Pediatric pain: Ethical issues and ethical management

Author(s): Walco, G. A.

Journal/Book: Child Health Care. 1996; 25: 10 Industrial Ave, Mahwah, NJ 07430-2262. Lawrence Erlbaum Assoc Inc. 253-264.

Abstract: Patients have traditionally received less pain relief than they could, and should. Surprisingly, numerous studies demonstrate that this agonizing gap between need and care is even larger for children. Three ''licenses'' that have traditionally been used to justify the undertreatment of pain are analyzed: (a) the revisionist justification (''The pain is not that bad''), (b) the comparative justification (''The pain is not the worst''), and (c) the pragmatic justification (''The pain may produce something better''). These justifications are challenged by a review of state-of-the-art scientific knowledge and by the principles of ethical decision making. The conclusion is that both scientific and ethical standards demand an end to the undertreatment of pain for pediatric patients.

Note: Article Cassidy RC, Long Isl Jewish Med Ctr, Schneider Childrens Hosp, New Hyde Pk,NY 11042 USA

Keyword(s): SICKLE-CELL DISEASE; CHILDRENS PAIN; MORPHINE; UNDERTREATMENT; ADOLESCENTS

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