Pain Management and Ethics

Nursing Students Student Assist

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I have to write a letter to a public official regarding an ethical dilemma. I have chosen pain management as my topic. I have a pretty good start but I wanted to get some of your opinions on the matter. For instance, I must include why there is a need for the official to act on the issue; a possible solution to the issue; the good AND the bad sides of the issue; etc.

Thanks for your input!

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Specializes in med/surg, telemetry, IV therapy, mgmt.

I don't understand how pain management becomes an ethical issue that a public official can address when narcotics are so highly regulated by law.

My first thought might be the legalization marijuana for medical use. This is very controversial! Some officials are condoning it's medical use. Is legalization far away?

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Specializes in Emergency/Trauma/Education.

Legalizing medical marijuana is a relevant topic.

Another avenue would be more strict regulation and punishment for those caught forging/altering prescriptions or deceptively obtaining narcotics. (I'm trying not to use the term "drug-seeking"!) These folks give anyone with true pain a bad name & potentially limit access to their appropriately needed medications.

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the issue is with the completely different pain tolerances of patients and when it is and isnt necessary to give them anything.

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You're right that it can be a tough call for clinicians to make decisions about pain management, but I'm not sure if that's really an ethical dilemma and I can't see how writing to a legislator would help in that decision-making.

If you haven't talked with your instructor, you might run your idea by him/her before forging ahead. Good luck!

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Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

I would be interested to hear why a public official would need to get involved as well.

I also agree it can be an ethical delimena, such as when to medicate at the end of life (i.e. a patient is moaning in in pain, dying, and respirations are 8 and bp is 70/30....some nurses will hold the mediation). The nurse doesn't want to give the pain medicine because it might kill the patient. Maybe the legislature can help with this aspect?

People are suing MDs, hospitals and nurses and getting settlements for inadequate pain control. MDs are getting in trouble and charged with crimes for over-prescribing drugs and contributing to addiction and street availability, thus making MD's afraid to prescribe drugs like oxycontin for pain. Maybe a legislator can help with this aspect.

It is a very relavent topic. JACHO is going over patients charts with a fine toothed comb looking for compliant pain control. When I took the Med Surg Certification this last time (I took it twice because my first one expired) there was a lot of pain control questions.

Personally, I'd rather not see an MD get involved in when to medicate a person with a high tolerance to narcotics, although these are the one's who sue for inadequate pain control.

Medical marijuania is one an official can intervene in, but that is so overused probably more than half of your classmates are doing it.

Good luck. I'd like to hear how it turns out.

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Specializes in Emergency/Trauma/Education.

I guess I thought of elected officials in regards to regulation/consequences of forging or altering prescriptions. :angryfire

I was connecting it to the ethical issue of prescribers making the determination of whether a person is "seeking" or actually in need of pain medications.

Funny how the two ideas linked together nicely in my brain the other day... :confused:

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