Virtual Mentor. May 2013, Volume 15, Number 5: 399-487. Full Issue PDF

May 2013 Contents

Ethics of Pain Measurement and Management

Ethics Poll

The pain rating scale currently in clinical use asks people to rate how they feel from 0 (no pain) to 10, the most intense pain imaginable. Which of the following best expresses what you think about this scale?
It’s a good way to measure pain.
It’s the best we can do for sensations that are subjective experiences.
We should develop a functionality scale, based on what a person can or cannot do because of the pain.
Don’t know.

A narcotics contract is an agreement signed by a patient with pain and the physicians who is going to prescribe narcotics for that patient. Most narcotics contracts stipulate that the patient can get prescriptions from one physician only and have them filled at one pharmacy only; lost drugs will not be replaced; and some monitoring of drug use by pill count or urine sample will take place. Do you think that narcotics contracts are fair to patients? (Select the best answer.)
Yes, if all patients who receive narcotics have to sign them.
Yes, if only patients with histories of substance abuse or drug-seeking behavior have to sign them.
No, because they are not used for other classes of dangerous drugs, only for narcotics.
No they are not fair but they are necessary for protection of the patient, they physician, and the community.

Do you think that use of marijuana for treatment of pain should be legal? (Select the best answer.)
Yes. It should be legalized for treatment of pain across the U.S.
The voters of each state should decide whether to legalize it in their state.
No. It should be illegal in all of the U.S. because there are better pain-relief alternatives.
No. It should be illegal in all states because legal use of "medical marijuana" opens the door to legal recreational use.

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From the Editor

Ethical Perspectives on Pain
Bharat Kumar
Full Text | PDF
Virtual Mentor. 2013; 15:401-402.

Educating for Professionalism

Ethics Cases

Common Misconceptions about Opioid Use for Pain Management at the End of Life
Commentary by Jack M. Berger and Nalini Vadivelu
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Virtual Mentor. 2013; 15:403-409.

Drug Seeking or Pain Crisis? Responsible Prescribing of Opioids in the Emergency Department
Commentary by Pamela L. Pentin
Full Text | PDF
Virtual Mentor. 2013; 15:410-415.

Use of Narcotics Contracts
Commentary by Kristy Deep
Full Text | PDF
Virtual Mentor. 2013; 15:416-420.

Medical Education

Undergraduate Medical Education on Pain Management across the Globe
Nalini Vadivelu, Sukanya Mitra, and Roberta L. Hines
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Virtual Mentor. 2013; 15:421-427.

The Code Says

The AMA Code of Medical Ethics’ Opinions on Sedation at the End of Life
Full Text | PDF
Virtual Mentor. 2013; 15:428-429.

Journal Discussion

Physicians’ Responsibility to Understand Patients’ Pain
Robert Learch and Jeremy Cumberledge
Full Text | PDF
Virtual Mentor. 2013; 15:430-433.

State of the Art and Science

Long-Term Opioid Treatment
Craig T. Hartrick
Full Text | PDF
Virtual Mentor. 2013; 15:434-438.

Objectifying Chronic Pain: From the Patient to Diagnostic Metrics
David Borsook
Full Text | PDF
Virtual Mentor. 2013; 15:439-442.

Law, Policy, and Society

Health Law

Fighting Prescription Drug Abuse with Federal and State Law
Valarie Blake
Full Text | PDF
Virtual Mentor. 2013; 15:443-448.

Policy Forum

Pain and Ethnicity
Ronald Wyatt
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Virtual Mentor. 2013; 15:449-454.

Medicine and Society

Chronic Pain Patients and the Biomedical Model of Pain
Gillian Bendelow
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Virtual Mentor. 2013; 15:455-459.

History, Art, and Narrative

Images of Healing and Learning

Pain and the Paintbrush: The Life and Art of Frida Kahlo
Fernando Antelo
Full Text | PDF
Virtual Mentor. 2013; 15:460-465.

Op-Ed and Correspondence

Op-Ed

Medicinal Cannabis and Painful Sensory Neuropathy
Igor Grant
Full Text | PDF
Virtual Mentor. 2013; 15:466-469.

Resources

Suggested Readings and Resources
PDF
Virtual Mentor. 2013; 15:470-484.

About the Contributors
Full Text | PDF
Virtual Mentor. 2013; 15:485-487.