems for Better Care. PCNSW Management Committee Secretary Joan Ryan OAM will be presenting at OPCC on Friday 12th September:
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Written by Sarah Whiteley.