Fears About Using Morphine Leading to Unnecessary Pain for Millions, Says Consultant


(22.05.2013) The prejudice and fears of healthcare professionals about using morphine to relieve pain are causing millions of patients to suffer unnecessarily, a leading pain specialist consultant told a meeting today (Wednesday), co-sponsored by the World Medical Association. 

Dr. Mary Cardosa, a Malaysian consultant anaesthesiologist and pain specialist and Immediate Past President of the Malaysian Medical Association, said that tens of millions of people around the world suffer from significant pain and other debilitating symptoms related to illnesses such as cancer, advanced diabetes, heart disease, other non-communicable diseases, and HIV and TB. 

'These patients require palliative care, a health service that can restore or maintain their quality of life and allows them to live with dignity. Despite this great need, palliative care services remain sparse in much of the world,' Dr. Cardosa told the meeting in Geneva during World Health Assembly week. 

Dr. Cardosa went on: 'Apart from having national policies on pain and palliative care, efforts must include education of the public and of healthcare professionals, in order to overcome barriers to effective pain management and palliative care. 

'Among the big challenges are the prejudices and fears of healthcare professionals regarding the use of morphine which is the mainstay of pain relief in patients with acute pain as well as those with advanced cancer and other painful conditions. 

'Morphine provides cheap and effective analgesia to such patients but is often not accessible because of legal barriers or, worse still, because of healthcare professionals’ fear of addiction and side effects as well as lack of knowledge on the appropriate prescription of morphine and morphine-like substances for pain relief in these patients.' 

Dr. Cardosa said the Worldwide Palliative Care Alliance estimates that about one hundred countries worldwide do not have any palliative care services available, while in another 74 countries such services are limited to isolated locations and reach only a small proportion of patients in need. 

She said the Executive Board of the World Health Organization (WHO) and the World Health Assembly (WHA) are expected to discuss palliative care needs and barriers next year. The WMA meeting today, organised with other bodies, including the Human Rights Watch and the African Palliative Care Association, was designed to discuss successful palliative care models from different world regions and exchange views on how a potential WHA resolution could most effectively promote palliative care.  

Dr. Cardosa said that building a global coalition for palliative care was a means to ending unnecessary suffering from treatable symptoms for the millions affected, especially those in countries where palliative care services were not readily available. 

The meeting today was sponsored by the permanent missions to the UN of Panama, Uganda and the United States, and organised by the WMA together with the African Palliative Care Association,

Asociacion Latino americana de Cuidados Paliativos, Hospice Africa Uganda, Human Rights Watch,

International Association for Hospice and Palliative Care, Kenya Hospice and Palliative Care Association,

Open Society Foundations and the Union for International Cancer Control. 

In 2011 the WMA adopted a Declaration on End of Life Medical Care with recommendations on pain management and calling on all national medical associations to develop national policies on palliative care.