Pain at the end of life – a call for change

Across the world, events have been taking place to mark World Cancer Day (4 February 2012), which urges us all – individuals, organisations and government – to work together to reduce the global cancer burden. Our first guest blogger, Dr Shelagh Wright PhD, former Lecturer in Psycho-oncology, School of Nursing and Health Sciences, Dublin City University, Ireland, comments:

The experience of severe pain at the end of life is estimated to be about 25% in patients with cancer, with about 75% of patients with advanced cancer experiencing pain and 50% of terminally ill patients experiencing moderate to severe pain. 1 Effective medications are readily available – the problem is an ongoing need for high-level attitudinal change, policy development and implementation and strong political advocacy towards fully meeting the needs of the patient in pain. There is a growing Human Rights movement focusing on putting pressure on governments to develop and implement policies to improve access to effective multidisciplinary pain treatments.

The International Psycho-Oncology Society (IPOS) have set up a Human Rights Task Force. The International Association for the Study of Pain (IASP) have supported a highly enlightening film with accompanying videos called ‘LIFE Before Death’ currently on release at international venues. We all hope fervently to die with peace and dignity. All of us who have lost loved ones know intimately the vital importance of being able to be present emotionally and spiritually for the loved one’s last hours, with pain and fear removed, and no longer a concern, giving hope to allow death with dignity and peace. This is both consoling for the person dying and for their close others at the time of dying and death, in bereavement affording a sense that ‘all that could be done was done’… which is very comforting, a vital comfort denied relatives and close others of deceased persons who have not experienced a pain free, peaceful and dignified death. Achieving peace and dignity and a pain free death for terminally ill patients will also increase the long-term consolation of bereaved loved ones.


1. Foley KM, Fitzgibbon DR et al, Weiss SC et al cited in Breitbart WS, Park J and Katz AM ‘Pain’. In: Holland JC, Breitbart WS et al (eds) Psycho-oncology 2nd ed. New York, Oxford University Press, 2010.

More information on the EAPC can be found at

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