Transforming recognition into responsibility: moral obligations to informal caregivers in palliative care

Informal caregivers are widely recognised as part of the 'unit of care' in palliative care, yet this recognition has rarely been translated into clearly specified ethical obligations. The present paper argues that informal caregivers are not merely instrumentally relevant to patient-centred care but are independent moral stakeholders whose vulnerability grounds direct obligations of support. The analysis demonstrates that ethical obligations towards caregivers cannot be justified solely by reference to patient welfare. While many such duties are best understood as prima facie obligations, some reach the level of threshold obligations where caregivers' fundamental interests-such as autonomy, integrity or protection from serious harm-are at stake. The paper argues that the provision of support to informal caregivers should not be regarded as a discretionary component of good palliative care but a threshold requirement of ethically grounded palliative practice, with implications for clinical decision-making and institutional responsibility.