“Hippocratic,” a documentary about the life of Dr. M.R. Rajagopal, India’s leading advocate of palliative care, is now touring the United States — a country where attitudes toward pain relief have changed because of the overdose epidemic.
Dr. Rajagopal’s chief message — and that of the film — is that the essence of care for the dying is simple compassion. His inspiration came from Mahatma Gandhi, said Dr. Rajagopal, who in 2014 won a global award from Human Rights Watch for his activism.
But for a doctor, part of compassion is relieving pain when a patient’s tumors have become so large, burns so deep or wounds so grievous that they are beyond cure, Dr. Rajagopal said. And that usually can be done only with opioid-based pain relievers — like morphine and fentanyl.
People in agony may kill themselves, and the film recalls such cases.
But opioids have been demonized in recent years because so many young Americans — often prescribed narcotic pills for dental or back pain rather than for fatal illnesses — have become addicted and gone on to use heroin, street fentanyl or other concoctions, sometimes with fatal consequences.
America’s crisis “is an issue,” even in India, Dr. Rajagopal said in an interview before “Hippocratic” was screened in New York on Tuesday. “It stopped the boat.”
Indian poppy fields supply much of the world’s legally grown opium, and the two government plants where it is refined were allowed to fall into disrepair, and then were blamed for pollution and sometimes shut down temporarily, he said, which drove up the prices of normally cheap palliative care drugs.
But the opioid crisis in the United States has not affected every struggling country.
On indexes measuring how well countries deliver care to the dying, Mongolia does unusually well, despite its poverty. The credit for that goes to Dr. Odontuya Davaasuren, founder of the Mongolian Palliative Care Society, who learned about palliative care only 18 years ago, at a conference in Sweden.
Death from liver cancer, common in Mongolia, is often excruciatingly painful. In an email, Dr. Davaasuren said her country imported only small amounts of morphine and had no drug-abuse problem.
“Not so many Mongolians understand English, and information about the American overdose epidemic did not reach most of the population,” she wrote.
She was reluctant to discuss the issue further, she said, for fear that health officials would take notice, get worried and make her work harder.
The 88-minute documentary “Hippocratic” is in theaters in the United States and Canada until April 17.