Ease of suffering
There are circumstances in which people will not be able to improve functioning, return to “their best possible” health, or extend time before death. Even when people cannot be cured, there may still be ways to reduce the pain or suffering they experience. Here we look at any special benefits, beyond what is counted in the health benefits section, that relate to easing pain and suffering.
Many measures used to quantify health benefits focus more narrowly on years of life gained or lost. Sometimes these measures are adjusted to take account of disability or the quality of those life years. However, there may be other types of benefits specific to how people experience physical pain or other types of suffering that are not well captured in the summary measures used to assess Health Benefits & Harms or Cost-Effectiveness.
To assess whether covering an intervention will have additional or special significance in easing people’s suffering, consider:
Potential for reducing symptoms, relieving pain, and minimising suffering
- If we cannot cure or improve a person’s condition or extend their life, does the health intervention reduce pain or other negative symptoms? For example:
- Does the intervention ease pain for people with incurable cancer or organ failure in the last days of life?
- Does the intervention address other unpleasant symptoms for people living with chronic, long-lasting health conditions, such as nausea, fatigue, sleeplessness, and stomach upset or bowel problems?
Beyond the direct benefits to patients, consider whether there are also important impacts for caregivers relevant to Impacts on important personal relationships
Note: This domain will not necessarily be applicable to every intervention. An evaluation of “ease of suffering” most commonly arises for palliative and end-of-life care, as well as symptom management of certain illnesses (e.g., chronic illnesses) or disabilities. It is unlikely to apply in the case of preventive interventions, at least with respect to preventing future illness. It may apply if a new prevention option has less pain or fewer side effects than the current options – particularly if these side effects are not well accounted for in the standard measures used to quantify health benefits and harms. There may also be improvements in the way researchers and health economists evaluate summary measures of health to further include these types of outcomes that patients care about. If the measures used for Health Benefits and Cost-Effectiveness are broadened to include these measures, you may not need to consider them separately.