Is There a “Fundamental Right” to Pain Control?

I am always uncomfortable when a new “fundamental right” is declared that nobody knew existed before.  I mean if everything that is beneficial is a “right,” then eventually the concept itself will become watered down like inflation devalues currency.  Or to put it another way, if everything people want or should have is a right, those truly important fundamental freedoms we now possess can come to seem much less important.

But that quibble aside, I am in total support of declaring that providing adequate pain control is a primary goal of medicine—and that failing to do so breaches the duty of care to patients.  And I totally endorse the goal—if not the terminology—of the ” “Declaration that Access to Pain Management is a Fundamental Human Right.”  From the story:

In its “Declaration that Access to Pain Management is a Fundamental Human Right,” delegates to the inaugural International Pain Summit proposed that all people:

1. Have a right to the access to pain management without discrimination.
2. 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.
3. 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.
4. 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.
5. Have a right to assessment and treatment by an appropriately educated and trained interdisciplinary team at all levels of care.
6. 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.
7. 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.
8. 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:

1. 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.
2. Governments and all healthcare institutions establish laws, policies and systems that will help promote — not inhibit — access to pain management.

I like pain as the fifth vital sign, not a new concept, but one that needs continual reinforcement.

Promoting good pain control is good medicine and good ethics—and it is woefully in short supply in many poorer countries. The more patients—and doctors—are educated about its importance, the better.