Palliative care has not been recognized as a medical discipline or as a specialty within the Mexican health care system. This implies lack of funding and reimbursement for services and of organizational and functional standards for practice and development nationwide.

Dr. Argelia Lara, consultant in palliative care at the Instituto Nacional de la Nutricion (National Nutrition Institute) in Mexico DF, outlines the situation of palliative care within the national health system as follows:

“ the truth is that terminally ill patients do not represent a health priority in this country. [There are other programmes that have historically preoccupied (governments more) from an epidemiological point of view such as paediatric attention, infection diseases and also cardiovascular problems. In consequence, there is big whole in terms of initiatives to support projects directed towards palliative care patients. In general, palliative care programmes have emerged in Mexico as pain clinic projects. This means, that palliative care has become an extension of the pain clinic and this has its pros and cons [On the one hand, the already existent infrastructure has been used, but palliative care projects have been satellites with no their own specific power]. Few places have a sector designated only for palliative care to look after exclusively this type of patients. There is only one place in Guadalajara that has received adequate governmental support; that is the Palia Institute that cares for terminally ill patients within the public sector. In the rest of the country, [palliative care programmes] are inserted within other projects and the governmental support is not very evident so far”.¹¹
NB: interview transcription edited by Dr. Argelia Lara (29-09-04).

Regarding reimbursement for service, Dr. Mayer says:

“… it has just recently happened that pain clinics are being recognized; therefore, would you think that there are jobs available in palliative medicine?. This has not happened in Mexico yet”. ¹²