Pain Management Ethics Statement
Historically, physicians have sought to alleviate pain and suffering. With the scientific and technological advances that have occurred in recent decades, clinicians have increasingly focused on the control or cure of disease. As a result, the traditional compassion of medical care has often been diluted or neglected.
This attitude of compassion was taught by Jesus in the parable of the Good Samaritan and was demonstrated in His ministry to those who were ill. As Christian physicians and dentists, we are compelled by love for our Lord Jesus Christ and love for our neighbor to include effective pain management in our ministry to our patients.
Pain management is important for all patients, but is especially important in patients with chronic or terminal illnesses. The total management of pain involves four areas: physical, emotional, social, and spiritual pain.
Physical pain should be treated by using all effective modalities. However, we understand pain to be an important symptom alerting the patient to a need or a potential problem. Therefore it may not always be appropriate to remove this symptom completely.
When pain cannot be completely eliminated, it is the clinician's responsibility to help the patient cope with the residual pain and to live as fully as possible. In patients who are imminently dying, it is acceptable to use increasing doses of analgesics to the level necessary to control severe pain without the intent of shortening life, but with the realization that in some instances control of pain might hasten death.
Emotional pain may include fear of pain, disability or death; frustration; worries of what will happen to those left behind; and feelings of being a burden on loved ones. Social pain may include a feeling of abandonment by loved ones or caregivers, and a fear of lack of access to medical resources. These aspects of pain can be addressed by a compassionate and supportive presence.
Spiritual pain may include a sense of isolation from God, fear of death, and feelings of guilt and anger. Management should include an affirmation of God's enduring love for us and an opportunity for repentance, reconciliation, and acceptance of His offer of eternal life.
As Christian physicians and dentists, we desire to address the physical, emotional, social and spiritual pain of our patients in order to more fully reflect the love and compassion of our Lord.
Approved by the CMDA House of Delegates
Passed with a vote of 56 in favor, 2 opposed, 1 abstention
April 30, 1993. Danvers, Massachusetts.