PPM ; 6 6: Pain as disease and illness, Part 2: Structure and function of the ethics of pain medicine. PPM ; 6 7:
The Role of Ethical Theory Practitioners and policymakers who seek to provide care for patients with pain face a number of difficult questions. What importance does pain have in medicine? What role does pain management play in the clinical care of patients?
What duties do health care practitioners have concerning the pain of their patients? What other duties must be balanced against the duty to provide pain relief? The vast majority of the medical literature published concerning the ethics of pain management addresses pain relief at the end of life.
This is a very important area, but does not address many of the most pressing concerns about pain management during other phases of life. Readers are referred to the IASP Curriculum in Pain Management and Research which lists many of the ethical issues with which practitioners should be familiar.
The purpose of this document is to give practitioners and policymakers some tools to use in thinking about the broad range of ethical questions pertinent to pain management. Though moral reasoning informs every choice we make about our actions, it becomes particularly important in the face of moral perplexity or uncertainty.
Beauchamp and Childress have identified two basic types of moral dilemmas Ethics as applied to pain management in medicine . In the first, there is evidence that act x is morally right and there is evidence that act x is morally wrong.
Abortion might represent this first kind of dilemma. In the second, we have obligations to do x and obligations to do y, but can't do both. Balancing obligations to preserve life and relieve suffering in the decision to terminate life-saving treatment might represent this second kind of dilemma.
In dilemmas such as these, our usually reliable sense of moral intuition may not provide adequate guidance. Ethical theory can bring some consistency and rationality to our moral judgments in these kinds of cases by describing what qualifies as relevant and adequate reasons for action.
Traditional ethical theory has conceived of moral judgment as the application of a rule to a particular case.
In this deductive model, moral justification is derived from preexisting normative precepts. Over the past twenty to thirty years, however, it has become clear that this deductive model alone is inadequate for clinical bioethics.
In practical ethics, choosing an ethical theory to apply and appropriately applying it can be very difficult. Furthermore, this model of deduction does not appear to capture how moral reasoning works in complicated cases.
Rather than a simple movement from general principles to particular judgments about cases, a reciprocal relation exists between general rules and particular elements in experience. The experience of philosophers and bioethicists in hospitals and clinics has taught them that clinical moral judgments involve specification and balancing of norms according to the concrete clinical situation.
One often cannot determine in advance what the critical detail in a case will be. The traditional deductive model of ethics is thus being combined with an inductive model that recognizes the importance of the individual precedent-setting case.
Bioethics continually refers to the Quinlan, Bouvia, and Quill cases. As medical technology evolves, what constitutes the critical ethical detail in a clinical case can change in ways unanticipated by theory. The inductive model allows our moral intuitions to be adjusted in light of compelling cases as well as compelling principles.
Bioethical principles thus exist in a dynamic relation with the clinical situation. Principles provide a considered and consistent way to interpret the clinical situation. The clinic provides the context within which principles should be specified, qualified, or adjusted so that they provide useful guidance.
Types of Ethical Theory A brief overview of the types of ethical theory developed is necessary so that pain management practitioners can be aware of the range of possible perspectives available for moral judgment.Ethical Implications of Pain Management Fr.
Clark is John McShain Chair in Ethics, St.
Joseph's University, Philadelphia. The effective management of pain is . Although consciously following the principles of ethics when deciding on pain treatment can be time consuming, applying the four basic principles to pain care in every situation is imperative if pain is to be managed at optimal levels.
Markkula Center for Applied Ethics. Palliative Care: An Ethical Obligation ; Stephanie C. Paulus. including effective pain management. 9 Most hospitals recognize these duties and have mission statements claiming a dedication to high-quality health care, and often a specific dedication to patient-centered care.
Hence, patients admitted. Code of Ethics for Pain (Adopted from AAPM) “The American Academy of Pain Management recognizes the many facets and problems that pain patients experience. For this reason, the American Academy of Pain Management endorses and reaffirms the benefit of the Standards are applied evenly and fairly to all individuals who receive services.
The American Academy of Pain Medicine (AAPM) is a medical specialty society representing physicians practicing in the field of Pain Medicine. The management of pain is fundamental to the practice of medicine. The Oneology Nursing Society's doeument "Integrating Ethics into Oneology Nurs- ing Praetiee," which is based on Seanlon and Glover's article,2 states that "Oneology nurses demonstrate the value of quality of life in practice ETHICAL ISSUES IN PAIN MANAGEMENT by assessing and managing a full and complex array of .