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31 July 2025 | Country Update
Parliament adopts the Act on Assistance in Voluntary End of Life
5.10. Palliative care
In Slovenia, palliative care is still in developmental stages, but progressing steadily to become an integral part of health care. According to the European Association for Palliative Care (EAPC) Task Force on the Development of Palliative Care in Europe (EAPC, 2013), in Slovenia the number of palliative care experts willing to work in palliative care as providers and teachers is insufficient. Furthermore, it found that a lack of established financing and classification of palliative care standards at the national level hinders care delivery, and that teamwork and multidisciplinary collaboration could be improved. The focus of palliative care planning is mainly on the development of primary care networks, with a secondary aim of providing palliative beds in hospitals. In terms of training, a specialist accreditation for palliative care was created by the Slovene Medical Society and the Slovene Palliative Medicine Society in 2011. It is awarded only to physicians upon completing a 50-hour course and passing the examination. This accreditation is part of the EAPC’s wider educational programme that has been adopted by the Slovene Palliative Medicine Society. While the 50-hour course is open to all health professional groups – the curriculum is the same for all groups – so far, only physicians may obtain a diploma. Courses and seminars are also organized by professional societies across disciplines involved in palliative care in Slovenia, although without a final examination, nor special diplomas. At the tertiary education level, an Institute for Palliative Medicine and Care was founded in 2013 within the Medical Faculty of the University of Maribor and is responsible for advanced education of all professional groups. Moreover, courses on various topics related to palliative care have been organized as part of the curricula for family medicine, public health, oncology and emergency medicine offered by the Faculty of Medicine at the University of Ljubljana. There is also a teaching unit at the acute palliative care department within the Institute of Oncology for general physicians who circulate during their specialty and oncology training, which provides practical insight into hospital-based palliative care. Practical training is available at General Hospital Jesenice for mobile palliative units, focusing on field-based palliative care and the special needs of patients and their relatives at home.
Palliative care services are provided in all hospitals as part of basic care: 16 palliative care teams are in operation and work in secondary hospitals throughout the country. Specialized beds are available in many hospitals as part of different wards. There is an acute palliative care department at the Institute of Oncology in Ljubljana, which is also a teaching unit for palliative care. There is also one hospice run by the LjubHospic, Ljubljana. The Slovenian society Hospic provides services primarily focusing on supporting the terminally ill, also in home settings, and volunteers help with bereavement (www.hospic.si). In addition, a paediatric palliative team is based at the Paediatric Clinic in Ljubljana, which coordinates palliative care for children all over Slovenia. The clinic makes it possible for children to be visited by the team in their home environment. Recently, mobile palliative care units have been launched. So far, they are only available in two regions (Gorenjska and Prekmurje). Four more were in progress but have not been implemented yet at the time of writing (July 2021).
Along with many other countries, Slovenia is bound by a number of palliative care-related recommendations implemented by the Council of Europe and WHO. The need to develop palliative care is also a consequence of demographic trends and the rising number of patients with chronic conditions. Against this background, the challenges and activities detailed below are of particular relevance (Albreht et al., 2016).
- A national programme for the development of palliative care was endorsed by the government in 2010 with the aim of enabling more patients to live and die at home; its main policies are based on an interdisciplinary approach, which will be implemented by general and specialist palliative care teams as well as through the active participation of patients and their families in treatment while respecting patient rights and autonomy.
- The new Health Services Act will cover all palliative care activities, thus providing the legal basis for the implementation and development of palliative care programmes.
- Educational programmes in palliative care are being implemented in undergraduate and postgraduate studies in order to develop palliative care professionals who will be able to educate experts in palliative care and offer professional support to palliative care teams.
- All opioids in all pharmaceutical forms are available in Slovenia and patients can obtain such medication in pharmacies with a prescription from a physician.
- There is a well organized pain management service and all hospitals provide outpatient pain clinics for chronic pain.
The Act on Assistance in Voluntary End of Life has been adopted by the National Assembly in July 2025. The act establishes the procedures to receive assistance in ending one’s life. It does not involve euthanasia, defined as the act where someone else ends a person’s life at the person’s request. Nonetheless, an intense public discussion surrounded the act, particularly on moral and ethical grounds and related to the need to strengthen palliative care before end-of-life assistance is established.
The act was adopted approximately one year after a referendum in which 54.8% of voters favoured the adoption of such an act. The bill, which was proposed by members of parliament, has been vetoed by the National Council (the other chamber of Parliament), leading to an additional vote by the National Assembly. Medical organizations, as well as the Commission for Medical Ethics, expressed their opposition to the adopted act. They argued, among other points, that the act contradicts the core principles of medical ethics, which emphasize the preservation and restoration of health as well as the prevention and alleviation of suffering. A further concern relates to the risk of abuse: vulnerable individuals could be persuaded, pressured or feel socially compelled to end their lives.
Authors
References
Medical Chamber of Slovenia, 2025. Koordinacija zdravniških organizacij v celoti podpira stališče Komisije Republike Slovenije za medicinsko etiko glede Zakona o pomoči pri prostovoljnem končanju življenja [The Coordination of Medical Organizations fully supports the position of the Commission of the Republic of Slovenia for Medical Ethics regarding the Act on Assisted Voluntary Ending of Life] Available at https://www.zdravniskazbornica.si/informacije-publikacije-in-analize/obvestila/2025/07/16/koordinacija-zdravni%C5%A1kih-organizacij-v-celoti-podpira-stali%C5%A1%C4%8De-komisije-republike-slovenije-za-medicinsko-etiko-glede-zakona-o-pomo%C4%8Di-pri-prostovoljnem-kon%C4%8Danju-%C5%BEivljenja
Zakon o pomoči pri prostovoljnem končanju življenja [the Act on assistance in voluntary end of life]. Not yet published in the Official Gazette. Available at https://imss.dz-rs.si/IMiS/ImisAdmin.nsf/ImisnetAgent?OpenAgent&2&DZ-MSS-01/4fd76594f5f589e37df9f25a3518f7a4db75346771ee5aad82f33a1ccfb75cc2