Abstract
ENSURING ACCESS TO PAIN RELIEF AS HUMAN RIGHTS
K. Shapoval-Deinega, A. Rokhanskiy, O. Riga, A. Penkov
The article presents the results of a selective study on the access to anesthesia. It has been determined that in most cases the goal of chronic pain management has not been achieved for a long time, the expected level of successful anesthesia has not been achieved in 80-90% of those in need, anesthesia is prescribed formally (“any prescription is a good prescription”), without taking into account clinical recommendations and clinical guidelines, that is doctors do not adhere to the principles of the WHO regarding the prescription of analgesics, approved by the Order of the Ministry of Health No. 311 as of 15 April 2012 “On the approval and implementation of medical and technological documents for standardization of palliative care in chronic pain syndrome”. The authors believe that professional training of doctors requires changes regarding the quality of palliative care in accordance with WHO standards, wide implementation of modern scientific concepts of anesthesia in all areas of medical staff training.
Key words: palliative care, anesthesia, human rights.
ЗАБЕЗПЕЧЕННЯ ДОСТУПУ ДО ЗНЕБОЛЕННЯ ЯК ПРАВА ЛЮДИНИ
К. Шаповал-Дейнега, А. Роханський, О. Ріга, А. Пеньков
У статті наведено результати вибіркового дослідження щодо забезпечення людини до знеболення. Визначено, що у більшості випадків не досягнута мета лікування хронічного больового синдрому протягом тривалого часу, не досягнуто очікуваного рівня успішного знеболення у 80–90 % осіб, що цього потребують, знеболення призначається формально («щось призначили – і гаразд»), без урахування клінічних рекомендацій та клінічних настанов, тобто лікарі не дотримуються принципів ВООЗ щодо призначення знеболюючих засобів, які містяться у наказі МОЗ № 311від 25.04.2012 "Про затвердження та впровадження медико-технологічних документів зі стандартизації паліативної медичної допомоги при хронічному больовому синдромі". Автори вважають, що ротребує змін фахова підготовка лікарів щодо якості надання паліативної допомоги відповідно до стандартів ВООЗ, широкої імплементації сучасних наукових уявлень про знеболення в усі ланки підготовки медичних працівників.
Ключові слова: паліативна допомога, знеболення, права людини.
ОБЕСПЕЧЕНИЕ ДОСТУПА К ОБЕЗБОЛИВАНИЮ КАК ПРАВО ЧЕЛОВЕКА
К. Шаповал-Дейнега, А. Роханский, О. Рига, А. Пеньков
В статье приведены результаты выборочного исследования по обеспечению человека к обезболиванию. Определено, что в большинстве случаев не достигнута цель лечения хронического болевого синдрома в течение длительного времени, не достигнуто ожидаемого уровня успешного обезболивания в 80-90% лиц, нуждающихся, обезболивания назначается формально ( «что-то назначили - и ладно»), без учета клинических рекомендаций и клинических руководств, то есть врачи не соблюдают принципы ВОЗ по назначению обезболивающих средств, которые содержатся в приказе Минздрава № 311вид 25.04.2012 "Об утверждении и внедрении медико-технологических документов по стандартизации паллиативной медицинской помощи при хроническом болевом синдроме ". Авторы считают, что ротребуе изменений профессиональная подготовка врачей по качеству оказания паллиативной помощи в соответствии со стандартами ВОЗ, широкой имплементации современных научных представлений о обезболивания во все звенья подготовки медицинских работников.
Ключевые слова: паллиативная помощь, обезболивание, права человека.
References
Human Rights Watch, 350 Fifth Avenue, 34th floor, New York, NY 10118-3299 USA, Tel: +1 212 290 4700, Fax: +12127361300, hrwnyc@hrw.org
Human Rights Watch (2009). Please, do not make us suffer any more. Access to Pain Treatment as a Human Right. Ruth Fremson/The New York Times/Redux, р. 45. Available at:
https://www.hrw.org/sites/default/files/reports/health0309ruwebwcover.pdf
Human Rights Watch (2011). Uncontrolled Pain. Ukraine’s Obligation to Ensure. Evidence-Based Palliative Care. Scott Anger & Bob Sacha/Open Society Foundations, р. 94. Available at:
https://www.hrw.org/sites/default/files/reports/ukraine0511rusWebVersion.pdf
Rohanskij A., Kotenko A., Lazarevich Ju. i drugie (2012). My imeem pravo zhit' bez boli i stradanij otchet pravozashhitnyh organizacij o sobljudenii prav palliativnyh pacientov Ukrainy. [We have the right to live without pain and suffering the report of human rights organizations on the observance of the rights of palliative patients in Ukraine]. Kiev: Izdatel'skij dom «Kalita», p. 112.
Senjuti І.Ja. (2015). Prava ljudini v galuzі ohoroni zdorov’ja 2007–2016. [Human rights in the health galusies 2007-2016]. 5-te vid., dop. – L'vіv: Vidavnictvo LOBF «Medicina і pravo», p. 989.
