A few weeks ago we learned the story of the doctor, an expert in bioethics, Liliana Ortiz, a former academic at the Universidad de Concepción. After dealing with aggressive breast cancer, she decided to receive palliative sedation so that her death would be painless.

With this, wounds were opened again on issues that as a society we do not want to attend to. Among them, euthanasia. This event reminds us that we need to discuss and legislate on individual freedoms in health problems, and delve into how pain can affect people’s quality of life.

According to research by the World Health Organization, it is estimated that annually 40 million people need palliative care for pain in the world, and 78% of them live in low- and middle-income countries. In the case of children, 98% of those in need of palliative care live in low- and middle-income countries. In Chile, palliative care for oncological diseases is covered by the AUGE guarantees, and within them is the treatment of pain.

Pain affects the entire life of the patient, their quality of life, their ability to work, their personal relationships, their self-esteem. In extreme cases, there are patients who have committed suicide because they cannot bear it. Generally, stress aggravates pain, regardless of what type of pain it is. Living with chronic pain makes it difficult to make decisions, it stifles thinking, it takes over the person.

For this reason, it is very important to monitor the patient with chronic pain. In addition to drug treatment to reduce pain, psychological and emotional support is essential. This applies to all stages of life and, of course, to the end of life. The challenge is to find multidisciplinary treatment and involve medical treatment, physical and psychological therapy.

The pharmacological therapies available at the moment are not ideal, since their effectiveness is relatively low and they have adverse effects that cause many patients to discontinue them. In Chile, the MiNuSPain nucleus is working to achieve a better understanding of the neurobiological bases of pain. In this way it will be possible to lay the foundations for new drug targets that improve people’s quality of life.

* Associate Professor Faculty of Biological Sciences, Pontificia Universidad Católica de Chile.

Director of the Millennium Nucleus for the study of pain, MiNuSPain