Systemic Failures in End-of-Life Care

This article examines the systemic failure of India’s healthcare infrastructure in ensuring dignified end-of-life care, situating this crisis within the broader political economy that perpetuates inequality and neglect. Despite about 1.5 million new cancer cases annually, with 70%–80% diagnosed at advanced stages, less than 4% of Indians requiring palliative care receive it, and only 1% of cancer patients access adequate opioid analgesia. Through a narrative analysis of existing literature on infrastructural deficits, legislative inertia surrounding opioid laws, socioeconomic determinants, and socio-cultural barriers, this study argues that the widespread suffering of marginalized populations is neither incidental nor inevitable, but arguably a structural consequence of the interplay between political indifference, bureaucratic apathy, and sustained negligence. Drawing on successful state-level innovations, particularly Kerala’s community-based model that accomplishes 60%–70% palliative care coverage, this article proposes a comprehensive policy blueprint for systemic reform, ensuring dignity in dying as a fundamental right guaranteed to every citizen.