Stjernswärd Jan, Foley Kathleen M, Ferris Frank D
Cancer Control and Palliative Care, World Health Organization, Open Society Institute, New York, NY, USA.
J Pain Symptom Manage. 2007 May;33(5):514-20. doi: 10.1016/j.jpainsymman.2007.02.031.
Good policies lay the groundwork for an effective health care system and society. They facilitate the implementation of palliative care programs aimed at providing care for all people in need of these services, and they ensure equitable access to affordable medications and therapies. The lack of good policies can lead to unnecessary suffering and costs for patients, families, and society. Three-quarters of cancer patients worldwide are incurable when diagnosed. Because the size of the problem--and the suffering associated with cancer--is enormous, development of a national cancer control policy is an effective point of entry to begin integrating palliative care into a country's health care system. To be comprehensive, every cancer center must include palliative care. Ideally, palliative care is incorporated as a priority within all aspects of each country's national health plan, so that all patients living with or dying from any chronic disease may have their suffering relieved, including children and the elderly. To this end, policies that address essential medicines must include a list of palliative care medications. Supplies of affordable, generic medications that are "equally efficient" must be adequate and available throughout the country wherever patients live (especially opioids for pain control).
良好的政策为有效的医疗保健系统和社会奠定基础。它们有助于实施旨在为所有需要这些服务的人提供护理的姑息治疗计划，并确保公平获得负担得起的药物和治疗。缺乏良好的政策会给患者、家庭和社会带来不必要的痛苦和成本。全球四分之三的癌症患者在确诊时已无法治愈。由于这一问题的规模以及与癌症相关的痛苦巨大，制定国家癌症控制政策是将姑息治疗纳入一个国家医疗保健系统的有效切入点。要做到全面，每个癌症中心都必须包括姑息治疗。理想情况下，姑息治疗应作为每个国家国家卫生计划各方面的优先事项纳入其中，以便所有患有任何慢性病或因慢性病死亡的患者，包括儿童和老年人，都能减轻痛苦。为此，涉及基本药物的政策必须包括一份姑息治疗药物清单。必须有足够的、可在全国各地患者居住处获得的（尤其是用于控制疼痛的阿片类药物）“同等有效”的负担得起的通用药物供应。
