News Briefs – JULY-AUGUST 2023
by Brandon Glick
Global Morphine Disparity in Lower-Income Nations
Though its reputation has been tainted by recreational abuse over the last century, morphine has been an essential part of palliative care and pain treatment for far longer. In a public report by the World Health Organization, the disparities surrounding how morphine is used and distributed is growing increasingly skewed toward wealthier countries. The WHO further recognizes the stigma around morphine distribution in lower-income nations, suggesting that the lack of public education, research, and government-regulated policies cause both medical professionals and patients to be hesitant in recommending and using it.
Advocating for a universal affordable pricing plan for morphine, the WHO proposes a reallocation of funds toward health care systems in lower-income countries: “It is important to note that any efforts to improve the availability of morphine products must be accompanied by a health workforce that is well-trained in the use of opioids for medical purposes through professional education,” the report states The benefit-cost analysis of morphine accessibility is one worth consistently monitoring, the WHO acknowledges, though preventing those in pain from receiving proper treatment is not a viable alternative.
Texas Adopts Longer Waiting Period for DNR
Over the last 25 years, the Texas Advance Directives Act’ dictated the end-of-life care procedures in hospitals and medical care facilities in the state. The act stated that patients could pen a directive to physicians to explain how they wanted procedure surrounding their end-of-life care to go. Now, the Texas House of Representatives has passed a bill that changes those procedures. Under the new terms, named agents or family members are allowed 25 days (as opposed to the previous ten) to find alternative health care facilities before the current hospital is allowed to halt life-sustaining care.
Further included in this bill is a new review process for written directives, which involves an ethics committee debating the following topics: “They [the ethics or medical committee] must consider whether the treatment will: prolong the natural process of dying or hasten death; result in you feeling substantial, irremediable and objectively measurable physical pain that is not outweighed by the treatment’s benefit; be medically contraindicated, and any benefit will be outweighed because it seriously exacerbates your life-threatening medical problems; be consistent with the prevailing standard of care; be contrary to your clearly documented desires.”
Other changes involved in the bill include disability considerations (i.e., the committee may not take disabilities into account unless they are directly involved in the medical treatment), easier access to second opinions, and mandated procedures when moving between health care facilities. In all, the bill’s author, Rep. Stephanie Klick, aims to provide more agency for patients and their loved ones to make significant end-of-life care decisions.
Global Brain Health Study Targets Inequities
A new report published by the Global Council on Brain Health focuses on the multitude of factors that can contribute to diminished brain health and cognitive decline throughout one’s life. Obvious factors, such as an unregulated sleep schedule and a non-nutritious diet, are highlighted at length. The report takes great care to address social circumstances as well, including isolation, discrimination, intellectual pursuits, and equality. As the GCBH explains: “Within every country, public policies, political systems, economic conditions, social norms, and environmental factors influence health and wellness for better or worse. Discrimination based on age, race, ethnicity, gender and gender identity/roles, sexual orientation, national origin, caste, disabilities (visible as well as invisible), and genetic forms of neurological diseases contributes to poor physical and mental health in many societies.”
Advocating vehemently for a long-term solution plan, the GCBH encourages readers and political figures alike to make changes favoring equal opportunity, big and small. Within the report, the GCBH conveys a strong belief that our purview of brain health is limited by the current zeitgeist; people can assuredly be happier and healthier while living more fulfilling lives if everyone is afforded a chance to properly explore and express themselves.