The Ethical Responsibility to Manage Pain and the Suffering It Causes

Purpose
The purpose of this position statement is to provide ethical guidance and support to nurses as they fulfill their responsibility to provide optimal care to persons experiencing pain. The national debate on the appropriate use of opioids highlights the complexities of providing optimal management of pain and the suffering it causes. While effective in treating acute pain and some types of persistent pain, opioids carry significant risks. This causes a tension between a nurse’s duty to manage pain and the duty to avoid harm. While there are many important topics related to pain management, this document will not attempt to address many of the specific terms, including suffering and the definitions and management of drug tolerance, dependence, or addiction. Additionally, the term “complementary health approaches” (CHA) is used throughout even though we recognize that the term “integrative therapy” or “complementary alternative medicine” may also be used (National Center for Complementary and Integrative Health, 2016). Further information may be found in the reference section.

Statement of ANA Position
American Nurses Association (ANA) believes:

• Nurses have an ethical responsibility to relieve pain and the suffering it causes
• Nurses should provide individualized nursing interventions
• The nursing process should guide the nurse’s actions to improve pain management
• Multimodal and interprofessional approaches are necessary to achieve pain relief
• Pain management modalities should be informed by evidence
• Nurses must advocate for policies to assure access to all effective modalities
• Nurse leadership is necessary for society to appropriately address the opioid epidemic