Theunissen, J.M., et al. (2007). Symptoms in the palliative phase of children with cancer. Pediatr Blood Cancer, 49(2), pр. 160-165.
Riga O.O., Marabyan R.V., Penkov A. Yu. et al (2015). Problems and development prospects of children’s palliative care in Ukraine. Family Medicine, 6 (62), рр. 138-140.
Joan MarstonrI GA, Riga O., Marston J, Penkov A. (2016) The first experience of mobile pediatric palliative team in Ukraine. Zaporoxhian Medical Journal, 6(99), рр. 62-66.
Riga O., Gonchar M., Konovalova N., Marabyan R. (2016). Outcomes And Need Of Palliative Care For Children With Paralitics Syndrome». 6th Congress of the European Academy of Paediatric Societies, р.409.
Penkov A., Riga O., Gonchar M., Marabyan R. et al (2016). «Access To Palliative Care For Children In Ukraine – Challenges And Views». 3rd Congress on Pediatrics Palliative Care), Abstract book, р.112.
Rіga O.O., Gonchar' M.O. Marabjan R.V., Pen'kov A.Ju. i drugie (2016). Problemi ta perspektivi rozvitku pedіatrichnoї palіativnoї dopomogi. [ Problems and prospects of pediatric palliative care development]. Reabіlіtacіja ta palіativna medicina №2(4), pp. 73-76.
Rіga O.O., Osichnjuk L.M., Marabjan R.V. (2016). Ocіnka bol'ovogo sindromu u dіtej іz nevrologіchnoju patologієju Hіrurgіja Donbasu. [Evaluation of pain syndrome in children with neurological pathology of the Donbass Surgery]. Tom 5, № 3, pp. 59-64.
Rіga O.O., Marston Joan, Gonchar' M.O., Pen'kov A.Ju. (2016). Pedіatrichna palіativna dopomoga v prakticі ditjachogo endokrinologa. [Pediatric palliative care in the practice of children's endocrinologist]. Materіali naukovo-praktichnoї konferencіі z mіzhnarodnoju uchastju «Endokrinna patologіja u vіkovomu aspektі», рр. 74-75.
Rіga O.O. Marabjan R.V., Gavrish T., Pen'kov A. i drugie (2015). Chi є lokal'nі protokoli palіativnoї dopomogi dlja dіtej v ustanovah. [ Are there any local palliative care protocols for children in institutions]. Materіali naukovo-praktichnoї konferencії: palіativna dopomoga v Ukraїnі: skladovі ta shljahi rozvitku. Reabіlіtacіja ta palіativna medicina, №1(1), pp. 88-89.
Gonchar' M.O., Rіga O.O., Pen'kov A.Ju. (2015). Principi nadannja palіativnoї dopomogi dіtjam: pershij dosvіd viїznih palіativnih brigad v Harkіvs'kij oblastі Navchal'nij posіbnik. [Principles of the provision of palliative care for children: the first experience of visiting palliative brigades in the Kharkiv region]. Vidavnictvo RA ART-MAK, Harkіv, p. 112.
Rіga O.O., Koval'ova O.M., Korobka O.V., Gonchar' M.O. i drugie (2015). Palіativna dopomoga u novonarodzhenih: mediko-etichnі ta fіnansovo-ekonomіchnі aspekti. [Palliative care for newborns: medical and ethical and financial and economic aspects]. Ekonomіka і pravo ohoroni zdorov’ja, №1, pp. 31-35.
Rіga O.O. (2015). Kroki dlja sprijannja vprovadzhennja neonatal'noї palіativnoї dopomogi v Ukraїnі. [Steps to Promote the Implementation of Neonatal Palliative Care in Ukraine]. Neonatologіja, hіrurgіja ta perinatal'na medicina T V № 2 (16), pp. 5-10.
Rohans'kij A. O. (2016). Prava ljudini v galuzі ohoroni zdorov'ja 2015-2016 (persha polovina): dopovіd' pravozahisnih organіzacіj. [Human rights in the field of healthcare 2015-2016 (first half): report of human rights organizations]. Іn-t prav. doslіdzh. і strategіj. Harkіv: Prava ljudini, p. 107.
"Inter Collegas" is an open access journal: all articles are published in open access without an embargo period, under the terms of the CC BY-NC-SA (Creative Commons Attribution ‒ Noncommercial ‒ Share Alike) license; the content is available to all readers without registration from the moment of its publication. Electronic copies of the archive of journals are placed in the repositories of the KhNMU and V.I. Vernadsky National Library of Ukraine.
Copyright Agreement
1. This Agreement on the transfer of rights to use the work from the Co-authors to the publisher (hereinafter the Agreement) is concluded between all the Co-authors of the work, represented by the Corresponding Author, and Kharkiv National Medical University (hereinafter the University), represented by an authorized representative of the Editorial Board of scientific journals (hereinafter the Editorial Board).
