Journal of global health · 2026
How national laws enhance palliative care integration: lessons from the Philippines, South Korea, and Taiwan.
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Monzón-Llamas Laura, Carpen Timo, Hamzah Ednin, Wang Yinwei, Corvera Rumalie, Bausa-Claudio Agnes B, Kim Sujeong, Centeno Carlos
Аннотация
BACKGROUND: Palliative care is increasingly recognised as a public health priority, yet its integration into national health systems remains uneven. Legal frameworks can enable or constrain access to services. This study examined how national laws influence palliative care integration in the Asia-Pacific region through a comparative analysis of legal frameworks in Taiwan, South Korea, and the Philippines.
METHODS: This two-phase multimethod study combined a regional assessment of palliative care development with legal document analysis. In Phase 1, country profiles were developed using the World Health Organization palliative care indicators framework. In Phase 2, national legislation was collected and analysed using a structured coding framework aligned with an expanded palliative care development model. Findings were validated through consultation with national experts.
RESULTS: Taiwan's legislation provides a comprehensive and enforceable framework for palliative care, anchored in universal health coverage, and supported by strong governance and patient autonomy provisions. South Korea's legislation prioritises end-of-life decision-making and institutional procedures but lacks community-based service mandates. The Philippines has advanced palliative care through broader health laws and insurance reforms, but the absence of a standalone law and weak enforcement continue to limit integration. Across all three countries, legal clarity, institutional support, education, and community engagement influenced the effectiveness of legal provisions.
CONCLUSIONS: Legal frameworks can facilitate palliative care integration when they are binding, well enforced, and aligned with governance structures, health system capacity, and sociocultural context. Limited legal scope or weak implementation mechanisms are associated with fragmented access. Context-sensitive legislation is a key structural enabler of equitable palliative care within universal health coverage.
METHODS: This two-phase multimethod study combined a regional assessment of palliative care development with legal document analysis. In Phase 1, country profiles were developed using the World Health Organization palliative care indicators framework. In Phase 2, national legislation was collected and analysed using a structured coding framework aligned with an expanded palliative care development model. Findings were validated through consultation with national experts.
RESULTS: Taiwan's legislation provides a comprehensive and enforceable framework for palliative care, anchored in universal health coverage, and supported by strong governance and patient autonomy provisions. South Korea's legislation prioritises end-of-life decision-making and institutional procedures but lacks community-based service mandates. The Philippines has advanced palliative care through broader health laws and insurance reforms, but the absence of a standalone law and weak enforcement continue to limit integration. Across all three countries, legal clarity, institutional support, education, and community engagement influenced the effectiveness of legal provisions.
CONCLUSIONS: Legal frameworks can facilitate palliative care integration when they are binding, well enforced, and aligned with governance structures, health system capacity, and sociocultural context. Limited legal scope or weak implementation mechanisms are associated with fragmented access. Context-sensitive legislation is a key structural enabler of equitable palliative care within universal health coverage.