Photo @ AJ Photo / Hop Americain / Science Photo Library
Pain is difficult to define and hard to convey. The way both patients and clinicians respond to it can be influenced by a multitude of possible biases. This month’s Ethical Issues column in AJN is by Doug Olsen, PhD, RN, an associate professor at Michigan State University College of Nursing. In “Ethical Practice with Patients in Pain,” Olsen summarizes the challenge nurses and other clinicians face in treating patients’ pain:
Responding to a patient’s pain is a fundamental ethical obligation in nursing. However, nurses caring for patients in pain can run into ethical conflicts from both over- and undertreatment of pain. Undertreatment of pain represents a failure to fulfill the core nursing obligation to alleviate suffering—but overtreatment may ultimately harm the patient, contradicting a core nursing value, nonmaleficence. The complex nature of pain complicates efforts to provide treatment that is ‘just right.’ Nurses must understand that complexity if they are to make ethical decisions in the care of patients who experience pain.
In the article, Olsen uses two hypothetical patients to shed light on the elusive nature of pain, the various ethical considerations that come into play for clinicians, and the various sources of potential bias that influence the way we understand pain. The article, which is currently free, is both engaging and insightful. We hope you’ll give it a read.—Jacob Molyneux, senior editor
You have 2 different terms in your article 1) “alleviate suffering- an ethical obligation and core nursing function 2) “contradiction of core nursing value, non maleficence- this is a law school & court term. Understanding that the function of nursing begins with alleviating pain and suffering and is key to what the profession of nursing is all about is essential in order to provide patients with utmost nursing care! In short, let the lawyers be lawyers- but let the nurses be nurses? The professional nurse is capable of determining whether the patients for which she/he cares is over treated for pain and, by assessment, under treated and acts accordingly by notifying the physician or contacting the pharmacist on duty.