Egypt has a strong cultural tradition of family support. When a family member is diagnosed with a life-threatening disease the family will assume the care for their relative. However, as Dr Helmy at NCI notes that in additional to the problem of financial support for providing services there remains a lack of adequate knowledge about the importance of palliative care. Dr Elkateb explains that there is a great need to educate ‘families about home palliative care’ and not to rush into an inappropriate approach. As she notes ‘we have a shortage of nurses; and we need to teach families [about palliative care]. We have a high respect for families.’²⁴

As several authors have noted in their observations around the world, different cultural approaches to death and dying may present considerable challenges in developing palliative care services that are sensitive to and appropriate for the different communities they serve.²⁵ There is a continuing ethical challenge and debate concerning openly discussing diagnosis and prognosis with patients. For many of the cultural and religious traditions in this region, as in other parts of the world, there is marked resistance to openly discuss with a patient the fact of their imminent death. The family will tend to protect their relative and talk with the medical professionals directly, regardless of whether the patient would wish to know their prognosis and prepare themselves for death.²⁶