Palliative care: managing the total pain

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This article was exclusively written for The European Sting by Mr. Vinicius Kaiser Queiroz, 20 years old, a second year medical student at UFPel, located in Pelotas, RS, Brazil. He is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.


Palliative care, has been gaining recognition and prominence nowadays, however advances in coverage are necessary to amplify this access and provide health in a broad and complete way.  

According to the World Health Organization (WHO), in a concept defined in 1990 and updated in 2002, “Palliative Care consists of assistance promoted by a multidisciplinary team, which aims at improving the quality of life of patients and their families, in the face of a life-threatening disease, through prevention and relief of suffering, through early identification, impeccable evaluation and treatment of pain and other physical, social, psychological and spiritual symptoms”.

As can be seen from the description above, palliative care goes far beyond the process of dying or terminality, is to treat the human being as in fact a human, mortal, complex and encompass all its peculiarities.  

To defend palliative care is to defend one’s own quality of life, to guarantee support in a moment of vulnerability and hopelessness. It is worth mentioning that even from the name, which from the Latin “Pallium” means mantle or blanket, one can analyze the importance of palliative care and that in fact they are essencial for Universal Health Coverage (UHC), representing the welcoming and integral aspect of this service. 

Promoting universal health is based on the principle of welcoming, supporting and striving to ensure quality of life for thousands of people, so the concept of “Total Pain” initially described by Cicely Saunders fits perfectly to achieve the goals of the UHC. Total pain, addresses the individuality of the being and multidisperses pain into physical, psychic, social and spiritual pain, ensuring the integrity of health. 

For years, social and spiritual pain has been overlooked, however with the emergence of person-centered medicine and public health policies this approach has changed. Therefore, being a trivial specialty to ensure the relief of these pains, palliative care becomes essential when thinking in a universal health context. 

In Brazil and other countries, there are still few places focused on this care, however with the growth of hospices and professionals in the area, the population quality of life improved, especially in the process of death. Defending palliative care in UHC is necessary to guarantee the integral approach on health for all.

References

Nakasu MVP. Em defesa de uma certa Enfermidade: Cuidados Paliativos em Debate / In defense of a certain Disease: Palliative Care in Debate. Rev Cienc Saude [Internet]. 1 [citado 22º de dezembro de 2020];3(4):2-. Disponível em: http://186.225.220.186:7474/ojs/index.php/rcsfmit_zero/article/view/528

Panikulam A. Total pain management. Indian J Palliat Care. 2011 Jan;17(Suppl):S68-9. doi: 10.4103/0973-1075.76246. PMID: 21811375; PMCID: PMC3140083.

About the author

Vinicius Kaiser Queiroz, 20 years old, is a second year medical student at UFPel, located in Pelotas, RS, Brazil. He is affiliated to the International Federation of Medical Students Associations (IFMSA).  Vinicius is passionate about making this world a better place and help others to achieve a better quality of live.

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