ABSTRACT
Over the past years, several strategies have been developed to allow greater access of the general population to health care in Latin America. This has included a change in the organization of services and the generation of new models of caring. The majority of these models, however, were designed by international agencies and have failed to reconcile the population characteristics that determine the organizational culture of health services and human resources, and the response of users and their families to them. Furthermore, end of life issues have not been recognized, or even discussed, in relation to these models. The process of dying has been assumed, paradoxically, to represent a pathological process that requires institutionalization and professional management. Increasingly, the supply of health care services considered palliative in developed countries is poor in developing countries (Harding and Higginson 2005). There is limited access to what has been called “death with dignity” or “good death”, defined by Marcos Gómez Sancho in 2005 as “the right that everyone has to terminate his life in a serene, peaceful process, without pain or other significant symptoms and surrounded by their loved ones”.
