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legal and ethical issues with chronic pain
cultural perceptions of pain
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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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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.
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Autonomy is a concept found in moral, political, and bioethical reasoning. Inside these connections, it is the limit of a sound individual to make an educated, unpressured decision. Patient autonomy can conflict with clinician autonomy and, in such a clash of values, it is not obvious which should prevail. (Lantos, Matlock & Wendler, 2011). In order to gain informed consent, a patient
This assignment will explore a case study on an episode of care where a patient with chronic pain was hoisted. This will be written from the perspective of the author, a student nurse. The purpose of this assignment is to underline the ethical, legal and professional issues surrounding the episode of care during nursing practice and how these issues influence the role of the nurse and their professional judgement in delivering holistic, person-centred care for the patient. The author will cover the complications on delivering care when healthcare professionals should consider and respect the patient’s decisions and personal preferences whether it may benefit the patient or not. Therefore, the author will argue the principles of the patient’s autonomy against the concerns for the patient’s health and well-being, considering what form of care is appropriate and what must be done and how the nurse can maintain their professional role in being an advocate. Moreover, this will consider the nurses’ approach in providing the best care possible by means of ethical, legal and professional values. Furthermore, this assignment will briefly show an awareness of the roles of other professionals involved in the care.
Principles of Biomedical Ethics, by Tom Beauchamp and James F. Childress, has for many critics in medical ethics exemplified the worse sins of "principlism." From its first edition, the authors have argued for the importance and usefulness of general principles for justifying ethical judgments about policies and cases in medical ethics. The organization of their book reflects this conviction, dividing discussion of particular ethical problems under the rubrics of the key ethical principles which the authors believe should govern our moral judgments: principles of autonomy, nonmaleficence, beneficence and justice.
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Assessing and managing pain is an inevitable part of nursing and the care of patients. Incomplete relief of pain remains prevalent despite years of research due to barriers such as lack of kn...
Learmonth, M. (1999) No Pain, No Gain, Metroactive News and Issues. Retrieved August 31, 2007, from http://www.uwink.com
Hall, J. K., Boswell, M. V. (2009). Ethics, law, and pain management as a patient right. Pain
When Dr. Turner talked about physicians giving pain medicine as “cure all” I was concerned about how much physicians are really paying attention to patients and if they are even taking serious the pain that they are having. I feel as though the problem with drugs begins with physicians and the lack of education on alternative ways to treat pain. When observing during fieldwork, patients would receive pain medication either before or after their therapy sessions. While listening to Dr. Turner I couldn’t help but think if doing what I saw in fieldwork is appropriate. Why aren’t therapist, nurses, or physicians trying alternative ways to treat their pain? They automatically go to using medication. Is giving the pain medication before or after session without providing alternative ways ethical? Another area I found concerning is that she never really talked about how OT can be a part of providing and teaching individuals. In her presentation I could not believe she did not address OT; because she stated, “chronic pain can be improved by things you do in your daily life” I feel that OT has specific skills that address the daily life aspect of these patients
on Pain Care will evaluate the adequacy of pain assessment, treatment, and management; identify and
...tive pain management and Improvement in patients outcomes and satisfaction [Magazine]. Critical Care Nurse, 35(3), 37,35,42. Retrieved from
Conclusions. An adequate and clear understanding of the concept of pain and implementing interventions of pain treatment and management is essential in the clinical settings. Understanding the concept of pain is necessary for its relationships with other concepts that are related and similar to the pain experience for theory building. The in the end, understanding the concept of pain will ultimately benefit the patient and lead to better and approp...
Effective treatment of cancer pain is essential for ensuring the best outcomes for cancer patients, in terms of physical, psychological and social aspects. Although there are no NICE guidelines for management of cancer pain, WHO guidance should be used to inform clinical practice. Careful assessment is a critical element of the process to ensure that patients are offered the treatment which is likely to offer the best outcomes, yet without providing a greater than necessary risk of complications such as tolerance and addiction to opioids. The main outcome that this paper highlights is that “Pain is what the patient says it is and exists when he says it does” (McCaffery 1983
Marion Good, PhD, RN, has focused her study, “A Middle-Range Theory of Acute pain Management: Use in Research,” on complementary medicine for pain and stress, acute pain, and stress immunity. The purpose of this theory is to put into practice guidelines for pain management. Good, 1998, noted the need for a balance between medication usage and side effects of pain medications. The theory also promoted patient education related to pain management following surgery and encouraged plan development for acceptable levels of pain management. This theory was developed through deductive reasoning. Chinn & Kramer, 2008, defined deductive reasoning as going from a general concept to a more specific concept. Good, 1998, related that there was a balance between analgesia and side effects in which two outcomes can be deduced: (1) a decrease in pain, and (2) a decrease in side effects. These outcomes can be studied further or more detailed concepts can be deduced from them.
The principle of autonomy states, that an individual’s decision must be respected in all cases, also an individual can act freely in accordance to their plan. For example, in a case where a patient and family demands to continue medical or surgical care and a physician want the patient to stop further treatment. In this case the patient’s choice will matter the most. According to the principle of autonomy it will be the patients and family choice whether to continue or discontinue treatment. The principle of beneficence which states, “one must promote good” comes into play in this case. In accordance to beneficence the patient will not benefit from the physicians responses personally. He/she will not benefit from harming her body with more surgeries. The patient will be going against the principle non-maleficence, which states that “one must cause no harm to an individual” by causing harm to herself. In this case the physician is justified in his/her actions by discontinuing medical or surgical care to the patient because it will not it her. These principles are what healthcare provider use to help and guide patients with the ...
Even doctors and scientists work with only a rudimentary knowledge of how and why pain occurs. The complexity and the personal nature of pain make research and advancement a challenging problem. Most modern tests cannot fully account for pain – scans and laboratory tests cannot document the severity of pain, but many tests can reveal pain-related chemicals in the body and potential physical or disease causes. After ruling out potential physical causes, doctors must rely on the patient’s own description of the pain in order to properly treat or manage the