TY - JOUR
T1 - Ethical perspectives
T2 - Opioid treatment of chronic pain in the context of addiction
AU - Cohen, Mitchell J.M.
AU - Jasser, Samar
AU - Herron, Patrick D.
AU - Margolis, Clorinda G.
AU - Jamison, Robert N.
PY - 2002
Y1 - 2002
N2 - The authors apply eight ethical domains of analysis to the question of treatment of chronic pain with opioids in patients with histories of substance use disorders: autonomy, nonmaleficence, beneficence, justice, medical condition, patient preference, quality of life, and consideration of specific individual or sociocultural issues. These eight domains are drawn from principle-based and case-based ethical perspectives. The domains are developed by review of available literature and through application to a specific presented case. Factors that interfere with rational, ethical decision-making regarding opioid pain management are identified. Chronic pain and substance use disorders share a history of stigmatization, underdiagnosis, and undertreatment. Using the presented case as a point of departure, the authors discuss principles for prescription of opioids for treatment of chronic noncancer pain in the setting of history of substance use disorders.
AB - The authors apply eight ethical domains of analysis to the question of treatment of chronic pain with opioids in patients with histories of substance use disorders: autonomy, nonmaleficence, beneficence, justice, medical condition, patient preference, quality of life, and consideration of specific individual or sociocultural issues. These eight domains are drawn from principle-based and case-based ethical perspectives. The domains are developed by review of available literature and through application to a specific presented case. Factors that interfere with rational, ethical decision-making regarding opioid pain management are identified. Chronic pain and substance use disorders share a history of stigmatization, underdiagnosis, and undertreatment. Using the presented case as a point of departure, the authors discuss principles for prescription of opioids for treatment of chronic noncancer pain in the setting of history of substance use disorders.
KW - Ethics
KW - Medical decision-making
KW - Principle of double effect
KW - Pseudoaddiction
KW - Quality of life
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U2 - 10.1097/00002508-200207001-00012
DO - 10.1097/00002508-200207001-00012
M3 - Article
C2 - 12479260
AN - SCOPUS:0036325851
SN - 0749-8047
VL - 18
SP - S99-S107
JO - Clinical Journal of Pain
JF - Clinical Journal of Pain
IS - 4 SUPPL.
ER -