7 Steps to Better Pain Management

The Compassion in Dying Federation in Portland, OR, is requesting all 50 state medical boards to correct faulty perceptions regarding pain relief among the nation's physicians.

The federation's officers believe that state medical boards are key to correcting the imbalance and recommend the following steps be taken:

1. Adopt pain relief guidelines for the dying, specifying that addiction is not a concern.

2. Remove "unreasonable" barriers to pain relief prescriptions for the terminally ill.

3. Establish ombudsmen or other advocacy offices for the dying and their families.

4. Encourage or require continuing medical edu cation on the subject.

5. Notify physicians that "it may be appropriate to discipline physicians who fail to apply proven methods of pain control for dying patients."

6. Investigate allegations of inadequate end-of- life pain control and require remediation and education for responsible physicians.

7. Enforce pain control standards, treating failure to provide adequate pain medication as failure to meet professional standards.