Public health and palliative care: principles into practice?

Public health approaches to palliative care have a valuable contribution to make in understanding and developing community capacity related to death, dying, loss and care, acknowledging that carers of the dying and bereaved are an important group who have their own significant needs in end-of-life care. Drawing upon a sociological framework, this article suggests that an even greater contribution is possible by an emphasis upon understanding lay and community logic within a social context. In particular, the article examines an emerging but significant shift to public health approaches in the 'developing world' and the 'developed world'. It is argued that such approaches can contribute to a much broader agenda and potential for palliative care. Some obstacles to achieving this considerable potential are also noted. These relate to imbalances of power between a number of groups including medicine, palliative care, socio-cultural scientists and, not least, communities themselves. It is concluded that Weber's ideas about understanding may have much to offer in broadening out the principles of a palliative care that works with, and for, communities.