Abstract:

Background: Palliative care in Iraq remains severely underdeveloped, despite growing recognition of its critical role in alleviating the suffering of patients with terminal illnesses. Structural limitations, socio-cultural barriers, and political instability continue to undermine its accessibility and integration into the national health system.

Objectives: This paper explores the evolution, current gaps, and future opportunities for palliative care in Iraq, with a focus on institutional readiness, geographic equity, and cultural dimensions. It aims to offer a comprehensive overview of the systemic challenges and to outline a strategic path forward.

Methods: This is a narrative review and policy analysis based on published literature, institutional observations, and recent regional developments in palliative care infrastructure, training, and cultural attitudes. Special emphasis is placed on the interaction between family roles, healthcare delivery, and end-of-life decision-making in the Iraqi context.

Results: Findings reveal a profound misalignment between the need for palliative care and its current availability. Terminal patients often receive aggressive, non-beneficial treatments in intensive care settings, while community-based services are scarce or absent. Cultural stigma, lack of trained personnel, insufficient funding, and the legacy of conflict further complicate access. Family caregivers carry a disproportionate burden, often without professional or psychosocial support.

Conclusion: Integrating palliative care into Iraq’s health system requires both structural reform and cultural transformation. A national policy that prioritizes palliative education, decentralizes services, and respects local values could significantly improve end-of-life care for Iraqi patients and their families.

Keywords: Palliative care, end-of-life care, health system challenges, Iraq, cultural barriers