The following ethical concerns have been mentioned in the interviews or they can be found in the literature:

1. lack of adequate availability, accessibility and provision of opioids to patients
2. lack of medical skills for establishing the therapeutic or palliative scope of treatments at the end of patients’ lives
3. insufficient medical skills for adequate pain management
4. physicians and families’ conspiracy of silence and the withholding of diagnostic or prognostic information from patients
5. the futility of medical treatments prescribed to terminally ill and dying patients
6. lack of general agreement for prescribing palliative sedation at the end of life
7. lack of public discussion and misunderstandings on end of life care
8. poor legal and political frameworks and a lack of standards for practice and education at governmental levels - making for inadequate accessibility to health resources for palliative care providers
9. lack of interest and support from local health authorities, leading to a poor recognition of the discipline and weak structures for practice and education