Ethical/legal/comm

Question 1

Ethical and legal issues

Answer 1

• While 30% or more of patients may experience some response to placebos, there is no ethical basis for use of placebos to assess or treat pain.
• Pain management is seen as a component or provision of competent medical care, not a human right.
• Clinicians have been successfully sued for under treatment of pain.
• Some physicians report worry about being prosecuted or sanctioned for prescribing opioids
• In managed care settings, income bonuses for prescribers are frequently linked to patient satisfaction; patients may not be satisfied if medications are not automatically refilled

Question 2

Patient-provider comm

Answer 2

Matthias 2014 Presentation: Communicating about Opioids for Chronic Pain
• Patients describe feeling burdened and depressed when physicians did not believe their pain complaints.
• Providers describe caring for patients with chronic pain as a “thankless task” in which they are “confronted with failure every day.”
Matthias 2017: I’m not gonna pull the rug out from under you: Patient-provider communication about opioid tapering