The urgent need for palliative care

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“All medicine, not just the dissection of corpses, encroaches on the sacred spheres. Doctors invade the body in every way imaginable. They see people in their most vulnerable, most frightened, most private state. “

Paul Kallanithi

Hospitals in Pakistan cater for most areas of medicine, cardiology, oncology, rheumatology, gastroenterology, but the crucial area of ​​palliative care is sorely neglected, in fact there is barely. The ratio of palliative services to population in Pakistan is said to be 1:90 million, which is a terribly dismal picture.

Afghanistan is the world’s largest producer of opium. Its opium harvest accounts for 80 percent of the world’s supply. So now, instead of just beating their eyes at the new Taliban rulers, Pakistani authorities should consider importing opium, the most abundant and useful commodity produced in their country, instead of importing the brand. religion of the Taliban. And then to use that opium to make morphine, to help all those who need this narcotic in this country.

What is palliative care?

Palliative care is the help given to a patient when his disease no longer responds to curative treatment, that is to say at a “terminal” stage, when the disease is considered likely to lead to death. This is when palliative care and hospices are needed.

Of all the other areas of medicine, palliative care is the most holistic care for a patient.

Palliative care includes non-medical care for the dying person, it addresses a person’s physical and emotional needs, such as providing religious facilities when needed, responding to patient and family questions and concerns, and generally caring for this period of life as as simple as possible.

Palliative care takes into account a person’s quality of life and aims to make death as peaceful, dignified and painless as possible.

At some stage, this care is ideally provided in the patient’s home, when the role of the family becomes even more important, but this depends on the individual situation. In a poverty stricken country like Pakistan, this may not always be possible. Therefore, adequate facilities must be available in hospitals and professional training, equipment and personnel must be provided.

There is the usual set of people who say death is not the business of hospitals and medical professionals. These are usually the people who also say that since it is God who determines the mode of death, everyone should stay out of the question. Again, these are usually the same people who fail to rationalize religion, who actually imagine reason to contradict faith.

God is certainly the one who determines the mode of death. However, if humans are to stay out of this issue, then we should all also stop taking drugs and having surgery, because “all medicine encroaches on the sacred spheres” yet no one expects it.

There are other misconceptions.

Palliative care is sometimes confused with euthanasia, when in fact they are two very different things. Euthanasia is the practice of actively ending a person’s life in order to minimize suffering. Palliative care does not end life, it strives to make life easier and the end – when it comes, less difficult.

Paul Kalanithi, an American neurosurgeon who chose to work in palliative care until he himself died of metastatic lung cancer, was 37 at the time of his death. His book on this subject, When the breath becomes air, worth reading. Obviously, after a certain point, Paul was unable to write himself, and then the story was taken up by his wife. One of the book’s most notable features is its description of how Paul died. The quote at the top of this piece is taken from this book.

One of the most important requirements of palliative care is morphine, which is used to minimize pain and help the dying person move on with as little suffering as possible. Unfortunately, this is another misconception, that allowing morphine in mainstream medical care is to encourage drug addiction. This is very inaccurate. Equating the two is like equating breathing polluted air with suicide. Pollution must be prevented, which would minimize the related deaths. Likewise, the way in which morphine is dispensed should be controlled, to prevent it from falling into the wrong hands.

Morphine, an essential narcotic, is not available in Pakistan. At least not legally, not even in hospitals.

Morphine is an extract derived from the opium plant. Heroin is also made from the opium plant, which is used as an addictive substance.

It’s time for morphine to be available in hospitals for pain relief.

Afghanistan is the world’s largest producer of opium. Its opium harvest accounts for 80 percent of the world’s supply. So now, instead of just beating their eyes at the new Taliban rulers, Pakistani authorities should consider importing opium, the most abundant and useful commodity produced in their country, instead of importing the brand. religion of the Taliban. And then to use that opium to make morphine, to help all those who need this narcotic in this country.

Palliative care is probably a difficult concept for our authorities to understand, making death easy for its inhabitants, when they seem to have such a hard time making their lives easier, but it is good to remember that we have all of us experience death, which is an integral part of life, and we cannot all be airlifted to another country and treated in foreign hospitals when the time comes.


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