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Recommended: Legal and ethical issues with chronic pain

Pain Management as an Ethical Issue
The socio-cultural aspects of pain make the assessment and management of pain very complex. One factor complicating delivering appropriate care in relation to pain is individual bias. Far too often, a practitioner ignores the intrinsic or individual nature of pain. Since pain is very subjective, there is a tendency to underestimate it. A case in point is that a provider would not argue against laboratory results showing the need for medication to treat hypertension but if a patient states that they are not receiving relief from pain after several administrations of pain medicine, the caregiver is likely to regard the patient as a pain medicine abuser or a “drug seeker”. Such a response shows the need to develop a framework to address pain management less attached to personal biases and emotion. It is in this context that the basic principles of bioethics can come in to play. The standard principles of autonomy, beneficence, non-maleficence, and justice can help guide pain management issues.
The Ethical Principle of Autonomy
Autonomy is perhaps the most individual of the medical ethics principles. Autonomy is the right for an individual to make their own decisions regarding the care that they will receive (McCormick, 2013). In the context of pain management autonomy is important because it highlights the indeterminable aspect of pain. A provider is essentially violating the principle of autonomy when they disregard a patient's request and choose the plan for managing pain on their own volition. Another aspect of respect for autonomy relates to failing to provide a patient with appropriate detail on the parameters of pain management. Particularly patients have a right to know ...

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..., Quill, T., Bordley, D., & Ladwig, S. (2009). Evaluation of a required palliative care rotation for internal medicine residents. Journal of palliative medicine, 12(2), 150-154.
Petersen, A. (2013). From bioethics to a sociology of bio-knowledge. Social Science & Medicine, 98, 264-270.
Schatman, M. (2011). The role of the health insurance industry in perpetuating suboptimal pain management. Pain Medicine, 12(3), 415-426.
Schopflocher, D., Taenzer, P., & Jovey, R. (2011). The prevalence of chronic pain in Canada. Pain Research & Management: The Journal of the Canadian Pain Society, 16(6), 445.
US Department of Health and Human Services. (2012, February 14). Testimony on Pain Research & Care. Retrieved from HHS.gov: http://www.hhs.gov/asl/testify/2012/02/t20120214a.html
Wu, C., & Raja, S. (2011). Treatment of acute postoperative pain. The Lancet, 377(9784), 2215-2225.

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