As debates rage across Europe over attempts by some countries to introduce assisted dying laws, Latvia’s first hospice day center for palliative care has been hailed as a success, raising hopes of a national roll-out. It comes only five years after parliamentary deputies refused to legislate for euthanasia.
In 2021, deputies rejected a “For Good Death” (Par Labu Nāvi) bill in the Saeima in Rīga by 49 votes to 38, with two abstentions.
The vote followed a 10,000-strong civic petition that prompted a parliamentary review. It was in line with a recommendation from the Mandate, Ethics and Submission Committee to reject the assisted dying initiative.
The decision came despite some medical experts expressing support for assisted dying.
“Despite the public claims of the Latvian Medical Association, the attitude of physicians towards assisted dying is rather supportive,” noted the RSU Research Portal in a study on the issue.
While the Latvian Medical Association maintained that euthanasia conflicts with “the professional tasks of a physician and the principles of medical ethics,” data from an online study conducted between May and June 2021 showed that 58% of certified physicians and 82% of medical students supported voluntary euthanasia for adults. Additionally, 49% of certified physicians and 73% of medical students supported physician-assisted suicide.
Even so, palliative care advocates recognised an urgent need to improve state-funded end-of-life care.
The State Audit Office of Latvia (Valsts Kontrole) reports that 12,000 patients a year receive state-funded palliative care. However, the audit office acknowledged in September 2024 that “in reality, the number who would need this service is almost twice as high” - an estimated 21,000 Latvians every year.
While standard state-funded care focuses heavily on clinical and hospital-based medical needs, the Hospice Day Center (Hospiss Māja) fills a vital gap by offering day-based, non-acute social care, respite for caregivers and specialised hygiene services that are not usually covered by the state health budget.
The facility, Latvia’s first hospice day center, officially opened in April this year in central Rīga, specifically for hospice patients whose care at home is complicated by health and social circumstances.
Ramona Innusa, project manager for the Hospice Day Center, told Christian Daily International that the initiative has continued to prove successful.
“We definitely see the high demand for social services in combination with medical services for severely ill patients, especially full-body bathing of bedbound patients,” said Innusa.
“After the official public opening of our Hospice Day Center, we received feedback and comments stating it is a pity that there is none of this kind in other cities of Latvia, because ours is located in the capital city, Rīga.
“Therefore, we also see the potential to replicate these kinds of centers in at least four regions of Latvia – Vidzeme, Kurzeme, Zemgale, and Latgale.”
The project’s social enterprise, Hospiss Māja, funded the renovation of the premises. The European Social Fund Plus financed vital equipment for the project - including a functional bath specially adapted for washing fully bedbound patients, a medical trolley, a laundry trolley and four functional chairs - as well as personnel costs for two caretakers, a social worker, a spiritual support worker, a volunteer coordinator, a part-time project manager and a part-time accountant. It opened its doors in January after extensive renovation works.
In total, 44 individual patients received care during the initial six-month trial period, primarily adults with incurable illnesses who had been assessed by a medical board as having a life expectancy of up to six months.
During the same period, 392 social care activities were carried out. Hospiss Māja provided round-trip transportation to the Hospice Day Center on 118 occasions, including 66 journeys using specialized transport for bedridden patients. It also provided 113 full-body baths, 64 consultations with a spiritual support worker for patients, five consultations for accompanying relatives and 91 volunteer-led sessions. These included haircuts, nail care, outdoor walks in specialized wheelchairs, board games and conversations over lunch and snacks.
In addition to these social services, 61 medical procedures were carried out during the trial period. These included 10 physician consultations on palliative care matters, two intramuscular injections, nine instances of medication administration, three episodes of port catheter care, 11 episodes of pressure ulcer care, three episodes of postoperative wound care involving secondary healing, two episodes of care for infiltrative skin and subcutaneous tissue lesions, four episodes of gastrostomy care, seven episodes of indwelling urinary catheter care and 10 instances of vital-sign monitoring.
“Up until June 30, 2026, we had 125 bookings from patients, and to this day that number has risen to 153 bookings. There are patients who visit our daycare center regularly, two to four times a month, but there are also patients who have visited just once and have passed away,” said Innusa.
Despite the valuable support provided by the hospice services, securing ongoing funding remains a challenge, according to Innusa.
“The particular problem and challenge we are facing is that the services are not covered by the state or municipality,” she said.
“Most of the service costs are covered by donations provided by our affiliated non-governmental organization, HOSPISS LV. To date, there have been five patients in total who have covered the costs of the day center services they needed out of their own funds.”
