title: Do surrogates have a right to refuse pain medications for incompetent patients?
abstract: The relief of pain is widely considered to be a basic human right. Physicians are expected to make every attempt to relieve pain and suffering, especially in patients who do not have capacity. This article presents a case in which the family of a woman with severe somatic pain from metastatic breast cancer requests that pain medications be reduced and, at times, held. The ethical issues associated with surrogate decision making and the refusal of medical treatments are reviewed. The obligation to treat pain remains paramount despite family objections.
authors.affiliation: Division of Palliative Medicine, Department of Anesthesiology, Columbia University Medical Center, New York, New York 10032, USA. cdb21@columbia.edu
authors.forename: Craig D
authors.initials: CD
authors.lastname: Blinderman
mesh_terms: D000368:Aged; D005190:Family; D005260:Female; D006801:Humans; D007872:Legal Guardians / Q000331:legislation & jurisprudence*; D009020:Morphine / Q000627:therapeutic use*; D059226:Nociceptive Pain / Q000188:drug therapy*; D010344:Patient Advocacy / Q000941:ethics / Q000331:legislation & jurisprudence; D010819:Physician's Role; D011368:Professional-Family Relations / Q000941:ethics*; D019727:Proxy / Q000331:legislation & jurisprudence*; D016312:Treatment Refusal / Q000941:ethics* / Q000331:legislation & jurisprudence*; D014481:United States; D028761:Withholding Treatment / Q000941:ethics / Q000331:legislation & jurisprudence
chemical_list: D009020:Morphine