But liberal democracy in the Third World, for instance, lets 99.6% of its population who are in need of palliative care do without it, "spending their last days writhing in agony, wishing death would hurry":
Although opium was one of the chief exports of British India and the country still produces more for the legal morphine industry than any other country, few Indians benefit. They end up like millions of the world’s poor -- spending their last days writhing in agony, wishing death would hurry.The world's largest democracy does have occasionally useful parliamentary Communists, and one of the things that they are reportedly good at is prescribing opium for the masses:
About 1.6 million Indians endure cancer pain each year. Because of tobacco and betel nut chewing, India leads the world in mouth and head tumors, and has high rates of lung, breast and cervical cancer. Tens of thousands also die in pain from AIDS, burns or accidents.
But only a tiny fraction -- Dr. [M. R.] Rajagopal ["India's 'father of palliative care'"] estimates 0.4 percent -- get relief.
Clinics dispensing morphine are so scarce that some patients live 500 miles from the nearest. Calcutta, a city of 14 million, has only one. (Donald G. McNeil, Jr., "In India, a Quest to Ease the Pain of the Dying," New York Times, 11 September 2007)
The exception is Kerala, where Dr. Rajagopal practices and about 80 percent of India’s palliative care is delivered. A small slice of the southwest coast, it is sort of India’s Massachusetts: it has a mere 3 percent of the population, but high literacy rates, responsive local leadership and a bent for bucking central government.
The state government allows any doctor with six weeks of training -- which Dr. Rajagopal provides -- to prescribe morphine. (McNeil, Jr., 11 September 2007)