An ethical dilemma that is currently happening in the medical field regards pain management. Doctors and other medical professionals are faced with this ethical decision on whether to prescribe strong pain medication to patients who claim to be experiencing pain, or to not in skepticism that the patient is lying to get opioids and other strong medications. “Opioids are drugs that act on the nervous system to relieve pain. Continued use and abuse can lead to physical dependence and withdrawal symptoms,” (Drug Free World Online). Opioids are often prescribed to patients experiencing excruciating pain, but doctors are faced with prescribing these drugs as an ethical issue because only a patient can measure the pain they are in, it is simply impossible …show more content…
The range of medications from anti-inflammatory to opioids is extreme, and have different effects on the human body. Medical professionals have to make the decision whether to give a patient a lower grade pain management drug or a higher grade drug, and they are the ones who have to determine how much pain the patient truly is in when most of a patient 's pain in unseen to the physical eye. “Pain as a presenting complaint accounts for up to 70% of emergency department visits, making it the most common reason to seek health care. Often, it is the only reason patients seek care,” and with this knowledge health care professional need to treat each patient equally in the sense that they are the emergency room or a physician 's office for a reason, and that reason is to relieve the pain they are in (American College of Emergency Physicians Online). The article from the American College of Emergency Physicians continues on to say that, “it is the duty of health care providers to relieve pain and suffering. Therefore, all physicians must overcome their personal barriers to proper analgesic administration,” this is in regards to medical professional who are bias toward specific patients, such as “frequent flyers” or even patients of certain class standing; no matter what their patient may look like or be like they must be treated equally and
We have one resident in the long-term facility who has stage four cancer of spinal cord and he has been suffering from intense pain. Every time when I enter his room, he cries and implore to the god that he can minimize his suffering. He has prescription of hydromorphone 8 mg every 4 hourly PRN , oxycodone 5 mg every 6 hourly and 50 mcg of fentanyl path change every 3rd day. After giving all scheduled and PRN medicine his pain level remains same as before. When I see that patients I feel like to give highest dose of medicine as well as alternative pain management therapy so that he can have some comfort but ethically I have no right to do that. He is hospice but he has no comfort at all. Following are the nine steps of Uustal ethical decision making model.
Today, there are so many legal dilemmas dominating trial for the courts to make a sound legal decision on whose right in a complicated situation. Despite the outcome of the case, the disagreement usually has a profound effect on the healthcare organization, and the industry as a whole. Many cases are arguments centered around if the issue is a legal or moral principle. Regardless what the situation maybe, the final decision is left to the courts to differentiate between the legality issues at hand opposed to justifying a case based on moral rules. According to Pozgar (2012), an ethical dilemma arises in situations where a choice must be made between unpleasant alternative. It can occur whenever a choice involves giving up something good and suffering something bad, no matter what course of action is taken (p. 367). In this paper, I will discuss cases that arose in the healthcare industry that have been tried and brought to justice by the United States court system.
There exists rich and extensive literature on pharmaceutical use, chronic pain, morality, and the relationships create...
Case managers work in an environment, in which exposes them to resolve issues in health care delivery leaving them to face ethical issues often. According to “Case Management: A Practical Guide for Education and Practice”, Managed care intersects with scarcity of resources, over 40 million uninsured Americans, and 76 million well-informed baby boomers who are on the verge of turning 65 years of age. This can leave the case manager to be faced with many complex ethical issues and dilemmas. They are often left to be facing ethical issues from the roles they must perform, which is to be the gatekeeper of resources versus patient advocates, and as coordinator facilitators of multidisciplinary teams. (Powell, S., 2010) It all comes down to their
Doctors work under intense pressure, and if a pill could fix a patient’s problems than many saw nothing wrong with that. What exacerbated the problem was that many hospitals also changed their modus operandi with regards to treatment. In some hospitals, “doctors were told they could be sued if they did not treat pain aggressively, which meant with opiates (95). However once the patient became addicted and could no longer get their prescription legally refilled, the drug dealers saw their chance. What is surprising is the fact that pharmaceutical companies acted in the same manner as drug dealers. Both sides did not care about the end user, and the problems they would have to deal with after using what was given to them. Their motive was purely to profit as much as possible, and they did not care about who would get hurt as a result of their
By the year 2000 opioid medicine containing oxycodone etc., are being abused and misused and more than doubled in 10 years’ time.
