Ethical dilemmas in pain management

Betty R. Ferrell, Diane Novy, Mark D. Sullivan, John Banja, Michel Y. Dubois, Melvin C. Gitlin, Daniel Hamaty, Allen Lebovits, Arthur G. Lipman, Philipp M. Lippe, Jeffrey Livovich

Research output: Contribution to journalArticlepeer-review


The purpose of this study was to survey the membership of the American Pain Society and the American Academy of Pain Medicine to determine their beliefs about ethical dilemmas in pain management practice. Respondents rated ethical dilemmas for their importance as well as their own competence in dealing with these ethical issues. The survey also included an open-ended question that asked respondents to describe clinical situations in which they had encountered ethical dilemmas. A total of 1, 105 surveys were analyzed, with physicians (n = 612), nurses (n = 189), and psychologists (n = 166) representing the professions with the greatest response. Management of pain at the end] of life, general undertreatment of pain, and undertreatment of pain in the elderly were the most frequently encountered dilemmas. Qualitative data were analyzed to identify ethical issues in the case examples provided by the respondents. Major themes included inappropriate pain management, barriers to care, interactions and conflicts with others, regulatory/legal issues, euthanasia, assisted suicide, and research issues. We conclude that ethical dilemmas are common in pain management practice and that resolution of these dilemmas requires commitment by individual professionals as well as health systems.

Original languageEnglish (US)
Pages (from-to)171-180
Number of pages10
JournalJournal of Pain
Issue number3
StatePublished - 2001


  • Ethical dilemmas
  • Ethical issues
  • Ethics
  • Management
  • Undertreatment of pain

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Anesthesiology and Pain Medicine


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