Beyond consensus that pain is “an unpleasant sensory and emotional experience,” its biology remains poorly understood, and options for its treatment remain frustratingly inadequate.
Because knowledge about the efficacy of long-term opioid use is lacking, decisions about opioid treatment for chronic nonmalignant pain should be guided by a six-step decision making process that is based in clinical ethics.
AMA J Ethics. 2015;17(6):521-529. doi:
10.1001/journalofethics.2015.17.6.nlit1-1506.
We consult our doctors for expert medical advice, not phenomenological analysis, but perhaps a wide gulf ought not separate empirical science and research from phenomenological reflection and analysis on illness.
Narrative ethics derives its ethical force from continually comparing and critiquing new narratives against existing narratives that guide the way we live.
Patients’ personal or cultural views toward illness, the business of health care under which we all operate, and our own personal opinions about the ideal of health and wellness can all compromise pain treatment. It is our responsibility to see that it does not.
Rates of referral to a cardiologist, which markedly improves cardiovascular outcomes, differ significantly based on nonclinical patient characteristics.