The Bioethics Of Pain Management

In this book, public health ethicist Daniel S. Goldberg sets out to characterize the subjective experience of pain and its undertreatment within the US medical establishment, and puts forward public policy recommendations for ameliorating the undertreatment of pain. The book begins from the position that the overwhelming focus on opioid analgesics as a means for improving the undertreatment of pain is flawed, and argues instead that dominant Western models of biomedicine and objectivity delegitimize subjective knowledge of the body and pain in the US. This general intolerance for the subjectivity of pain is part of a specific American culture of pain in which a variety of actors take part, including not only physicians and health care providers, but also pain sufferers, caregivers, and policymakers. Concentrating primarily on bioethics, history, and public policy, the book brings a truly interdisciplinary approach to an urgent practical ethical problem. Taking up the practical challenge, the book culminates in a series of policy recommendations that provide pathways for moral agents to move beyond contests over drug policy to policy arenas that, based on the evidence, hold more promise in their capacity to address the devastating and inequitable undertreatment of pain in the US.

Specifically designed to address the needs of all specialists involved in the care of chronic pain patients, this source clarifies the ethical and legal issues associated with the diagnosis, assessment, and care of patients suffering from long-term pain. Divided into five comprehensive sections, this source covers a variety of topics to help the ch

The treatment of pain and scientific pursuits to understand the mechanisms underlying pain raise many ethical, legal, and social issues. For the first time, this edited volume brings together content experts in the fields of pain, pediatrics, neuroscience, brain imaging, bioethics, health humanities, and the law to provide insight into the timely topic of pain neuroethics. This landmark volume of the state of the art exploration of pain neuroethics will be a must read for those interested in the ethical issues in pain research, treatment, and management. Provides the authority and expertise of leading contributors from an international board of authors Represents the first release in the Developments in Neuroethics and Bioethics series The content includes representatives from a diversity of disciplines

This book sets out to characterize the subjective experience of pain and its undertreatment, and puts forward public policy recommendations for ameliorating the undertreatment of pain. Goldberg argues that the US medical establishment's overwhelming focus on opioid analgesics is flawed, and that the general intolerance for the subjectivity of pain is part of a specific American culture of pain tha implicates not only physicians and health care providers, but also pain sufferers, caregivers, and policymakers. Concentrating primarily on bioethics, history, and public policy, the book brings a truly interdisciplinary approach to an urgent practical ethical problem.

This is a book about the meanings we make out of pain. The greatest surprise I encountered in discussing this topic over the past ten years was the consistency with which I was asked a single unvarying question: Are you writing about physical pain or mental pain? The overwhelming consistency of this response convinces me that modern culture rests upon and underlying belief so strong that it grips us with the force of a founding myth. Call it the Myth of Two Pains. We live in an era when many people believe--as a basic, unexamined foundation of thought--that pain comes divided into separate types: physical and mental. These two types of pain, so the myth goes, are as different as land and sea. You feel physical pain if your arm breaks, and you feel mental pain if your heart breaks. Between these two different events we seem to imagine a gulf so wide and deep that it might as well be filled by a sea that is impossible to navigate.

NPR Best Book of 2019 A bioethicist’s eloquent and riveting memoir of opioid dependence and withdrawal—a harrowing personal reckoning and clarion call for change not only for government but medicine itself, revealing the lack of crucial resources and structures to handle this insidious nationwide epidemic. Travis Rieder’s terrifying journey down the rabbit hole of opioid dependence began with a motorcycle accident in 2015. Enduring half a dozen surgeries, the drugs he received were both miraculous and essential to his recovery. But his most profound suffering came several months later when he went into acute opioid withdrawal while following his physician’s orders. Over the course of four excruciating weeks, Rieder learned what it means to be “dope sick”—the physical and mental agony caused by opioid dependence. Clueless how to manage his opioid taper, Travis’s doctors suggested he go back on the drugs and try again later. Yet returning to pills out of fear of withdrawal is one route to full-blown addiction. Instead, Rieder continued the painful process of weaning himself. Rieder’s experience exposes a dark secret of American pain management: a healthcare system so conflicted about opioids, and so inept at managing them, that the crisis currently facing us is both unsurprising and inevitable. As he recounts his story, Rieder provides a fascinating look at the history of these drugs first invented in the 1800s, changing attitudes about pain management over the following decades, and the implementation of the pain scale at the beginning of the twenty-first century. He explores both the science of addiction and the systemic and cultural barriers we must overcome if we are to address the problem effectively in the contemporary American healthcare system. In Pain is not only a gripping personal account of dependence, but a groundbreaking exploration of the intractable causes of America’s opioid problem and their implications for resolving the crisis. Rieder makes clear that the opioid crisis exists against a backdrop of real, debilitating pain—and that anyone can fall victim to this epidemic.