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The recent establishment of palliative care and medicine as a medical specialty to be taught in postgraduate courses starting from the 2021/2022 academic year in Italy is certainly good news. Some doubts arise, anyway, if the academic programs will be limited to the postgraduate area instead of involving every university in the undergraduate courses. The risk is to maintain the reductionism of future physicians receiving a kind of education centered on the biomedical paradigm only. this website Since at least thirty years we know that there should not be a definite time marking a clear break between previous active treatments for the disease and subsequent palliative ones. Mainly in very old people affected by multiple chronic disorders a simultaneous presence of both forms of treatment should be scheduled, with increasing weight of palliation as the disease progresses and the probability of responding to active treatments becomes less and less. Unfortunately the reality of assistance in the last thirty days of life of papists is mandatory.The spread of palliative care in Italy encountered many difficulties and took place outside - if not despite - the health establishment and medical academia. The lack of a recognized role has conditioned for years the work and lives of the doctors who have dedicated themselves to it. Now the diffusion of palliative care and its institutional acknowledgement have obtained the establishment of specific schools of speciality. This undeniable success involves two important orders of risk, capable of severely limiting if not completely cancelling the value and impact of palliative care the risk of becoming a marginal part of other medical disciplines much more rooted and organized on the one hand, and the other, the loss of their nature of authentic medical revolution, a new way of being doctors and of taking care of the "unhealed" people, the chronic ills, the elderlies, all the sufferers not necessarily in terminal phase. Crystallizing into a "medical speciality" could undo that paradigm shift that medical art, today more than ever, is in dire need of.With the conversion of law decree no. 34 of 19 May 2020, bearing urgent measures concerning health, support to work and the economy, as well as social policies related to CoViD-19 epidemiological emergency, thanks to the approval of an amendment to legislative decree "Rilancio" signed by Giorgio Trizzino, the Specialization school in medicine and palliative care will be established starting from a.y. 2021-2022. Additionally, a course in pediatric palliative care will be introduced in pediatrics specialization schools. The news has been welcomed with enthusiasm by the scientific community and the main stakeholders, some of which have made a strong contribution to this result the Italian Society for Palliative Care, the Italian Federation for Palliative Care, the Maruzza Levebvre d'Ovidio Foundation, as well as the many professionals, institutions, and NPOs that have been supporting for the past forty years the progress of palliative care in Italy. An assessment of the impact of such a measure and its effects entails due process and contextualization in different areas first of all, that of demand and current supply, followed by the historical-cultural, the social, and the normative.The so-called artificial intelligence tools applied to palliative care (machine learning, natural language processing) have great potential to support clinicians in improving decision-making processes and in identifying those who are at high risk of mortality or at greater risk of inappropriate treatment and/or non-positive outcomes. The improvement of prognostic abilities may help to avoid that some choices of patients with serious diseases are taken only in the last days of life, in the face of treatment options not previously discussed in an adequate and shared way. These tools can facilitate some essential aspects in the practice of palliative care, for example the activation of interviews that have as their objective the advance care planning and the definition of treatments consistent with the needs and desires of patients, especially in final stages of life. The development, also in our country, of projects for the application of artificial intelligence in palliative care requires particular attention to the possible organizational repercussions and to some ethical and relational aspects. It will be necessary to reflect on the most appropriate organizational models and on the specialized resources necessary in relation to the foreseeable increase in the number and variability of patients with early identified palliative care needs. These tools must not interfere in fundamental elements of the relationship between patient and doctor, that is the ability to communicate a poor prognosis in an individualized and ethically appropriate way.Machine learning techniques, applied in the palliative field, are able to define an increasingly accurate prognosis in patients with advanced neoplasms and to identify patients at greater risk of functional decline or short-term mortality. The improvement of predictive abilities can allow an enhancement of prognostic abilities and also a more accurate detection of the most complex needs of patients. Moreover, data, even scientific data, are not values, any intervention based on them must be endowed with meaning. Predictive models can therefore be useful but only as a complementary and above all optional tool for the doctor, one of the parameters to evaluate the usefulness in different specific situations. Otherwise, the risk is to add a new type of persistence, the prognostic one.In Italy, a recent legislative decree establishes that from the 2021-22 academic year, medical graduates can specialize in palliative care. The proposal is to be greeted with enthusiasm. However, some concerns remain about how palliative care will become part of the care process. Two scenarios are of concern. First, that training in this area is reserved for specialists only, rather than being part of the competence of any therapist. Second, that palliative care is implemented sequentially rather than when necessary throughout the entire care span. The palliative intervention cannot be equivalent to the finding of "there is nothing more to be done". Because palliative care is part of the care itself and not a residual intervention.