Italy became the first European country to adopt a law on chronic pain management with Law 38/2010. Eight years later, however, few people know the law exists and it is inadequately applied. But what does the law say and how can we make it more effective?

Law on chronic pain management

The law on chronic pain management recognizes the right not to be forced to suffer for people afflicted by an incurable disease or a disease that causes unbearable pain. Health facilities that provide palliative care and pain therapy ensure individual treatment programs for patients and their families respecting the following principles:

Defend a patient’s right to dignity and autonomy in care without any discrimination

Safeguard patients and promote quality of life until its end

Provide adequate healthcare and social assistance support for patients and their families

What is pain therapy?

Pain therapy is for people affected by chronic diseases that have no current treatment options or, if treatment exists, it has proved inadequate or ineffective in significantly prolonging the life of the patient. It is also for people affected by painful, chronic diseases that may not be fatal, but that generate unbearable pain.

It should be noted, however, that “pain” refers “not only to physical, but to social and moral pain as well”, explains Raffaella Pannuti, president of the ANT Foundation Italy . “The humanization of treatment, communication between doctors and patients, treating the person and not only the disease- all this becomes part of treatment to fight all forms of pain”.

In addition to hospitals with specific pain management wards, the law has specifically designated healthcare facilities called hospices to provide palliative care. These structures provide temporary or permanent residence for people suffering from chronic diseases who can no longer be helped by specialized home programs or who the hospital is no longer adequate for.

No one knows about it

Only 15% of doctors, according to a Fimmg (Italian Federation of General Practitioners) survey, have extensive knowledge about the law on chronic pain management and 15% of doctors sustain that there is no palliative care in Italy. As can only be expected, an even greater percentage of citizens are misinformed. Two out of three Italians do not know the law exists and among people affected by chronic pain, 45% have been living for more than six months without any solution to their pain and 17% have found no effective remedies in more than five years.

Furthermore, according to data gathered by an institutional voluntary observatory that monitors pain therapy and palliative care units coordinated by former minister Livia Turco, access to palliative care and pain therapy is not uniform on the national level. “Few places have advanced and effective health services”, the Observatory explains. “There are also setbacks in training healthcare operators and still little attention is given to tracking pain and documenting related treatment”.

Training is the objective

For Antonio Saitta, Health Assessor of the Piedmont Region and Health Commission Coordinator of the Regional Conference, training is fundamental in raising awareness. “In several meetings we have even asked that training on certain subject matter be given to doctors as well.”

Even the Ghirotti Foundation confirms the need to “…invest in the training and humanization of healthcare professionals immediately at university and into their years of specialization” and “to promote the role of the family caregiver” and to establish “new information strategies to inform citizens about the existence of law 38 regarding palliative care and pain therapy networks”.

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