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The Undertreatment of Pain-Legal, Regulatory and Research Perspectives and Solutions
Journal of Law, Medicine & Ethics 29(1)

Vence L. Bonham, Race, Ethnicity, and Pain Treatment: Striving to Understand the Causes and Solutions to the Disparities in Pain Treatment, Journal of Law, Medicine & Ethics, 29(1) J. LAW, MED. & ETHICS (2001) 52 [PDF]
Racial and ethnic minorities are at higher risk for the ineffective treatment of pain. While others have investigated racial and ethnic disparities in access to health services generally, this article represents the first comprehensive review of the literature on racial and ethnic disparities in the treatment of pain. In addition to conducting this review, the author also outlines some of the causes for the disparities as well as provides suggestions for future health-services research in this area.

David B. Brushwood, From Confrontation to Collaboration: Collegial Accountability and the Expanding Role of Pharmacists in the Management of Chronic Pain, Journal of Law, Medicine & Ethics, 29(1) J. LAW, MED. & ETHICS (2001) 69 [PDF]
The war on drugs has created an environment where both physicians and pharmacists are afraid to aggressively manage pain — which, for many patients, means horrific unrelieved suffering. Although the policy-on-paper, as the author calls it, regarding controlled substances has eased, the policy-in-practice has not, and physicians and pharmacists are still fearful of prosecution or other disciplinary action. As a solution, the author proposes and discusses in detail collaborative drug therapy management for chronic pain.

Barry R. Furrow, Pain Management and Provider Liability: No More Excuses, 29(1) J. LAW, MED. & ETHICS (2001) 28 [PDF]
The author confronts the fact that pain is undertreated at all levels of the American health-care system and investigates how the threat of malpractice may change this state of affairs. Specifically, the author analyzes existing and emerging liability theories and doctrines that may be used to motivate physicians, hospitals, nursing homes, and managed care organizations — with regard to the particular standard of care they owe to the patient — to properly treat pain.

Diane E. Hoffmann and Anita J. Tarzian, The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain, Journal of Law, Medicine & Ethics, 29(1) J. LAW, MED. & ETHICS (2001) 13 [PDF]
In general, women report more severe levels of pain, more frequent incidences of pain, and pain of longer duration than men, but are nonetheless treated for pain less aggressively. The authors investigate this paradox from two perspectives: Do men and women in fact experience pain differently — whether biologically, cognitively, and/or emotionally? And regardless of the answer, what accounts for the differences in the pain treatment they receive, and what can we do to correct this situation?

Sandra H. Johnson, Introduction: Relieving Unnecessary, Treatable Pain for the Sake of Human Dignity, Journal of Law, Medicine & Ethics, 29(1) J. LAW, MED. & ETHICS (2001)11 [PDF]

 

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