Palliative Care: the guarantee of a Human Right

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This article was exclusively written for The European Sting by Loren Dias Braga Barroso and Luísa Silva de Azevedo, both first-year medical students at the State University of Rio Grande do Norte (UERN) in Mossoró, Brazil. They are affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writers and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.


“Don’t make me suffer so much, death, kill me without pain”. In the verse cited, a prestigious Brazilian poet Patativa do Assaré, raises the discussion on an important theme: the right to a dignified death. Even though it is a natural process, death is still treated as a taboo and many patients who are in terminal stages have their rights to end-of-life care denied, in general, because they are seen as irrelevant – according to data from the Worldwide Palliative Care Alliance, in 2012, around 18 million people died on the planet suffering unnecessary pain due to inadequate access to pain treatment. Access to palliative care is one of the most important prerogatives, according to the World Health Organization (WHO) – which is part of Human Rights -, since this type of treatment can relieve suffering effectively, which directly contributes to the physical and mental health of terminally ill patients. Therefore, defending the inclusion and effectiveness of palliative care within the Universal Health Coverage (UHC) is extremely important.

It is essential to clarify the concept of “Palliative Care”, which consists of assistance, attention, and therapy provided by a pluralized and multifaceted team of professionals from different areas, who have the purpose of relieving the last period of life of the patient in a state of health. incurable. This type of treatment is one of the essential health services that make up the UHC – a project that offers ways in which people and communities can access quality health services, when needed, without being exposed to financial difficulties – in addition to being one of the goals from several countries, led by the United Nations and WHO, committed to reaching the Sustainable Development Goal worldwide by 2030. Despite this, according to the WHO, only 1 in 10 people in the world has access to this type of assistance in the world.

One of the major challenges for the full adoption of palliative care within the UHC is precisely the fact that this type of treatment is linked to political, cultural, and economic interests. Many terminally ill individuals are treated in a subhuman way and seen only as people occupying vacancies for patients with healing potential in hospitals and also as a financial expense that can be avoided. This negligence mainly affects individuals with low purchasing power who cannot afford the costs of treatment and end up being denied their right to a dignified death.

Finally, the urgent need to expand the discussions that permeate this theme becomes indisputable, to demystify a cultural knowledge, unfortunately still ingrained in society, that medicine is merely curative. In addition to this view, it is necessary to guarantee and effect real democratization in access to palliative treatments – these, which involve a transdisciplinary team and relate physical, mental, and even spiritual health.

Resources

Frossard Andrea. Os cuidados paliativos como política pública: notas introdutórias. CADERNOS EBAPE.BR [Internet]. 2016 July [cited 2020 Dec 20];14(Edição especial):640-655. DOI http://dx.doi.org/10.1590/1679-395114315. Available from: https://www.scielo.br/pdf/cebape/v14nspe/1679-3951-cebape-14-spe-00640.pdf

Munday D, Kanth V, Khristi S, et al. BMJ Supportive & Palliative Care Epub aheadof print: [please include 21 Dec 20]. doi:10.1136/bmjspcare-2018-001579; Available from: https://www.researchgate.net/publication/328711457_Integrated_management_of_non-communicable_diseases_in_low-income_settings_Palliative_care_primary_care_and_community_health_synergies

O direito fundamental à saúde e a obrigação de fazer do Estado no tratamento paliativo dos pacientes terminais [Internet]. [Brazil]: Álvaro Felipe Câmara da Silva Fernandes; 2020 Dec 23. ARTIGOS; [cited 2020 Dec 22]; Available from: https://jus.com.br/artigos/46616/o-direito-fundamental-a-saude-e-a-obrigacao-de-fazer-do-estado-no-tratamento-paliativo-dos-pacientes-terminais  

Observatório de Direitos Pacientes [base de dados online]. Brasília: Universidade de Brasília. 2018. Acesso em 22 de janeiro de 2020. Disponível em: https://www.researchgate.net/publication/329999924_Cuidados_Paliativos_e_Direitos_Humanos

Palliative care [Internet]. World Health Organization; 2020 Dec 23. Health topics : Palliative care; [cited 2020 Dec 21]; Available from: https://www.who.int/health-topics/palliative-care

Universal health coverage (UHC): What is UHC? [Internet]. [place unknown]: World Health Organization; 2019 Jan 24. Universal health coverage (UHC); [cited 2020 Dec 21]; Available from: https://www.who.int/news-room/fact-sheets/detail/universal-health-coverage-(uhc)#:~:text=What%20is%20UHC%3F,%2C%20rehabilitation%2C%20and%20palliative%20care.

About the author

Loren Dias Braga Barroso and Luísa Silva de Azevedo are both first-year medical students at the State University of Rio Grande do Norte (UERN) in Mossoró, Brazil. They are members of the Local Council of the International Federation of Medical Students’ Associations (IFMSA). Both believing in the efficiency of a more humanized medical practice.

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