• Xingran R Weng, Rama Nakdali, Barrak Almoosawi, Mahmood Al Saeed, Samuel Maiser, and Mona Al Banna.
• Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA.
• J Pain Symptom Manage. 2021 Jul 1; 62 (1): 98-106.e1.

ContextPresent studies suggested that cultural and religious factors, as well as law and policy, may have impeded the advancement of palliative care in the Middle East. Little is known about health care providers' perceptions of palliative care and the barriers to its development in the Gulf Cooperation Council.ObjectivesTo understand health care professionals' attitudes and beliefs regarding palliative care and highlight current practice barriers in Bahrain.MethodsSemistructured interviews with 16 health care providers (physicians and nurses) were conducted. Thematic analysis was then performed after interviews were transcribed verbatim.ResultsHealth care professionals perceived palliative care as a service only delivered to patients at the end of life. Palliative care was only offered to patients who have been diagnosed with cancer and had exhausted all curative treatments. Do-not-resuscitate orders and code status discussions are not currently practiced. Palliative care decisions are usually decided by patients' families. Middle Eastern culture, health care law and policy, conservative interpretations of Islam, and a lack of professional expertise were identified as barriers.ConclusionThis study unveiled the perceptions of palliative care among health care professionals in a Gulf Cooperation Council country. Six major barriers that hindered palliative care practice were identified. Future health care policy in the region needs to address these barriers within the current health care system while taking culture, religion, and social factors into consideration.Copyright © 2020 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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