Paraphrased from Pain Relief, 1994 by Jane Cowles. Here is a short list of what you or your loved one's rights are when faced with pain. Before even this however, have a serious and no nonsense discussion with your doctor about how he feels about medicating pain overall. Some doctors still refuse medication for acute pain- even in times of terminal illness- so be sure he/she will treat the problem as you wish. Also recognize that acute pain can easily distort reality, so you may wish to have a trusted friend or relative know your desires and be willing to carry them out through a living will or other written document.

PAIN: Many men believe that they must endure pain, but it's also undoubtedly why we live shorter lives- we're stupid. It is not a noble virtue- living with pain- and can lead to complications. The Palo alto Medical Association noted

The US Agency for Health Care Policy and Research suggested these guidelines.

So why the commentary? Taking care of a patient costs money. The faster and better you get well, the more money you'll have overall and the less demanding my job is in keeping you solvent and happy.

PAIN: (1999) About 97 million Americans suffer form chronically painful conditions. A 1997 survey found that 66% of older Americans said that pain prevented then from performing routine tasks or engaging in other activities.

PALLIATIVE CARE LINK (Annals of Internal Medicine 2000) Comprehensive palliative care (Pain management), as exemplified by many state-of-the-art hospice programs, is the standard of care for the dying. Although palliative care is very effective, physicians, nurses, patients, families, and loved ones regularly face clinically, ethically, legally, and morally challenging decisions throughout the dying process. This is especially true when terminally ill patients are ready to die in the face of complex, difficult-to-treat suffering and request assistance from their health care providers.

The World Health Organization estimates that 4.5 million patients in developing an industrialized nations die each year in pain.

Pain Management: (2002) Chronic pain -- continuous pain lasting longer than six months -- afflicts an estimated 30 million to 50 million Americans, with social costs in disability and lost productivity adding up to more than $100 billion annually. However, only in recent years has it become a focus of research. There used to be no pain specialists because pain had always been understood as a symptom of underlying disease: treat the disease and the pain should take care of itself. Thus, specializing in pain made no more sense than specializing in fever. Yet the actual experience of patients frequently belied this assumption, for chronic pain often outlives its original causes, worsens over time and appears to take on a puzzling life of its own.

Pain Conditions cost $80 billion annually in lost production (2002)

Palliative Care:  (2004) Journal of the American Medical Association found that many people who die in institutions (i.e. hospitals or nursing homes) do not receive effective end-of-life care. The study, based on a survey of over 1,500 family members or other close acquaintances of individuals who died, found that many reported high rates of unmet needs in the management of pain or other discomfort, trouble communicating with physicians, a lack emotional support, and a belief that the dying person was not always treated with respect. These findings highlight the important role of palliative care, which is the field of health care focused on relief of pain and suffering and promoting the best possible quality of life for dying or seriously ill individuals and their families.

Advance Care Planning  The Center for Palliative Care Education (2004)