Presented at the 2012 AAPM Annual Meeting « Back

Chronic Pain Ethics

Summer J. McGee, PhD, smcgee@practicalbioethics.org, University of Kansas Medical Center, Kansas City, Missouri

Introduction/Statement of the Problem: Although chronic pain is increasingly recognized as a societal and even public health problem, few have attempted to identify and articulate the broader societal and public health ethics issues at stake in the diagnosis and treatment of chronic pain. Materials and Methods: Focus groups in five states were convened to discuss the current issues in chronic pain care. Commentary from approximately 125 stakeholders was analyzed across focus groups using an interpretivist method of qualitative data analysis to determine whether a consensus about moral issues in chronic pain care exists. Results: Six major themes emerged regarding chronic pain, all of which contained an ethical component. These were 1) reducing disparities in access to pain care among the young, elderly, and lower socioeconomic groups; 2) defining quality of care in pain management; 3) the need to train qualified providers and training programs in pain medicine; 4) the need for evidence-based public policy regarding opioid use and diversion; 5) the need to raise awareness about chronic pain as a disease to prevent stigmatization and discrimination; and 6) promotion of multimodal therapies for pain care as a way of diverting attention from opioid abuse problem. Conclusions: There is nationwide consensus among those holding a stake in the diagnosis and treatment of chronic pain regarding the ethical issues that must be addressed to ensure a morally justifiable approach to chronic pain management in the 21st century

Funding: Funders of the PAINS project were Purdue Pharma, Rx Alliance, and the Livestrong Foundation.