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An Ethical Analysis of the Barriers to Effective Pain Management

Published online by Cambridge University Press:  01 January 2000

BEN A. RICH
BEN A. RICH
Affiliation:
Ben A. Rich, J.D., Ph.D., is Assistant Professor in the Department of Preventive Medicine and Biometrics, and Assistant Director of the Program in Health Care Ethics, Humanities, and Law at the University of Colorado Health Sciences Center in Denver, Colorado.
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Abstract

Among the most significant findings of SUPPORT was that 50% of ICU patients suffered from moderate to severe pain during the last days of life. At the time of its publication late in 1995, SUPPORT was merely the latest in a long series of articles in the medical literature documenting the widespread and significant undertreatment of pain, beginning with a 1973 study of hospital inpatients. Much has been written about the phenomenon of undertreated pain and inadequate care of patients at the end of life, and many positive suggestions for reform of clinical education and clinical practice have been iterated and reiterated in the two decades separating the studies. Proposals for modifying clinician behaviors in this aspect of patient care have tended to focus on particular barriers to effective pain management and palliative care.

Type
SPECIAL SECTION: TERRA INCOGNITA: UNCHARTED TERRAIN BETWEEN DOCTORS AND PATIENTS
Information
Cambridge Quarterly of Healthcare Ethics , Volume 9 , Issue 1 , January 2000 , pp. 54 - 70
Copyright
© 2000 Cambridge University Press

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