"The World Health Organization (WHO) estimates that 5 billion people
live in countries with low or no access to controlled medicines and
have no or insufficient access to treatment for moderate to severe pain."
Declaration of Montreal, 2010
Around the world countries are beginning to view the management of pain as a crisis in healthcare. It is under-funded and under-treated on a global scale, leaving sufferers to live and die in pain.
Management of acute pain is inadequate for more than 50 percent of people in developed countries and 90 percent of people in developing countries, while chronic non-cancer pain occurs in at least one in five people worldwide, including Australia.
As part of the 13th World Congress on Pain in Montreal, the International Pain Summit, hosted by the International Association for the Study of Pain in September 2010, the summit delegates from 129 countries supported a Declaration that Access to Pain Management is a Fundamental Human Right.
The Declaration states that all people:
- Have a right to the access to pain management without discrimination.
- Have a right to be both informed about how their pain can be assessed through the recording of a fifth vital sign, and informed about the possibilities for treatment.
- Have a right to access an appropriate range of effective pain management strategies supported by policies and procedures appropriate for the particular setting of health care and the health professionals employing them.
- Have a right to access appropriate medicines, including but not limited to opioids, and to access health professionals skilled in the use of such medicines.
- Have a right to assessment and treatment by an appropriately educated and trained interdisciplinary team at all levels of care.
- Have the right to a health policy framework that, in governing pain relief treatment in the social, economic and regulatory environment, is compassionate, empathetic and well-informed.
- Have a right to access best-practice, non-medication methods of pain management (ranging from relaxation and physiotherapy methods to more complex cognitive behavioral treatment) and to specialist-performed interventional methods, depending upon resources of the country.
- Have a right to be recognized as having a disease entity, requiring access to management akin to other chronic diseases.
Additionally, the Declaration proposes that:
- Healthcare professionals have an obligation to offer a patient in pain the management that would be offered by a reasonably careful and competent healthcare professional.
- Governments and all healthcare institutions establish laws, policies and systems that will help promote access to pain management.
Endorsements of the Declaration
The principles of the Declaration have been endorsed by the Institute of Medicine and the World Medical Association.
Institute of Medicine
the report Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education and Research is the result of rigorous study into pain as a national health problem. The report details the burden of pain in human lives, dollars, and social consequences and states relieving pain should be a national priority.
|World Medical Association
The 62nd World Medical Association (WMA) General Assembly adopted a Resolution on the Access to Adequate Pain Treatment. Delegates from almost 50 national medical associations attended the annual General Assembly of the WMA in Montevideo, Uruguay from 12 to 15 October.
The resolution on the Access to Adequate Pain Treatment states that people facing pain have a right to appropriate pain management, including effective medications such as morphine. Denial of pain treatment violates the right to health and might be medically unethical.
Editorial on the Declaration
The following papers have been written in response to the Declaration of Montreal, which states access to pain management is a fundamental human right.
Denial of Pain Relief, December, by Professor Michael Cousins AM
Presentation to the International Federation of Health and Human Rights Organisations, The Netherlands, 2011
PAIN - Journal of the IASP
Chronic pain is a growing public health problem with inadequate access to care. Scientific and economic arguments have failed to get the attention of government and policy markers, many advocates are turning to the moral persepective offered by the health and human rights movement.