Diederik Lohman is a senior researcher with the Health and Human Rights Division at Human Rights Watch, where his work focuses on access to palliative care, including controlled medicines for the treatment of pain and international drug control policy.
The lecture is introduced by Jim Cleary, MD, Director of the Pain and Policy Studies Group and palliative care physician at the University of Wisconsin – where the lecture was hosted last month.
Cleary provides some background on the history of regulation of narcotic drugs and the use of opioids for pain relief around the world and introduces the concept of balance between drug control and ensuring medical access to opioids, as well as the disparity in use of opioids around the world.
During the lecture, Lohman discusses why access to palliative care and pain relief should be considered a human rights issue and outlines how Human Rights Watch and others are working to promote and improve access to palliative care around the world.
Lohman says: “The good news is that we have the tools and knowledge to provide good relief of symptoms and to maintain a good quality of life for most patients… The bad news is that 80% of the world’s population live in countries with no, or very limited, access to strong pain medications such as morphine.”
In persuading his audience that access to relief from pain is a human right, Lohman talks about his work with torture victims and the similarities between the pain suffered by these victims and the extreme pain experienced by people who are dying from cancer and other conditions. He highlights three case studies from Ukraine, Russia and India which demonstrate the suffering caused by the lack of access to pain relief.
Lohman goes on to discuss the reasons why pain relief is not easily accessible for the majority of the world’s population. As well as restrictive drug regulation, which often means that dying patients are ‘collateral damage’ in the war on terror, he also highlights how the evolution of medicine and health policy mean that both tend to focus on diagnosis and cure, rather than symptom management and ‘whole person care’.
In talking about the work of Human Rights Watch, Lohman describes how the organisation works with individual countries, identifying the difficulties that patients and doctors have in accessing palliative care and pain relief and working with governments to overcome and remove these barriers. He also highlights its work on the global stage, ensuring that palliative care and pain relief are on the agenda of world leaders.
The lecture is followed by a panel discussion, led by lawyer Asra Husain, who highlights recent changes to legislation in India which should improve access to pain relief.
The lecture is part of an ongoing project by the University of Wisconsin School of Medicine and Public Health making new videos on a wide range of subjects available daily.