On October 1st, 1990, Dr. Lisbeth Quesada Tristan created the Pediatric Palliative Care Unit at the National Children’s Hospital (Hospital Nacional de Niños). This unit was the first in Costa Rica and Latin America in providing home and hospital care for patients.
Its origin was driven by an appeal for constitutional right’s legal protection presented by a patient who was facing a terminal cancer with a lot of pain because the hospital refused to give him the morphine dosage prescribed by the treating physician, Dr. Quesada Tristan.
There was a shortage of morphine in the country at the time and professionals were outdated in the theme of pain therapy. Thought such dosages were unscientific. The application was accepted and the law protected the right of the patient of dying with dignity and without pain. So, the Constitutional Court pronounces that:
“All Costa Rican persons, have the right to a dignified and painless death”.
Though pharmacies are private entities, no pharmacy in the country can deny if it is in stock , to fill a prescription of morphine duly prescribed by a physician, because it would be in prejudice of the patient who needts to relieve his/her pain.
No pharmacist may refuse to dispense a prescription that meets the requirements of the law, even when doses are high.
This resolution is a milestone in the history of palliative care in Costa Rica; in fact, we can talk about an effect before and after it. This was useful to create awareness among the civilian population, and for families who have a member who faces a terminal illness in order to demand proper care and management of pain to the physicians indicated or directly to the Social Security.
On July 1992, the Pro Palliative Care Unit Foundation was born, its purpose is to support palliative care in the National Children’s Hospital and other medical centers concerned with the topic.
In 2006, the Foundation started a Palliative Care Masters program in conjunction with the Catholic University of Costa Rica. With this program it is pretended to train formally health professionals not only in Costa Rica but also in other countries in the area.
On May 2007, the Costa Rican Social Security Fund (CCSS) designated the Palliative Care Unit of the National Children’s Hospital as “lead agency in all the palliative care and pediatric pain control at national level”. Currently, the Foundation is exercising its functions efficiently and with the necessary commitment through its programs of patients and family care, training and decentralization of functions.