A Rose by Any Other Name: Pain Contracts/Agreements

Barriers to Guideline-Concordant Opioid Management in Primary Care—A Qualitative Study

“…Prior studies using different methodologies have identified additional barriers to uptake of recommended opioid management practices, including inadequate physician knowledge, 25 ethical concerns, 24 and insufficient evidence for effectiveness of specific practices. 10,26 This study complements and extends our understanding of barriers to guidelineconcordant opioid management.…”

On the Erroneous Conflation of Opiophobia and the Undertreatment of Pain

“…The target article cites Robert Merton's work regarding unintended consequences, and it is instructive to note that the first two causes Merton enumerates apply quite well to my analysis; I am claiming precisely that (1) ignorance of the complexity of the policy problem and (2) error in the analysis of the problem are substantial weaknesses in the admittedly well-intentioned efforts to ameliorate the undertreatment of pain (Payne et al 2010). In my work on pain, I endeavor to apply a ruthless pragmatism, and to translate evidence related to the culture of pain into practical policy recommendations (Goldberg 2009a).…”

Ethics in the Discipline(s) of Bioethics

“…It is worth noting that these practices are controversial, and not necessarily universally supported by regulatory or ethical argument (see e.g.,Payne et al 2010). The preceding argument is sound if these practices are ethically allowed; if they are not, then no argument which depends upon these exceptions being ethical, including the one being rebutted herein, can follow.…”