Pain in society: Ethical issues and public policy concerns

Abstract

This volume appears in the second half of the congressionally declared "Decade of Pain Control and Research" (H.R. 3244, 2000). Such a declaration by the Congress of the United States generates a perception that we are in the midst of a major national public policy initiative promoting the importance of pain relief to the health and well-being of all citizens who are currently or at some time in the future may become the victims of pain. Such a perception would not, however, necessarily comport with reality. Indeed, the very context in which H.R. 3244 arose was the persistent efforts of the opponents of physicianassisted suicide in general, and the Oregon Death With Dignity Act in particular, to enact federal legislation (under the guise of promoting pain relief) that would make it a federal offence for a physician to provide a competent, terminally ill patient who requested it with a lethal prescription, even if state law and public policy supported it. Such a tension is emblematic of tensions and conflicts inherent in how western culture thinks about and responds to the phenomenon of pain.