Skip to main content

Ethics in Pain Management and End of Life Care

  • Chapter
  • First Online:
  • 3834 Accesses

Abstract

“Do the kind thing, and do it first,” said William Osler as advice to physicians. But in 1904 there were limited things that physicians could do for their patients with chronic pain or who were in need of care at the end of life. In their article published in Critical Care Medicine in 1992, Cowley et al. concluded that “Despite the miraculous advances in medical theory and medical practice, the ethics surrounding medical care for the dying are more troubling today than they were in ancient Athens at the time of Plato. In classical antiquity, the primary concerns were for health and living well. The “Middle Ages” saw the emergence of the principle of sanctity of life. To these basic ideals, the “Renaissance” and the “Enlightenment” added the aspiration to prolong life. Finally, in the 20th century, modern science has rendered this aspiration a reality of unclear merit.”

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  • Butler RN, Burt R, Foley KM, Morris J, Morrison RS. Palliative medicine: providing care when cure is not possible. A Roundtable discussion: Part 1. Geriatrics. 1996a May;51(5):33–6, 42–44.

    Google Scholar 

  • Butler RN, Burt R, Foley KM, Morris J, Morrison RS. A peaceful death: how to manage pain and provide quality care. A Roundtable discussion. Part 2. Geriatrics 1996b Jun;51(6):32–5, 39–40, 42.

    Google Scholar 

  • Cassel EJ. Nature of suffering and the goals of medicine. NEJM 1982;306(11):639–45.

    Article  PubMed  CAS  Google Scholar 

  • Christakis NA, Asch DA. Biases in how physicians choose to withdraw life support. Lancet 1993;342:642–6.

    Article  PubMed  CAS  Google Scholar 

  • Cowley LT, Young E, and Raffin TA. Care of the dying: an ethical and historical perspective. Crit Care Med. 1992;20(10):1473–82.

    Article  PubMed  CAS  Google Scholar 

  • Cozzaglio L, Palzola F, Cosantino F, et al. Outcome of cancer patients receiving home parenteral nutrition. Italian Society of Parenteral and Enteral Nutrition (S.I.N.P.E). J Parenter Enteral Nutr. 1997;1(6):339–42.

    Article  Google Scholar 

  • Dotson DA, Why not relief? Pain Physician 2000;3(1):65–68.

    Google Scholar 

  • Dotson DA, Treat the disease or treat the patient? Am J Pain Manag 1997;7:130–132.

    Google Scholar 

  • Doyle D, Hanks WC, MacDonald N, eds. Oxford textbook of palliative medicine. 2nd ed. New York, NY: Oxford University Press; 1998.

    Google Scholar 

  • Practice guidelines for chronic pain management: a report by the American Society of Anesthesiology Task Force on Pain Management. Chronic Pain Section. Anesthesiology 1997;86:995–1004.

    Article  Google Scholar 

  • Saucier Lundy K, Janes S. The art of palliativge care – living with hope dying with dignity. Oncol Nurs Forum 1998;25(6):995–1004.

    Google Scholar 

  • Spiegel D, Stroud P, Fyfe A. Complementary medicine. West J Med. 1998;168:241–7.

    PubMed  CAS  Google Scholar 

  • Thorns SA, Sykes N. Opioid use in the last week of life and implications for end of life decision making. Lancet 2000;356:398–9.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Berger, J.M. (2011). Ethics in Pain Management and End of Life Care. In: Vadivelu, N., Urman, R., Hines, R. (eds) Essentials of Pain Management. Springer, New York, NY. https://doi.org/10.1007/978-0-387-87579-8_29

Download citation

  • DOI: https://doi.org/10.1007/978-0-387-87579-8_29

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-87578-1

  • Online ISBN: 978-0-387-87579-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics