A primer of ethical issues involving opioid therapy for chronic nonmalignant pain in a multidisciplinary setting.
OBJECTIVE
This forum presents a clinical vignette of orofacial pain and expounds on ethical issues related to opioid therapy in the context of multidisciplinary treatment. The purpose of this forum is to assist health care providers from different disciplines in identifying ethical issues and conflicts regarding opioid therapy encountered in multidisciplinary clinical pain practices.


METHODS
We use the case vignette and opioid therapy as a backdrop for a discussion of 1) an overview of ethics terminology; 2) a presentation of key ethics principles; 3) our conceptualization of ethical obligations of patients regarding opioid therapy; and 4) the process of developing an appropriate treatment plan within the context of the discussed ethical principles.
Novy
Diane M
DM
University of Texas M.D. Anderson Cancer Center, Department of Anesthesiology and Pain Medicine, Houston, Texas 77030, USA. dnovy@mdanderson.org
Ritter
Laura M
LM
McNeill
Jeanette
J
D000701:Analgesics, Opioid / Q000627:therapeutic use*; D002644:Chickenpox / Q000150:complications; D002763:Cholecystectomy; D002908:Chronic Disease; D003975:Diazepam / Q000009:adverse effects; D005157:Facial Pain / Q000188:drug therapy; D005260:Female; D006562:Herpes Zoster / Q000150:complications; D006801:Humans; D006853:Hydrocodone / Q000009:adverse effects; D006993:Hypnotics and Sedatives / Q000009:adverse effects; D007044:Hysterectomy; D009293:Opioid-Related Disorders / Q000209:etiology / Q000628:therapy; D010146:Pain / Q000188:drug therapy*; D018710:Pain Clinics / Q000941:ethics*; D014594:Uterine Neoplasms / Q000150:complications / Q000601:surgery
D000701:Analgesics, Opioid; D006993:Hypnotics and Sedatives; D006853:Hydrocodone; D003975:Diazepam