BioMed
Palliative care in India grew through pain relief, community participation, and attention to family burden.
A medical system that turns away from a patient once the disease cannot be cured abandons the person while the suffering goes on. Patients have a right to care that keeps responding to their pain and needs, even when no cure is on offer.
Comfort care should not wait until treatment has failed. It belongs inside all healthcare, running in parallel with efforts to treat the illness, as the World Health Assembly recommended in 2014.
Fixing the body is only part of a doctor's job. The larger duty is to recognise, acknowledge and honour the person who has entrusted their life to the doctor's hands.
Much of the suffering of seriously ill people could be prevented, yet the system fails to deliver relief. In India, 96 per cent of the 10 million people with serious illness have no access to pain relief.
Medicine's purpose includes helping people die with dignity, grace and peace, not only helping them live healthy lives. Comfort and security for people at their most vulnerable are achievements of care in their own right.
It is a paradox that people sign advance directives to shield themselves from the very system meant to help them. They do it because the default at the end of life is aggressive machinery: a tube in every orifice and a lonely death among cables.
Clinicians learn to treat the person rather than just the disease by listening to patients' own stories. Those stories reveal what the suffering actually is and what relief would mean to that person.
The cost of care can become a second catastrophe on top of the illness. 55 million Indians who need hospital admission face catastrophic expenses in the course of their treatment, so a system can treat disease without truly providing healthcare.
Even devoted efforts to ease pain sometimes fail. Owning mistakes and misunderstandings openly is part of how a caregiver learns to do better for the next patient.