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
- 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.
- 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.
- 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.
- 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?
- Studies have shown ethnic and racial disparities in occurrence of pain, response to pain and usage of pain medication.
- 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.
- 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.
- What percentage could pain occupy in disability rating for a disabled individual?
- 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