Pope Francis has told doctors at the Vatican that when faced with the new challenges that arise with regard to "end-of-life" issues, "the categorical imperative is to never abandon the sick."

The Pope wrote a letter to participants in the European Regional Meeting of the World Medical Association on end-of-life issues.

They met Nov. 16 for a discussion with the Pontifical Academy for Life on end-of-life care.

At the same time, across St. Peter's Square, the Vatican Dicastery for Promoting Integral Human Development and the International Confederation of Catholic Health Care Institutions were hosting a meeting on inequalities in health care, Catholic Herald reported

"Increasingly sophisticated and costly treatments are available to ever more limited and privileged segments of the population," the Pope said.

He said, "and this raises questions about the sustainability of health care delivery and about what might be called a systemic tendency toward growing inequality in health care.

"This tendency is clearly visible at a global level, particularly when different continents are compared."

"But it is also present within the more wealthy countries, where access to health care risks being more dependent on individuals' economic resources than on their actual need for treatment," said the pontiff

A variety of factors must be taken into account when determining what medical interventions to use and for how long with a person approaching the end of his or her earthly life, the Pope said.

For those with resources, treatments are available that "have powerful effects on the body, yet at times do not serve the integral good of the person."

Francis referred to Pope Pius XII, who 60 years ago told anesthetists and intensive care specialists that "there is no obligation to have recourse in all circumstances to every possible remedy and that, in some specific cases, it is permissible to refrain from their use."

"From an ethical standpoint," the Pope said, withholding or withdrawing excessive treatment "is completely different from euthanasia, which is always wrong, in that the intent of euthanasia is to end life and cause death."