What is palliative care?
Palliative care aims to provide the best quality of life for adults and children living with and affected by life-limiting illness. The palliative care approach improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.
Why is palliative care a human rights issue?
Palliative care is a human rights issue because this is a severely neglected area of the right to health. For example, with respect to pain management, few governments have in place effective supply and distribution systems for morphine. This can be attributed in part to the excessively strict drug control regulation, which unnecessarily impedes access to morphine or establishes excessive penalties for mishandling it. In addition, many governments have not made sufficient efforts to ensure that morphine is affordable. Furthermore, health care workers are not receiving instruction and relevant training on pain management. The situation is exacerbated by the invisibility of suffering.A human rights based approach to palliative care has the potential to influence governmental policies and guidelines such that palliative care receives the attention it desperately needs.
What are the relevant sources?
- Strengthening of palliative care as a component of integrated treatment within the continuum of care (draft WHO Resolution, 2014)
- World Medical Association Resolution on the Access to Adequate Pain Treatment, 2011
- IFHHRO Position Statement on Access to Adequate Pain Treatment, 2011
- International Covenant on Cultural, Economic and Social Rights (CESCR), Article 12
- CESCR General Comment 14, paras 12 (a), 25, 43 (d)
- European Charter of Patients’ Rights, Art. 11
- WHO Model List of Essential Medicines, 2010
- Declaration of Cape Town, 2002
- Declaration on the Promotion of Patients Rights in Europe, Arts. 5.10, 5.11
- Single Convention on Narcotic Drugs, 1961
What are the relevant issues?
The umbrella of palliative care covers the following issues, among others:
- Pain relief
- Access to morphine
- Reducing drug dependence
- Symptom control for physical and psychological symptoms
- Non-discrimination in the provision of palliative care on the basis of age, gender, socioeconomic status, geographic location, national status, prognosis or means of information
- Access and availability of essential medicines
- Care provided by trained palliative care professionals
- Home-based care when dying and to die at home if desired
- Right to have treatment withheld or withdrawn
- Naming a health-care proxy for decision-making
- Information about diagnosis, prognosis and palliative care services
How could the state of palliative care be improved?
- Governments need to develop policies on pain management and palliative care.
- Chronic pain management needs to be part of palliative care services.
- Efforts must be made to provide home-based palliative care for individuals.
- The barriers which impede the availability of pain treatment medications need to be eliminated or reformed, including action to ensure affordability.
- Governments should draw from the expertise of the WHO Access to Controlled Medications Programme.
- Training and instruction must be introduced for health-care workers, including those already practicing.