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Pain Management for Chronically Ill Patients, and the AMA’s Code of Medical Ethics
Physicians have an Obligation to Relieve Pain and Suffering’

 
Leonard J. Morse, M.D; Letter to Chronic Pain Activist Cheryl Gaul, R.N., NFTP website; 2003-01-02. Posted: 2006-02-11.
[Identifier: http://www.doctordeluca.com/Library/Pain/AmaOnPainManagement03.htm]
[Source: http://www.paincare.org/about/message.php?id=52]

 
Related resources:
“War on Doctors and  Pain Crisis Weekly RSS Update”  Feed URL:    HTML view:
Drug War Journalism and Advocacy archives ; War on Docs Academic Lit, Reports, and Legal Documents
See also:
Ethical Analysis of Barriers to Effective Pain Management -
Rich, Cambridge Quarterly Healthcare Ethics, 2000
 

[Full Text of this Article in Adobe PDF format]

Dear Cheryl Gaul, R.N.:

Thank you for your e-mail message to the American Medical Association regarding adequate pain management for chronically ill patients.  The Council on Ethical and Judicial Affairs had an opportunity to discuss the concerns you presented in your e-mail message dated August 20, 2002 at its recent meeting.

Although the AMA's Code of Medical Ethics does not have specific Opinions that address pain management and chronically ill patients, the Code does contain several ethical policies regarding compassionate care. Principle I of the Code stresses that, "A physician shall be dedicated to providing competent medical care, with compassion and respect for human dignity and rights."  I have attached a copy of the AMA's Principles of Medical Ethics for your review. [Code of Medical Ethics, Section: Principles of Medical Ethics; AMA, Revision 2005-07-06]

Also, in the context of end-of-life care, the Code emphasizes that "Physicians have an obligation to relieve pain and suffering and to promote the dignity and autonomy of dying patients in their care. This includes providing effective palliative treatment even though it may foreseeably hasten death."  The Code speaks strongly against the practice of euthanasia and physician-assisted suicide. 

As a solution to these unethical practices, the Code stresses the importance of adequate pain control and good communication between patients and physicians.  This ethical guidance is found in Opinion 2.21 "Euthanasia" which states, "Patients near the end of life must continue to receive emotional support, comfort care, adequate pain control, respect for patient autonomy, and good communication."

A copy of Opinion 2.21 is also attached for your review. [Code of Medical Ethics, Current Opinion E-2.21 - Euthanasia; AMA, Revision 2005-07-06]  The Council believes that the same efforts to relieve pain must be exercised by physicians caring for patients who suffer from pain that is not related to a terminal condition.

Thank you for bringing this matter to our attention.

Sincerely yours,

Leonard J. Morse, MD [Chair Emeritus, AMA’s Council on Ethical and Judicial Affairs; and, Past-President of the Massachusetts Medical Society]

[Full Text of this Article in Adobe PDF format]

[END]

 

Dr. DeLuca's Addiction, Pain, and Public Health Website

Alexander DeLuca, M.D.

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Originally posted: 2006-02-11

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