23 - Ethical considerations in interventional pain management

Summary

Despite the intrusion of insurance forms and changing reimbursements, medicine in general and pain medicine specifically continues to be a humanitarian pursuit with goals of relieving suffering and restoring function. Pain is a subjective patient experience, and one of the greatest limitations of pain management is a lack of objective diagnostic tests that identify and quantify pain. The use of interventional procedures to diagnose and treat pain involves ethical concerns of beneficence and nonmaleficence as well as potential financial conflicts of interest for the physician. Complications may be mitigated by performing procedures in the safest environment possible, with the most up-to-date equipment, and by an experienced, highly-trained pain specialist. Pain management providers must deal with competing problems in pain management: under treatment of pain and opioid abuse. In pain management, patient vulnerability is a prominent feature of the doctor-patient relationship.