Tag Archives: ethics

Ethical decision making in pain management

Ethical decision making in pain management: a conceptual framework | JPR – DOI https://doi.org/10.2147/JPR.S162926 – May 2018

The practice and study of pain management pose myriad ethical challenges. There is a consensual opinion that adequate management of pain is a medical obligation rooted in classical Greek practice.

I’m surprised this is still considered a “consensual opinion” when doctors are abandoning patients or quitting practice entirely to avoid prescribing opioids to patients who need them.

Thanks to addiction-biased anti-opioid media reporting, the American public is clamoring for opioid prohibition and “being tough” with pain instead of treating it… as long as it’s someone else’s pain, that is. Continue reading


Navigating New Opioid Prescribing Requirements

Navigating New Opioid Prescribing Requirements: Practical Legal Advice for PCPs & Pain Specialists – By Angie Drakulich – April 2018
With presentations from Lynn Webster, MD, and Michael Barnes, Esq

Here’s a look at the current anti-opioid legal landscape from a practitioner’s point of view:

Perhaps one of the most well-attended sessions at the 2018 annual meeting of the American Academy of Pain Medicine was a unique presentation featuring Lynn Webster, MD, and Michael Barnes, Esq, on how changes in legislation and litigation are affecting patient care.

Presented in the context of the United States’ declared national public health emergency on opioids, an increase in DEA investigations into physicians working with chronic pain patients, and a slew of legal shifts, the session provided practical recommendations for today’s healthcare provider who may be concerned about opioid prescribing.   Continue reading

Restrictions on Opioids Are Threat to Human Rights

Yes, Restrictions on Opioids Are a Threat to Human Rights – May 12, 2018 by Lynn Webster, M.D.

In a recent Washington Post story, “Are restrictions on opioids a threat to human rights?,” Charles Lane states that the wave of prescription opioid overdoses has crested thanks to public policy changes including the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain.

Actually, opioid prescribing and overdoses essentially peaked four years before the CDC guidelines were introduced.

According to a recent report from the CDC, the rate of opioids prescribed is lower than at any time in the past 10 years. The peak occurred in 2010.   Continue reading

Epidemic of Unethical Addiction Treatment Providers

Fraud’s Newest Hot Spot: The Opioid Epidemic And The Corresponding Rise Of Unethical Addiction Treatment Providers – April 2018 – by Anuradha Rao-Patel, Michael Adelberg,  Samantha Arsenault,  Andrew Kessler

For decades, bad actors have followed the money through a string of sophisticated scamspower wheelchairs, home health, ambulance and medical transport, and counterfeit medicines.

SUD treatment was a $9 billion per year industry in 1986 and is now a $35 billion industry that is expected to reach $42 billion in 2020.

Now, the burgeoning opioid crisis is a hot spot for health care fraud.   Continue reading

The Power of Algorithms in Health Care

Algorithms Have a Role in Health Care, But Their Power Must Be Checked – Apr 2018 – By Jeffrey A. Singer

With the “aging of America”, the number of folks seeking health care will explode as the baby boomers get old and infirm. Financial interests have taken note of this and are investing heavily in all kinds of related businesses: biotech, hospitals, nursing facilities, medical practices, pain management, drug-testing, addiction-recovery…

Healthcare has been transformed into a new industry of huge corporations, organized and run by financial interests and for financial interests, with little concern for patients except as “customers” from whom to extract profit by sending them through a medical maze of procedures, each of which generates another chunk of money, either from insurance or the patient, that’s funnelled to the corporation and into the pockets of executives.   Continue reading

Ethical Responsibility to Manage Pain and Suffering

The Ethical Responsibility to Manage Pain and the Suffering It Causes – Position Statement of the American Nurses Association, 2018

The purpose of this position statement is to provide ethical guidance and support to nurses as they fulfill their responsibility to provide optimal care to persons experiencing pain. 

The national debate on the appropriate use of opioids highlights the complexities of providing optimal management of pain and the suffering it causes.

In these first sentences, the difference between nurses and doctors shine through: nurses are much more concerned with suffering, while doctors nit-pick about what is painful and what isn’t, who is “really” hurting and who is “catastrophizing”.   Continue reading

Social good versus private profit

“Is curing patients a sustainable business model?” Goldman Sachs analysts ask | Ars Technica – Beth Mole – 4/12/2018, 2:45 PM

One-shot cures for diseases are not great for business—more specifically, they’re bad for longterm profits—Goldman Sachs analysts noted in an April 10 report for biotech clients, first reported by CNBC.

The investment banks’ report, titled “The Genome Revolution,” asks clients the touchy question: “Is curing patients a sustainable business model?”   Continue reading

Sometimes the Journal of the AMA Gets It Wrong

Sometimes the Journal of the AMA Gets It Wrong! And so do careless journalists. | American Council on Science and Health – By Richard “Red” Lawhern — March 21, 2018

On March 6, 2018, the Journal of the American Medical Association published a 12-month randomized clinical trial [authors Erin E Krebs, Amy Gravely, Beth DeRonne, Elizabeth Goldsmith, and others] which compared opioids to non-opioid medications for treatment of moderate to severe osteoarthritis and back pain among 240 Veterans Administration patients.  

In the days since publication, the study has been picked up by popular online magazines and blogs under blaring, but incorrect, headlines.   Continue reading

Moral Choices for Today’s Physician

Moral Choices for Today’s Physician | Humanities | JAMA | The JAMA Network – Donald M. Berwick, MD, MPP

The current generation of physicians is the most challenged by moral choices in perhaps a century. Those choices come in three tiers: personal, organizational, and societal.

This is the moral choice in its simplest, purest, most elemental form. To tell the truth, or not, when “not” is perhaps in your short-term self-interest.

A second form of choice comes in equal silence and has to do with one’s self-image as a physician. It is the choice between being a hero and being a citizen. Continue reading

Pain Management: A Fundamental Human Right

Pain Management: A Fundamental Human Right – Anesthesia & Analgesia: July 2007

This lengthy article explores the moral and ethical aspects of pain care to make the case that access to pain control is a human right.

Today at the dawn of the 21st century, the best available evidence indicates a major gap between an increasingly sophisticated understanding of the pathophysiology of pain and widespread inadequacy of its treatment.

In the developed world, this gap has prompted a series of declarations and actions by national and international bodies advocating better pain control.   Continue reading