• Pain Manag Nurs · Dec 2021

    Ethical Dilemma: Healthcare Surrogate Refusal of Opioid Administration.

    • Sadeg Aldolaim.
    • From the Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia. Electronic address: sadeg1405@hotmail.com.
    • Pain Manag Nurs. 2021 Dec 1; 22 (6): 806-810.

    AbstractIt is morally distressing when a healthcare provider sees patients with undertreated pain but is unable to provide adequate relief because of a surrogate's refusal of such treatment. This issue might occur when there is no clear advanced directive that represents patients' wishes for treatment, and can be further complicated when patients are of minority cultural backgrounds. This article presents a case where the surrogate of a Korean-American woman with severe somatic pain from metastatic pancreatic cancer requested only acetaminophen be given to control the patient's pain. The ethical issues associated with surrogate misconceptions on therapeutic use of opioids are reviewed. This case highlights the ethical dilemma of withholding opioid treatment in a patient with advanced cancer. We conclude that the obligation to treat pain should be understood beyond the authority of surrogate refusal, in favor of patient quality of life, when an advance directive is not in place.Copyright © 2021 Elsevier Ltd. All rights reserved.

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