2. This Agreement is an accession agreement within the meaning of clause 1 of Article 634 of the Civil Code of Ukraine: that is, a contract, "the terms of which are established by one of the parties in forms or other standard forms, which can be concluded only by joining the other party to the proposed contract as a whole. The other party cannot offer its terms of the contract." The party that established the terms of this contract is the University.
3. If there is more than one author, the authors choose the Corresponding Author, who communicates with the Editorial Board on his own behalf and on behalf of all Co-authors regarding the publication of a written work of a scientific nature (article or review, hereinafter referred to as the Work).
4. The contract begins from the moment of submission of the manuscript of the Work by the Corresponding Author to the Editorial Board, which confirms the following:
4.1. all Co-authors of the Work are familiar with and agree with its content, at all stages of reviewing and editing the manuscript and the existence of the published Work;
4.2. all Co-authors of the Work are familiar with and agree to the terms of this Agreement.
5. The published Work is in electronic form in public access on the websites of the University and any websites and electronic databases in which the Work is posted by the University and is available to readers under the terms of the "Creative Commons" license (Attribution NonCommercial Sharealike 4.0 International)" or more free licenses "Creative Commons 4.0".
6. The Corresponding Author transfers, and the University receives, the non-exclusive property right to use the Work by placing the latter on the University's websites for the entire term of copyright. The University participates in the creation of the final version of the Work by reviewing and editing the manuscript of the article or review provided to the Editorial Board by the Corresponding Author, translating the Work into any languages. For the participation of the University in the finalization of the Work, the Co-authors agree to pay the invoice issued to them by the University, if such payment is provided by the University. The size and procedure of such payment are not the subject of this contract.
7. The University has the right to reproduce the Work or its parts in electronic and printed forms, to make copies, permanent archival storage of the Work, distribution of the Work on the Internet, repositories, scientometric databases, commercial networks, including for monetary compensation from third parties.
8. The co-authors guarantee that the manuscript of the Work does not use works whose copyright belongs to third parties.
9. The authors of the Work guarantee that at the time of submission of the manuscript of the Work to the Editorial Board, the property rights to the Work belong only to them, neither in whole nor in part have they been transferred to anyone (not alienated), they are not the subject of a lien, litigation or claims by third parties.
10. The Work may not be posted on the University's website if it violates a person's right to the privacy of his personal and family life, harms public order and health.
11. The work may be withdrawn by the Editorial Board from the University websites, libraries and electronic databases where it was placed by the Editorial Board, in cases of detection of violations of the ethics of the authors and researchers, without any compensation for the losses of the Co-authors. At the time of submission of the manuscript to the Editorial Board and all stages of its editing and review, the manuscript must not have already been published or submitted to other editorial offices.
12. The right transferred under this Agreement extends to the territory of Ukraine and foreign countries.
13. The rights of Co-authors include the requirement to indicate their names on all copies of the Work or during any public use or public mention of the Work; the requirement to preserve the integrity of the Work; legal opposition to any distortion or other encroachment on the Work, which may harm the honor and reputation of the Co-authors.
14. Co-authors have the right to control their personal non-property rights by familiarizing themselves with the text (content) and form of the Work before its publication on the University's website, when transferring it to a printing company for reproduction or when using the Work in other ways.
15. The Co-authors, in addition to the property rights not transferred under this Agreement and taking into account the non-exclusive nature of the rights transferred under this Agreement, retain the property rights to finalize the Work and to use certain parts of the Work in other works created by the Co-authors.
16. The Co-authors are obliged to notify the Editorial Board of all errors in the Work, discovered by them independently after the publication of the Work, and to take all measures to eliminate such errors as soon as possible.
17. The University undertakes to indicate the names of the Co-authors on all copies of the Work during any public use of the Work. The list of Co-authors may be shortened according to the rules for the formation of bibliographic descriptions determined by the University or third parties.
18. The University undertakes not to violate the integrity of the Work, to agree with the Corresponding Author on all changes made to the Work during processing and editing.
19. In case of violation of their obligations under this Agreement, its parties bear the responsibility defined by this Agreement and the current legislation of Ukraine. All disputes under the Agreement are resolved through negotiations, and if the negotiations do not resolve the dispute – in the courts of the city of Kharkiv.
20. The parties are not responsible for the violation of their obligations under this Agreement, if it occurred through no fault of theirs. The party is considered innocent if it proves that it has taken all measures dependent on it for the proper fulfillment of the obligation.
21. The Co-authors are responsible for the truthfulness of the facts, quotes, references to legislative and regulatory acts, other official documentation, the scientific validity of the Work, all types of responsibility to third parties who have claimed their rights to the Work. The co-authors reimburse the University for all costs caused by claims of third parties for infringement of copyright and other rights to the Work, as well as additional material costs related to the elimination of identified defects.