Pain Clinic and Sociology of Palliative Care: Request for Medical Assistance in Dying (MAiD) by Chronic Pain Patients
Olumuyiwa A. Bamgbade1*, Vera O. Onongaya2, Daniel O. Bamgbade3, Leili Adineh-Mehr4, Chantelle E. Clarke-Webster5, Hasti Donyagardrad6, Bolajoko E. Bada7, Oleksandra Chorna8, Paula S. Maude9, Aria G. Mwizero10, Olamide O. Oyewole11, Genet T. Yimam12, Lysiane M. Atcham-Amougou13, Olajumoke O. Lawal14
1Department of Anesthesiology, University of British Columbia, Vancouver, Canada.
2Department of Medicine, Cardiff University, Cardiff, United Kingdom.
3Research Department, Center for Societal & Health Equity, Vancouver, Canada.
4Research Department, Salem Anaesthesia Pain Clinic Surrey, Vancouver, Canada.
5Department of Medicine, University of the West Indies, Kingston, Jamaica.
6Department of Medicine, Yerevan State Medical University, Yerevan, Armenia.
7Department of Caring Science, A bo Akademi University, Vaasa, Finland.
8Department of Medicine, Yerevan State Medical University, Yerevan, Armenia.
9Department of Anesthesiology, Garki Hospital, Abuja, Nigeria.
10Department of Medicine, University of Rwanda, Kigali, Rwanda.
11Nursing Department, Northumbria Healthcare NHS Trust, Newcastle, United Kingdom.
12Medical Department, United Nations Economic Commission for Africa, Addis Ababa, Ethiopia.
13Department of Public Health, Ministry of Health, Yaounde, Cameroon.
14Nursing Department, University College Hospital, Ibadan, Nigeria.
*Corresponding Author: Olumuyiwa A. Bamgbade, Department of Anesthesiology, University of British Columbia, Vancouver, Canada. Postal address- POBox 75085, Surrey, BC, V4A 0B1, Canada. Email- olu.bamgbade@gmail.com; Phone- +1-7786286600
https://doi.org/10.58624/SVOAMR.2025.03.013
Received: June 13, 2025
Published: June 26, 2025
Citation: Bamgbade OA, Onongaya VO, Bamgbade DO, Adineh-Mehr L, Clarke-Webster CE, Donyagardrad H, Bada BE, Chorna O, Maude PS, Mwizero AG, Oyewole OO, Yimam GT, Atcham-Amougou LM, Lawal OO. Pain Clinic and Sociology of Palliative Care: Request for Medical Assistance in Dying (MAiD) by Chronic Pain Patients. SVOA Medical Research 2025, 3:4, 98-105. doi: 10.58624/SVOAMR.2025.03.013
Abstract
Background: Terminally ill patients require palliative care to mitigate suffering but may request medical assistance in dying (MAiD). Chronic pain patients experience psychosomatic disorders and suffering. The MAiD controversy in chronic pain patients requires continual review. This is a study of MAiD requests in a pain clinic. It examined the characteristics of patients requesting MAiD, their quality of life (QoL), and natural outcomes.
Methods: This is an observational study of 520 chronic pain patients who received treatment in a pain clinic. Data collection included patients’ age, gender, diagnoses, and QoL scores. QoL scores were collected using the Medical Outcomes Study Short Form 36 Health Survey (SF-36). QoL scores were recorded across the eight domains of physical functioning (PF), physical role (PR), bodily pain (BP), general health (GH), vitality (VT), social functioning (SF), emotional role (ER), and mental health (MH).
Results: Five patients (1%) inquired about or requested MAiD. All of them were men aged 43 to 80 years. All patients have neuropathic paraspinal non-cancer pain. QoL scores were monitored over 3 years. The average change in PF was minimal (-0.2 points). PR score showed an average increase of 0.2 points. BP scores showed an average increase of 1.6 points. GH scores increased by an average of 0.6 points. VT scores showed an average increase of 0.6 points. SF scores showed an average increase of 0.6 points. ER scores increased by an average of 0.8 points. MH scores showed a mean increase of 0.8 points.
Conclusion: Despite chronic pain and suffering, the study shows these patients maintained stable lives with ongoing value-based pain clinic care. Their pain levels are controlled, ensuring stable mental health and general functioning. Therefore, instead of MAiD, it is ethical and logical to continue providing high-quality pain management and compassionate support. These patients can live with dignity and comfort instead of a premature death.
Keywords: Value-based care, Quality of life, Medical assistance in dying, Medical ethics, Multimodal pain management