Pain Relief and Palliative Care

Abstract

Severe pain, which can undermine quality of life and cause incapacitating distress to patients and their accompanying family members, is a common consequence of advanced cancer and of other advanced incurable illnesses. Patients have a right to the adequate relief of their pain, and indeed a strong case has been made for having this recognized as a basic human right. This right is derived from principles of respect for persons, beneficence, nonmaleficence, and justice. Substantial obligations and duties derive from this claim that are relevant to individual health care providers (such as the professional staff attending to patients), the institutions in which they work, and the authorities responsible for public health policy in the provision and allocation of healthcare resources. This chapter explores these ethical domains and issues through a longitudinal case history of Michael, a 68-year-old man suffering from pain caused by metastatic colon cancer beginning from a pain crisis, through his ambulatory management and ultimately to his end of life care, which necessitated the use of sedation to manage otherwise refractory pain. (PsycINFO Database Record (c) 2018 APA, all rights reserved)