RT Journal Article
SR Electronic
T1 The active identification and management of chronic refractory breathlessness is a human right
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 393
OP 394
DO 10.1136/thoraxjnl-2013-204701
VO 69
IS 4
A1 David C Currow
A1 Amy P Abernethy
A1 Danielle N Ko
YR 2014
UL http://thorax.bmj.com/content/69/4/393.abstract
AB Chronic refractory breathlessness is defined as breathlessness at rest or on minimal exertion that will persist chronically despite optimal treatment of the underlying cause(s). At any time, 1% of the population report a modified Medical Research Council dyspnoea score of ≥3 chronically. Despite the prevalence, severity and chronicity of this symptom and an evidence base of affordable and safe interventions, chronic refractory breathlessness remains grossly undertreated. Many patients and clinicians accept the presence of the chronic refractory breathlessness as an inevitable part of an illness, with no thought of treating the symptom despite an evidence base for its safe treatment. Consensus statements from major respiratory clinician organisations now endorse such a clinical course. Failure to enquire about, assess and properly treat chronic refractory breathlessness with opioids as outlined in specialist clinical guidelines is now an unacceptable level of care ethically and is, arguably, a breach of people's human rights. Adequate pain control through access to pain relief is now accepted as a human right and, given its burden across the world, the symptomatic treatment of chronic refractory breathlessness should be seen in exactly the same way.