Description: Pain management is
deeply emotional and spiritual, making it difficult to promulgate laws for its
management
Are laws necessary for pain management?
Pain
management and existing laws have never been good friends. There are
regulations and laws at state and federal levels that have
attempted to regulate, organize and standardize pain management systems;
however, the exceptions outnumber the rules. In addition, the divergence in
pain therapies prescribed by different healthcare professionals hasled to an
altogether new debate on the effectiveness of a particular pain therapy. Therefore,
pain management has become a debatable subject.While some people question the
very existence of pain, there are others who debate about pain being a symptom
or disease and yet others question if it can be treated, or managed.
Some of the major pain
management issues are
1. Pain is multi- dimensional, in
the sense that it involves a number of influencing factors which may or may not
need treatment, and in spite of rapid development in technology, there has not
been much progress in pain therapy.
2. The stressors that cause pain
could be physical, social, relational, emotional, financial or spiritual
conditions, which make it difficult to diagnose the cause of pain or to plan a
treatment.
3. The basic healthcare
regulations, clinician perceptions and patient related factors are some of the
barriers to pain treatment which are believed to lead to chronic pain or pain under-treatment.
4. There are ethical questions
surrounding the existence or requirement for optimal treatment. If a physician
refrains from prescribing continued pain relief medication with the intent of preventing
the patient’s addiction to pain killers, is he doing the right thing? Is it
pain under-treatment? Or is it correct from an ethical standpoint?
5. Studies have shown ethnic and
racial disparities in occurrence of pain, response to pain and usage of pain
medication.
6. There is widespread abuse and
diversion of pain relief medication and it has become difficult to determine
which pain is existent and which is non-existent.
7. Till recently, fibromyalgia,
phantom pain, head ache, soft tissue pain were all considered either false
pains or physical manifestation of psychological conditions by many
psychologists and pain management professionals alike.
8. What percentage could pain
occupy in disability rating for a disabled individual?
9. Pain perception and pain rating
by patients is subjective and prone to wide variations.
The
existing pain management laws have not been able to answer or address most of
the above mentioned points effectively, thus leaving this space vague,
ambiguous and prone to severe misinterpretation.
Formulating
new laws or modifying the existing laws to address the above issues is
necessary and will be a good start in organizing and regulating the pain
management system. However, there might be several challenges in formulation,
implementation, monitoring and setting compliance requirements for the laws in
pain management.
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