After reading Waney's article re the current pattern of doubt, fear and misdiagnosis faced by chronic pain patients, I was sent searching for a related article. What makes it striking is not only the content, but the time in which it was witten. Please read on....

I will quote the article exactly as I found it on the web in 1999:

"...public opinion is becoming more tolerant of assisted suicide when patients are perceived to be suffering intolerably; while denying a constitutional right to assistance in suicide, the Supreme Court has voiced unequivocal support for adequate pain relief; These issues are pertinent for all physicians caring for patients regardless of the cause of their suffering and whether or not these physicians are specialists in palliative care. The availablility, accessibility, and effectiveness of modern methods of pain control make it morally mandatory for every physician to be knowledgeable in the use of analgesics. Not to relieve pain optimally is tantamount to moral and legal malpractice. Some fear addicting the patient. These fears are not justified factually or ethically. For example, it is known clinically that patients with severe pain receiving large doses of opiates rarely, if ever, suffer respiratory depression or addiction if doses are properly titrated."

Dr. Edmund D. Pellegrino in the May 20 Journal of the American Medical Association. JAMA May 20, 1998.  "Updates Linking Evidence and Experience Emerging Ethical Issues in Palliative Care, Edmund D. Pellegrino, MD."

My brief comment...it has not seemed to me that the "Supreme Court's unequivacal support for pain relief" has filtered down to the patients.  Apparently, physicians are either not effectively trained in pain managment or they simply consider it a risky proposition.  One to be avoided with benign anti-inflamatory's like vioxx and bextra.   That one turned out well.  When all else fails, refer the troublesome patient to a "specialist", usually regardless of the clinical veracity of their conditions and illnesses.  We've all been through the mill.  Many times.  Just buzz- sawed away by pervasive indifference.  I have not kept up well enough to know if any legeslative progress has been made.  My hopes are not high.  The above referenced article was published ten years ago...

Hope this proves interesting if not informative.  Anyone with political aspiratons in the group?

Best Wishes,

Reluctant Survivor