Unbearable Pain: India's Obligation to Ensure Palliative Care

A new report by Human Rights Watch reveals that thousands of patients in India lack access to essential pain treatment and palliative care.

The report, Unbearable Pain: India’s Obligation to Ensure Palliative Care, identifies the following three key obstacles to improving the availability of pain treatment and palliative care:

• Restrictive drug regulations: many Indian states have excessively strict narcotics regulations that make it very difficult for hospitals and pharmacies to get morphine.
• The failure to train doctors: most medical students and young doctors receive no training on pain treatment and palliative care because the government does not include such instruction in relevant curricula.
• Poor integration of palliative care into health services: national cancer and AIDS control programs do not contain meaningful palliative care components, thus depriving such care of public funds.

More than 70 percent of patients in India's cancer hospitals have advanced, incurable forms of the disease. Yet, the report found that fewer than four percent of these patients are given treatment to relieve their pain. Similarly, health centers that provide AIDS care either do not have morphine or lack doctors trained to prescribe the pain medicine.

According to the report, governments have an obligation to ensure that essential medicines are available to patients and that health care workers receive adequate training in their use. The Indian government's failure to fulfill this obligation violates the right to health. The report further states that the government’s failure to ensure that cancer hospitals offer pain treatment may violate the prohibition against torture and cruel, inhuman, and degrading treatment because of the widespread nature and severity of the suffering it causes.

The International Palliative Care Initiative, part of the Open Society Institute's Public Health Program, provided funding for the report.