BIOETYKA / ETYKA MEDYCZNA

BIOETYKA / ETYKA MEDYCZNA - Przeglądy aktów prawnych

Cancer Pain Relief with a guide to opioid availability – WHO 1996

Use of analgesics (s. 14)

A relatively inexpensive yet effective method exists for relieving cancer pain in 70-90% of patients. A number of centres in different countries field-tested the method in the 1980s and demonstrated its efficacy. The method can be summarized in five phrases:

• “by mouth”
• “by the clock”
• “by the ladder”
•   “for the individual”
• “attention to detail”

Impediments to cancer pain relief (s. 42)

There are many reasons why cancer pain is not adequately treated at present (7), including:

•  absence of national policies on cancer pain relief and palliative care;
•   lack of awareness on the part of health care workers, policy makers, administrators and the public that most cancer pain can be relieved;
• shortage of financial resources and limitations of health care delivery systems and personnel;
• concern that medical use of opioids will produce psychological dependence and drug abuse;
•   legal restrictions on the use and availability of opioid analgesics.

The WHO strategy

To respond to these issues, WHO advocates a strategy with the following key components (Fig. 2):

•   national or state policies that support cancer pain relief through government endorsement of education and drug availability;
•   educational programmes for the public, health care personnel, regulators etc;
•   modification of laws and regulations to improve the availability of drugs, especially the opioid analgesic.