Ethical and legal issues in nursing pain management

¶ … suffer anymore: Access to pain treatment as a human right, Human Rights Watch author Diederick Lohman discusses the issue of pain management as a human rights issue. Lohman addresses the fact that it has long been established that pain relieving drugs, particularly narcotics, are an essential element of healthcare. In fact, he points out that in 1961, the world community adopted the 1961 Single Convention on Narcotic Drugs, which instructed countries to make pain relieving medications available to people (Lohman, 2009). However, the reality is that, even now the majority of the world's people lack access to pain-relieving medication. This is particularly true in low and middle income countries. Moreover, the lack of access impacts patients at all levels, even those whose conditions are terminal, so that they literally die in pain.

In the article, Lohman cites an extraordinary amount of facts and figures to back up his assertion that pain relievers have not yet been made available to the majority of the world's population. However, Lohman's point goes beyond a scholarly discussion of the availability of these medications. Instead, it touches upon the ethical issues that are implicated when physicians make willing decisions to withhold critical pain management tools, including medication, from patients in need of relief. Therefore, the most important information that Lohman provides in the article is not contained in his exhaustive facts and figures; instead, it is found in his excerpted comments from real patients and his exploration of the underlying attitudes of treating physicians in various parts of the world. What he reveals is that there is some significant cultural bias surrounding the use of pain medication. Even well-trained doctors may erroneously believe that the use of pain medication hastens death or that non-fatal wounds or medical conditions that will resolve themselves without medical intervention are not sufficient to warrant pain medication.

If Lohman's assertions and conclusions about the systemic failure to provide pain relieving medications to suffering patients, as well as the complacency by doctors and governments who ignore the needs of these patients are true, then the failure to provide adequate pain management for those who are suffering may be the most significant ethical dilemma facing the modern medical community. Access to pain relieving medications is considered a basic human right (Purdue Pharma LP, 2012). Moreover, it seems to be a human right that is recognized at the levels of diplomacy; in other words, countries agree to the idea that pain management is a human right. In fact, according to Brennan et al., "we are at an "inflection point" in which unreasonable failure to treat pain is viewed worldwide as poor medicine, unethical practice, and an abrogation of a fundamental human right" (2007). However, there is a tremendous breakdown between what is seen as an ideal and what occurs in the everyday working environments in many modern medical communities. This is an unacceptable reality because pain management is not unduly burdensome or expensive. Morphine is the first-course medication for severe pain and the fact that is it both inexpensive and widely available removes many of the barriers to offering such relief to patients experiencing pain.