Editorials

PAIN MANAGEMENT AND PALLIATIVE CARE AS BASIC HUMAN RIGHT

This issue of the Journal contains an important report, The Joint Declaration and Statement of Commitment on Palliative Care and Pain Treatment as Human Rights (hereafter Declaration), which was coordinated by the International Association for Hospice and Palliative Care (IAHPC), the Worldwide Palliative Care Alliance (WPCA), and other organizations.¹ This Declaration calls for the recognition of Palliative Care and Pain Treatment as Human Rights. It was developed jointly with, and signed by, representatives of numerous international and regional organizations from Africa, Latin America, Eastern Europe, Western Europe, Asia and North America. The Declaration was presented on August 4, 2008 at the XVII International AIDS Conference in Mexico City.

The Declaration represents a truly unique effort; this is the first time that such a call has been developed and signed by a collection of leading pain, palliative care, hospice, cancer, HIV/AIDS, and related organizations. Of note, the Declaration is consistent with and predicated on International Human Rights Agreements, United Nations Declarations, and World Health Organization missives and publications This effort promulgated a never before assembled coalition of healthcare and patient advocacy organizations and agencies from around the world, working together to achieve seven specific goals in palliative care and pain management.

The Declaration will be used by non-governmental organizations (NGOs), professional societies, federations, alliances and concerned individuals to increase the visibility and understanding of the critical need for palliative care services and contemporary pain management by policy makers, regulators, governments and organizations to improve the care of patients with life-limiting conditions and to provide support to their families and loved ones.

The IAHPC and the WPCA invited other interested organizations and individuals to sign the Declaration, and on World Hospice and Palliative Care Day, October 11, the full list of individuals and organizations that signed the Declaration was published.

Those of us affiliated with the Journal of Pain & Palliative Care Pharmacotherapy remain committed to making pain and symptom control more available for the citizens of the world. We applaud the work of IAHPC and the WPCA and we commit to continuing to offer this publication as a platform to help publicize their important work.

EDUCATE AND ADVOCATE

Every pain clinician knows that knowledge is power. The more our patients understand about their pain and its management, the better able most are to follow their treatment plans, cope with their symptoms, and articulate to others what they are experiencing. The better patients understand their diseases and the management of their symptoms, they more realistic they can be in their expectations. Knowledge and understanding can empower patients, as exemplified by the art reated by persons with pain that appears on the cover of each issue of this Jounral.¹, ²

For several years, the Journal has been running a feature entitled “Pain Management Consultation—Information for Patients” written by Professor Scott Fishman, a leading pain specialist who is an internist and psychiatrist who also completed an anesthesiology pain fellowship. Dr. Fishman directs a University health system pain service and fellowship. He is also a past president of the American Academy of Pain Medicine, a member of the Board of Directors of the American Pain Foundation, and a member of the Journal Editorial Board. Dr. Fishman suggested the expansion of his feature to involve queries from patients receiving care at leading, academically-based Pain Management Centers across the United States with responses written by the attending physicians and pain management fellows who care for those patients. In this issue of the Journal, we present the first two such queries with responses. In future issues, we plan to expand this feature further. We invite readers to submit questions for consideration to be addressed in this feature.

Patients with chronic pain often feel helpless and alone. Many do not have ready access to support systems let alone well trained pain specialists. This is a larger segment of society. Approximately 20% of adult Americans experience moderate to server intermittent or chronic pain³ and the prevalence in much of Europe is the same.⁴ Recognizing the need for effective public advocacy for persons with pain and their families and support groups, leading pain clinicians and concerned citizens formed the American Pain Foundation (APF)⁵ in 1997. The Journal has been pleased to publish reports from the APF in the past and we are delighted to collaborate with APF on this new feature. Yvette Colón, MSW, PhD is an oncology social worker, patient educator and advocate who will coordinate this feature to assure that the responses we provide are written in ways that most patients can understand. Dr. Colón is the Director of Education and Internet Services at the American Pain Foundation, where she oversees the Pain Information Center and manages the organization's website and online support program with a membership of over 40,000, including discussion forums devoted to cancer and related topics. She is uniquely qualified to coordinate this expanded feature and we are delighted to welcome her to the Journal Editorial Board.

Education empowers. Educated people are more effective advocates. We encourage readers to use the questions and responses in this feature to help educate their patients when appropriate. It is our earnest hope that this new feature will become a valuable education and advocacy resource to help improve pain and symptom control.

Arthur G. Lipman, PharmD Editor