title: Ethical issues in palliative care: considerations.
abstract: Discussions on ethics in palliative care often concentrate on issues like patient autonomy or euthanasia. However, the reality in the developing world begs discussion on an entirely different set of problems altogether. One should have a good death, no doubt, but one should also have an opportunity for a good life. Globalization unfortunately seems to worsen many of the burdens of the developing world, like the negative influence of the mighty pharmaceutical industry. Continuing medical education offered only by the pharmaceutical industry instills bias into the minds of most medical professionals. Prescription practices by many professionals are influenced by the industry; so much so, inexpensive drugs or formulations are abandoned in favor of expensive ones, adding to the burden of a much-suffering individual. Palliative care should have been a major force against such evils, but it seems to get more clinical and institutionalized with time, with the social issues taking a back seat. Unethical research practices and preferential treatment in drug availability are practices that continue to marginalize the less privileged. Adoption of the dominant ideology from the West in the developing world also raises problems like cultural unsuitability. Considering that the bulk of the suffering in the world is in poorer countries, these issues need to be addressed.
authors.affiliation: Institute of Palliative Medicine, Pain and Palliative Care Society, Calicut 673008, Kerala, India. pain@vsnl.com
authors.forename: Abdulla
authors.initials: A
authors.lastname: Manima
mesh_terms: D000701:Analgesics, Opioid / Q000191:economics / Q000600:supply & distribution / Q000627:therapeutic use; D019380:Anti-HIV Agents / Q000191:economics / Q000600:supply & distribution / Q000627:therapeutic use; D016265:Conflict of Interest; D032981:Dehumanization; D003906:Developing Countries; D004345:Drug Industry / Q000191:economics / Q000941:ethics; D026690:Ethics, Clinical; D015658:HIV Infections / Q000188:drug therapy; D006297:Health Services Accessibility / Q000941:ethics; D006805:Human Experimentation / Q000941:ethics; D006801:Humans; D010146:Pain / Q000188:drug therapy; D010166:Palliative Care / Q000941:ethics*; D012935:Social Justice; D019366:Western World
chemical_list: D000701:Analgesics, Opioid; D019380:Anti-HIV Agents