Proposition 51K0551

Projet de loi modifiant la loi du 22 août 2002 relative aux droits du patient en y insérant le droit pour toute personne de recevoir des soins visant à soulager sa douleur, ainsi que l'arrêté royal n° 78 du 10 novembre 1967 relatif à l'exercice des professions des soins de santé.

General information ¶

Authors

PS | SP Colette Burgeon, Marie-Claire Lambert, Yvan Mayeur

Submission date

Dec. 4, 2003

Official page

Visit

Status

Adopted

Requirement

Simple

Subjects

patient's rights

Contact form ¶

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Discussion ¶

July 1, 2004 | Plenary session (Chamber of representatives)

Full source

Mr. Speaker, I would like to refer to the written report.

I would have thought so. That is good.

Mr. Speaker, Mr. Ministers, dear colleagues, I am very pleased to present the bill I had submitted with my colleagues Colette Burgeon and Marie-Claire Lambert and I am pleased that the committee approved the text unanimously.

It is true that it was written in the government agreement that one would be concerned about the pain on the ethical level in medical matters and health care to the population. In fact, medicine has evolved and, today, pain is no longer considered something inevitable. Pain relief was only the means of diagnosing a disease and then one no longer cared about it, except at the end of the treatment to find that, having the pain disappeared, the treatment has brought its fruits and the sick is healed and healthy.

Today, it can be considered that treating pain is part of the therapeutic, the process of care. Important experiments conducted in several hospitals in our country show, from pediatrics to adulthood, that one can grasp the pain of a patient, not only to relieve him in a number of clinical examinations that are imposed on him but also to truly accompany the process of care so that the patient does not suffer additional trauma due to intolerable suffering and unbearable pain.

To alleviate this suffering and this pain, it was recorded so far in our reflections, especially with regard to palliative care. The ambition of this bill is to incorporate it more widely into the entire care process.

The Minister referred to a day of scientific studies that we held at CHU Saint-Pierre on the issue. It was possible to see how, in pediatrics, therapeutic benefits could be relieved with a particular ointment. We have seen how, with nitrogen peroxide, we could relieve the pain of a child who was performing a lumbar puncture, as part of scientific examinations related to his cancer.

The child perfectly tolerated the punctuation in question thanks to this anesthetic product. That is, the use of these products in the relief of pain related to the therapeutic act is important and must be taken into account in the care processes in our country.

The government agreement provides for the implementation of a national plan to combat pain. We would like a compendium to be developed for doctors to explain how to use the different types of products for the various possible cases.

The ambition of today’s bill aims, on the one hand, to recognize the expression of this pain in the patient’s head, by amending the Patient Rights Act and giving him the opportunity to express his wish to be heard on this subject. This does not appear — paradoxically — in this formidable law on the rights of the patient that we were voted for in the previous legislature.

But the bill also implies a change in the head of the doctor and therefore also that the Royal Decree 78 on health care is modified so that the doctor is obliged to hear this pain, to respond to it and to try to relieve the pain of the patient. Therefore, there is both a new right in the patient’s head and a new obligation in the doctor’s head.

We believe it will be necessary to go further - the Commission insisted - on in particular: - the coverage by the health insurance of the anesthetic products and analgesics that are not currently included in the nomenclature, in order not to create discrimination in the access to this type of care; - a better training of health practitioners: doctors but also paramedical staff and all staff of hospitals; - the systematic development of the right to listen for patients, pediatric or adults; - the establishment of protocols at the national level in order to include pain in all therapeutic acts.

One last element does not fall within our level of power: education. The Minister would be well advised to contact the leaders of the Communities in order to insert this concern in the teaching of medicine in our country: it must indeed be considered today as a new and important ethical concern of the development of medicine.

This is the meaning of the bill that is being submitted and which was unanimously accepted in the committee, which I welcome. It is part of a global process of fighting pain and the plan that the government will soon come out, we hope.

I am pleased that the House will soon adopt this bill.

Mr. Speaker, Mr. Ministers, dear colleagues, we can only subscribe to this excellent initiative, because everyone has the right to receive care to relieve the pain. I would like to give you two reflections. First, that pain can also be related to end-of-life care and that every Belgian has the right to quality end-of-life care. However, the palliative care teams have been experiencing, for several months, financing problems due to the moratorium on the INAMI palliative care convention. Indeed, some teams - and I think more specifically at the Foyer Saint-François in Namur as well as at the ASBL Accompagner in Luxembourg - are obliged to use their own funds to ensure the accompaniment of people.

Mr. Minister, dear President of the Health Committee at the initiative of this bill, I would like to first draw your attention again to this problem. Relieving pain also means finding a structural solution so that these palliative care teams can maintain their services to patients.

The pain is not just physical. I would like to remind here the importance of mental health. I give you some key figures at the epidemiological level to show you its magnitude: 60 to 70 suicide attempts per day in Belgium, it is huge! Suicide is currently the leading cause of death in Belgium for men aged 25 to 44 and the second cause for the same age group among women. It is also the second leading cause of death among young people aged 15 to 24. We must therefore be very attentive to psychological pain or moral pain; whatever the term used, everyone will understand well what it alludes to. Per ⁇ , in the future, we will be able to supplement the text by defining the pain under these two components, as I had already proposed in the committee.

In conclusion, Mr. Speaker, Mr. Ministers, dear colleagues, we fully support this bill and welcome the initiative taken by Mr. Speaker. Mayor and his colleagues. It seems to me, however, indispensable to approach and respond to the suffering of the patient and his family in its multiple facets.