There is no denial that there must be open communication between doctors and family members of patients about the treatment the patient is going to get. On the same lines, a recent draft issues by the National Institute for Health and Clinical Excellence has claimed that those patients who are terminally ill must be given opioid painkillers.

This was found during a review of palliative care services in the NHS that not many family members are aware about the use of opioid painkillers which could make patients get rid of unbearable pain during their last days. Instead they are being referred for 'death pathway' known as the Liverpool Care Pathway.

There is requirement that patients under palliative care are being taken care of well and their pain is effectively catered to. "The explanation for this is complex and includes failure to assess pain and monitor symptoms, patients' and professionals' fears of opioids and their adverse effects, and difficulties accessing prescriptions and analgesia", said the report.

There is need that proper knowledge about the usage of strong opioids is being made available to family members of patients who are suffering from advanced disease, especially cancer so that they are not being bereft of the desired treatment.

It is not for the first time that the NICE has revealed about effective pain control measures as there was a report about the same in 2004 also, but this time, facts are far from what the NICE must have thought about. Patients must be given the best effective pain relieving treatment and that's what the NICE is aimed to achieve.

There is need to rationally examine the dose to be given to a particular patient as there is no hard and fast rule available. Doctors must take steps forward to allay such fears and raise the level of pain management.