Posted: August 31st, 2022

Ethical issues in pain management

Ethical issues in pain management
Assessment and treatment of pain can be complex, especially with the current opioid pandemic. While it is the right of patients to receive pain medication, physicians can be reticent on whether to prescribe pain medication from fear of addiction and misuse. This can be challenging for physicians as they try to balance between managing pain and preventing abuse.
Pain is subjective, and physicians can only assess it as whatever the patient says it is and existing whenever they say it does. As such, a physician’s personal bias on whether a person is a “drug seeker” may interfere with their decision when prescribing the pain medications. For instance, a physician may believe that a patient whose pain does not respond to standard pain dosage is a narcotic abuser.
Let us take a closer look at ethical principles in pain management and issues that emerge during the assessment and treatment of pain.
Autonomy
The principle of autonomy allows patients to make their own healthcare decisions. Physicians should respect the decisions of their patients irrespective of whether they agree with the choices. However, in pain management, this principle is often violated when a healthcare provider dishonors the right of a patient to choose how they want their pain treated. The challenge arises due to difficulties in assessing the type and quality of pain, which can interfere with a physician’s approach to manage the pain. Most physicians understand the possibility of addiction and often limit pain medication for fear of addiction and misuse of pain medication.
Beneficence and Nonmaleficence
The principles of beneficence and nonmaleficence denote that a healthcare provider has an obligation to provide appropriate and effective care (beneficence) without doing any harm to the patient (nonmaleficence). When it comes to pain management, the principle of beneficence requires physicians to alleviate pain and suffering. At the same time, the issue about dependency, addiction, and other fear of other side effects such as respiratory depression often make physicians prescribe inadequate pain treatment upholding the principle of nonmaleficence.
Justice
The principle of justice states that all patients should be treated fairly according to their medical issues. It is considered unethical when a health provider withholds or fails to administer services based on gender, age, ethnicity, or religion unless these factors affect treatment. In pain management, every patient has the right to receive an evaluation of their medical issues to the best capability of the health providers regardless of economic status. However, their need for pain medication must not have any personal gains. Age, however, determines the type and dosage of pain medication. Younger patients have been known to receive smaller dosages than older people. The nurses should be able to assess these and other factors before making any treatment decision.
To avoid prejudgment, the ethical guidelines of autonomy, beneficence, nonmaleficence, and justice are meant to guide health professionals in making better and informed decisions in pain management

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