Why has there been so much attention given to pain management in clinical medicine recently, especially by the courts, legislatures and regulators?
An epidemic of undertreated pain was copiously documented in the medical literature during the last quarter of the 20th century. Nevertheless, the response by the medical profession and the organizations that regulate it ranged from sublime indifference to outright denial. During the last 10 to 12 years, however, a remarkable number of legal and public policy initiatives far too many to list here acknowledged the problem and began to implement practical solutions to it. Question: Can the problem be legitimately characterized as an ethical one? Undertreated pain (and other distressing symptoms) is a multidimensional problem, and hence, requires multi-dimensional solutions. If we accept the proposition that the relief of suffering (one cause of which is persistent pain) is a core value of medicine, then a failure or refusal to relieve it when the means are available is unethical medical practice. If effective pain relief is an important element in good patient care, then the manifest ina
