http://www.jackstem.com/right_to_pain_relief.htm
To allow a patient to experience unbearable pain or suffering is unethical medical practice. Studies published in the past 25 years have indicated that physicians in the United States do not manage pain adequately. While the medical literature has elucidated the nature and extent of this problem, several state and national organizations have responded by promulgating clinical practice guidelines for the appropriate care of patients with acute and chronic pain. These guidelines have raised the prevailing standards of care or have created standards where previously there were none. Such standards necessitate that physicians become acquainted with the ethical, legal and professional responsibility of caring for patients with pain and adjust their practices to comply with the guidelines.
1.) Barriers to Pain Relief
Several studies have indicated that many physicians believe they could face regulatory scrutiny, disciplinary action, and even civil or criminal lia-bility if they diligently and persistently alleviate their patients’ pain through a long-term use of opioid analgesics. Other frequently-cited barriers to providing appropriate pain relief to patients include a physician’s Unfamiliarity with state-of-the-art pain management techniques; Lack of knowledge about the latest developments in the pharmacology of pain management; Scientifically unsupported concerns about addiction and the adverse side effects of opioid analgesics; and Inexplicable failure to make effective pain management a priority in patient care.
While these barriers might provide reasons for undertreating pain, their defense - if and when a lawsuit challenges the practice of under-treatment.
2.) The Right to Pain Relief
In ruling on the issue of physician-assisted suicide, a majority of the justices of the U.S. Supreme Court have taken the position that there are no legal barriers preventing physicians from providing appropriate pain relief to patients. In the view of these justices, this is true even in the care of dying patients suffering from pain so severe that effective relief might render the patient unconscious and/or hasten death.
Some distinguished legal scholars have interpreted the Supreme Court opinions as recognizing a constitutional right of patients to effective pain relief. When considered in conjunction with the preamble to the Federation of State Medical Boards’ model guidelines for pain management, which states that “principles of quality medical practice dictate that citizens … have access to appropriate and effective pain relief,” a physicians should acquire, maintain and apply state-of-the-art pain management knowledge, skills and techniques when caring for patients suffering from pain. The ethical responsibility of physicians to relieve the pain and suffering engendered by patients’ illnesses bolsters this mandate. The American Medical Association, the Institute of Medicine of the National Academy of Sciences, and the American Board of Internal Medicine - along with many other national professional organizations have issued similar admonitions recently con-cerning the physician’s professional duty in caring for patients who are at or near the end of life. The message from these distinguished national medical organizations strongly reaffirms the physician’s obligation to relieve human suffering - an obligation that stretches back into antiquity, according to medical ethicist Eric J. Cassell, MD.
The undertreatment of pain in America - whatever the causes or explanations - has been at variance with this age-old ethical precept that relieving pain and suffering due to illness is a fundamental goal of medicine. With concerted effort, the custom and practice of physicians once more can be congruent with this goal.