The major concern of clients that have made an Emergency Department visit is due to pain. In fact, according to Tanabe and Buschmann 70 percent of patients who go to the Emergency Departments are going due to pain. (Duignan & Dunn, 2008, p. 30). Olioganalgesia is a prevalent issue in emergency health care. In a study by Wilson and Pendleton in 1989 on 198 patients, 56% patients received no pain medicine while waiting in the emergency room; 69% had to wait more than one hour to receive pain medication, and 42 had to wait more than two hours. These patients that received analgesics, 32% received too little to meet their needs. Many factors seem to lead to this problem by it seems that the most widespread reason in the emergency department is the lack of time. There is much bias that contributes to inadequate treatment of pain. An evaluation of 321 clients showed 80% of the young clients received pain medicine received pain medicine while only 66% of the elderly patients received the same treatment. A study conducted by P...
Opioids are prescribed to help people; prescription opioids can be used to treat moderate-to-severe pain and are often prescribed following surgery or injury, or for health conditions such as cancer (Prescription Opioids). When taken as directed, opioids are safe and effective treatment options for relieving debilitating chronic pain (Highsmith). Doctors have screening protocol they follow before prescribing an opioid. Doctors ask patients about their past to see if any substance abuse was present, to rule out patients with a higher risk of becoming addicted to prescription opioids. Nonetheless, if the medication is used as directed, not only is your risk of addiction minimal, the odds of enjoying a better quality of life will be in your favor (Highsmith). In other words, doctors are doing their part to prevent prescription opioid drug abuse. Actually, dishonest people are the ones at
In medical school/pharmacology school, medical professionals are taught to treat severe pain with opioids. However, opioids should be prescribed with the possibility of future dependency in mind. Physicians often struggle with whether they should prescribe opioids or seek alternative methodologies. This ethical impasse has led may medical professionals to prescribe opioids out of sympathy, without regard for the possibility of addiction (Clarke). As previously stated, a way to address this is use alternative methods so that physicians will become more acquainted to not not treating pain by means of opioid
The major concepts deduced from the hypothesis fall under three categories: (1) multimodal intervention, (2) attentive care, and (3) patient participation. Multimodal intervention includes the concepts of potent pain medication, pharmacological adjuvants, and non-pharmacological adjuvants. Attentive care relates to the assessment of pain and side effects and intervention along with reassessments. Patient participation includes goal setting and patient education. The resulting outcome of these three categories working together is the balance between analgesia and side effects.
Physician-assisted suicide refers to the physician acting indirectly in the death of the patient -- providing the means for death. The ethics of PAS is a continually debated topic. The range of arguments in support and opposition of PAS are vast. Justice, compassion, the moral irrelevance of the difference between killing and letting die, individual liberty are many arguments for PAS. The distinction between killing and letting die, sanctity of life, "do no harm" principle of medicine, and the potential for abuse are some of the arguments in favor of making PAS illegal. However, self-determination, and ultimately respect for autonomy are relied on heavily as principle arguments in the PAS issue.
In critical and complicating medical cases, family members often find it tedious to decide as to what mode or procedure of treatment is idyllic for the recovery of their patient. In such cases, well-qualified and medically educated can play a pivotal role in deciding the kind of treatment that should be given to the patient to enhance its recovery. In a contrary situation a nurse may know that administering a particular drug may improve the patient’s condition, but may be refrained from conducting the required action due to doctor’s absence or non-permission. There are numerous cases through which ethical dilemmas in the profession of nursing can be discussed. Nurses in order to remain within the defined boundaries ...
2015). To increase the pain management for patients, solutions were raised on how to do so by providing nurses and other health professionals with more education around assessments and interventions that are appropriate, also the care for the patient needs to be more patient-centred and less generalised, and lastly an update or change in current protocols and policies regarding pain
Engebretson, J., Monsivais, D., & Mahoney, J. S. (2006). Pain management practice ethics. American Journal of Pain Management, 16(1), 21-35.
The nurse should educate the patient of the importance of pain control and how controlling pain is essential to a patient’s wellbeing and recovery. It needs to be a balance of what the patient says and what the nurse observes and interprets while always respecting the wishes of the patient. Nurses have a variety of assessment tools available to assess pain in their patients. One dimensional pain scales such as visual analog scale, verbal descriptor scale, numeric pain intensity scale and the combined thermometer scale all measure the intensity of the pain (Jensen, 2011). Other pain scales such as McGill pain questionnaire, brief pain inventory, and brief pain impact questionnaire take into account aspects beyond intensity (Jensen 2011). There are additional pain assessments specialized for children, older adults, patients who are unable to respond, and patients with opioid tolerance (Jensen, 2011). The nurse should be familiar with these methods of pain assessment and know the appropriate use of each. Incorrect medication and treatment choices due to inaccurate or poor pain assessment cause patient suffering (Jensen,