caringspain.com

A contribution from Caring Together. (Issued 5 March 2006)

In a country such as Spain, where as a result of advances in medicine there has been a considerable increase in the expectation of life, there has been a consequent increase in the number of people with chronic and incurable diseases.

This, along with social, cultural and economic change, has profoundly affected family structure and, as a result, the role of the family in the care of sick people is also in process of change.

Among those whose illnesses are most advanced, or terminal, chronic illnesses have many distressing aspects. They generate pain, both physical and emotional, in around 70% of cases , according to a group of Spanish doctors who published a report on medical attention at the end of life as long ago as 2002.

The medical objectives of end-of-life care, says the Report, are centred around Quality of care and Dignity of the patient. At the same time they must avoid both un-necessary prolongation of life as well as deliberately cutting it short. Individual and public calls for euthanasia and assisted suicide may be seen as a heart-cry for better care and may be reduced when the principles of palliative care are put into practice, say these doctors.

So they propose that palliative care programmes and services be put in place and developed with ample treatment of pain and that social programmes and open discussion of the ethics of palliative care are going to be necessary in the face of increasing public demand. Hospitals, primary healthcare centres, daycare centres and Residences will all have gradually to adapt their organization to the increasing number of people approaching the end of life.

The training of doctors, both before and after graduation, must include studies which enable them to be of more assistance to terminal patients, both in control of their symptoms, in the art of communicating with, and the emotional support of, dying patients along with a study of clinical ethics in the face of approaching death.

The development and practice of these principles represent the combination of the best traditions of humanitarian medicine with all the scientific advances which permit us to improve the quality of life and preserve the dignity of our patients. We must continue to treat and to care with the same energy and conviction as before. We must also take on board these new principles concerning care at the end of life.

Asociación Caring Together is not only comfortable with these ideas: it is promoting them and practising them to the extent that our resources permit, in collaboration with others who share the same concern and compassion.