Rich Ben A
J Med Humanit. 1997 Winter;18(4):233-59. doi: 10.1023/a:1025697920944.
For over 20 years the medical literature has carefully documented the undertreatment of all types of pain by physicians. During this same period, as the field of bioethics came of age, the phenomenon of undertreated pain received almost no attention from the bioethics literature. This article takes bioethicists to task for failing to recognize the undertreatment of pain as a major ethical, and not merely a clinical, failing of the medical profession. The nature and extent of the problem of undertreated pain is examined, as well as possible reasons for its disregard by bioethicists. The factors contributing to undertreated pain in the clinical setting are considered, as well as the hazards posed by recent failures to address ethically questionable clinical practices. Finally, suggestions are offered for refocusing the attention of bioethicists to this significant problem.
二十多年来，医学文献一直在详细记录医生对各类疼痛治疗不足的情况。在同一时期，随着生物伦理学领域的成熟，疼痛治疗不足这一现象在生物伦理学文献中几乎未受到关注。本文指责生物伦理学家未能认识到疼痛治疗不足是医学专业的一个主要伦理缺陷，而不仅仅是临床缺陷。本文探讨了疼痛治疗不足问题的性质和程度，以及生物伦理学家忽视该问题的可能原因。文中考虑了临床环境中导致疼痛治疗不足的因素，以及近期未能从伦理角度处理有问题的临床做法所带来的危害。最后，本文提出了一些建议，以促使生物伦理学家重新关注这一重大问题。
