Technical expertise is available to treat 90% of all pain in terminal illness. Guidance is available to medical facilities and doctors on how to treat pain and where to get help if they're stumped. Standards implemented in 2001 by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) require accredited facilities to routinely assess and have systems in place to manage pain. Nonetheless, untreated pain is still common. Studies confirm that far too many Americans die in pain in our hospitals and nursing homes.
Physicians have an ethical, moral, and legal obligation to manage pain or to assure that the patient is referred to another doctor who is competent and willing to do so. The Code of Ethics of the American Medical Association states that 'physicians have an obligation to relieve pain and suffering and to promote the dignity and autonomy of dying patients in their care.'
If pain is not being acknowledged or treated, however, the patient, or the patient's advocate — usually a family member or friend — will have to play an active and assertive role in making sure that the ethical obligation translates into comfort for the patient.
This list represents steps which the patient or patient's advocate can take when pain is uncontrolled. Although hospitals and nursing homes can be very intimidating, if the pain is very severe, the advocate should be prepared to walk through them very quickly. Even an hour of severe pain lasts forever.
Copyright 2009 NBC Health
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