Doctors Debate How Much Pain
Patients Should Endure
Medical experts say some of the weakest and most severely ill patients-even children and elderly people-are not getting adequate relief for the intense pain of serious surgery, injury, or prolonged or terminal illnesses.
Fear that the patient will have a serious physical reaction has historically made doctors and nurses reluctant to administer high doses of pain medications. Doctors also worry about scrutiny by state or federal agencies or legal action by a patient's family for allegedly excessive medication use. One Colorado physician believes that the fear of disciplinary action is real but that it is basically unfounded if doctors keep well-documented case records. Fears of opioid prescribing are rooted in what he calls "taboos that have been in place for years."
Proper pain treatment will be attained only when it is taught in medical school, says Ben Rich, former professor medical ethics and law at the University of Colorado School of Medicine, now at University or California, Davis. Yet most medical schools typically offer their students little education in pain management.
The University of Colorado School of Medicine recently began revising its curriculum to include more pain-management education. This change is consistent with the policies of the state of Colorado, which 4 years ago undertook a series of actions that encourage more aggressive treatment of pain and foster educational programs aimed at both medical professionals and patients' families. (Foster D. Rocky Mountain News. February 29, 2000.)
Stephen F. Grinstead, LMFT, ACRPS
Specializing in Addiction-Free Pain Management