So far, palliative solutions are given to palliative treatment in Armenia
There are situations in the life that are accepted to consider “hopeless”. Such situations occur, first and foremost, in contacts with physicians. Many people, unfortunately, have heard the following verdict: “That’s it, we can’t help with anything else, do not male you patient suffer, take him home, and let him die.” In practice, this means that the medicine is powerless, the hospital has no interest in keeping such a patient, and medical institutions, the so-called “wash their hands” of him.
Such an approach, as far as I understand, is quite consistent with the ancient medical theories and, in particular, the teaching of Hippocrates, under which the mortal should not cast doubt on the sentence, which is confirmed by the gods. It is clear that Christian doctrine cannot display such a brutal approach, and the first century CE onwards, was promoting the idea that the doctors and the patient’s relatives shall continue caring for the dying man, possibly mitigating his psychological and physical pains. The matter, of course, is first about cancer patients.
Today, the so-called “palliative treatment” is widely spread all over the world, which had became a separate branch of medicine, with its particular specialists in the fields of medicine and psychology. “Pallium” translated from Latin means “a cloak”, a “mantle”. Generally, when we say “palliative solution”, we mean half done, non radical, series of temporary events that cover and conceal the problem. In politics and economy, it is not so good, however, in the medicine, it is entirely a positive phenomenon. Accordingly, the relatives of hopeless patients do not reject the dying man, they are no longer trying to save him, prolong his life, neither speed up nor slow down the inevitable end. Together with the doctors, they are trying to make the life attributed to the patient be endurable, decent, and desirably interesting.
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Its tools are numerous. In Russia and the West, the so-called palliative (or symptomatic), surgery is accepted, when not the cause giving birth to the disease is eliminated, rather than its most acute symptoms (for example, malignant tumor metastases), which help to relieve the patient’s suffering. However, the main trend, of course, is the pain killing, because to have tolerable and decent life, the patient should not suffer from pain every moment. Here, the problem of psychotropic medications is very acute, the usual pain killers, naturally, do not help such patients. Last years, some steps have been taken in Armenia to correct the legislative base in this area. Before, the doctors were afraid of prescribing such drugs to the patients as they, otherwise, might appear simply as drugs. However, the legislation that would protect the rights of both doctors and patients is constantly in need for improvement.
“Hospices”, specialized medical centers, is an integral part of palliative treatment, which take care of such patients. Teams consisting of people working in different professions: doctors, psychologists, and clergymen, are working here. A special treatment, special care, and, often, tolerance to his quite understandable aggressive outbreaks is necessary to a man who is living the last months of his life. This attitude and, in general, care of these patients can not be an “inborn talent”, it needs a curriculum which is aimed at both the medical staff and the patient’s relatives. In the West, often volunteers are working in the hospices.
Pilot projects are being implemented in Armenia. There are 4 centers, two in Yerevan and one in Ararat and the other in Lori marzes. They can provide assistance to a few dozen people. Whereas, the experts estimates that approximately 3,000 patients are in need for such daily care in Armenia. In addition, inpatient palliative treatment in our country costs up to 20.000 drams. What percentage of the citizens of Armenia can afford spending that kind of money? Thus, so far palliative solutions are given to palliative treatment in Armenia.
ARAM ABRAHAMYAN
