title: Ethical quandaries in caring for primary-care patients with chronic pain.
abstract: In the past decade, more and more behavioral health providers have begun consultation practices in primary-care settings. Their availability makes multidisciplinary care a reality and the possibility of improved outcomes for patients with chronic pain more feasible. However, behavioral health providers encounter new ethical quandaries in providing services to patients with chronic pain and to the primary-care providers who plan their treatment. This article presents two cases to illustrate the questions that arise in delivery of primary-care behavioral health services to patients with chronic pain. Relevant professional ethical guidelines for psychologists, social workers, and physicians are examined and recommendations for addressing the gaps in extant guides are offered.
authors.affiliation: Mountainview Consulting Group, Zillah,Washington 98953, USA. robinsonpatricia@me.com
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Robinson
authors.forename: Julie A
authors.initials: JA
authors.lastname: Rickard
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage / Q000627:therapeutic use; D001416:Back Pain / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D001524:Behavioral Medicine / Q000941:ethics* / Q000639:trends; D059350:Chronic Pain / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D002983:Clinical Competence / Q000592:standards; D032781:Codes of Ethics; D004338:Drug Combinations; D005260:Female; D006801:Humans; D006853:Hydrocodone / Q000008:administration & dosage / Q000627:therapeutic use; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D009292:Narcotic Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D017008:Negotiating / Q000379:methods; D059408:Pain Management / Q000379:methods* / Q000523:psychology; D011320:Primary Health Care / Q000941:ethics* / Q000639:trends; D011369:Professional-Patient Relations; D011788:Quality of Life / Q000523:psychology; D012008:Recurrence; D012017:Referral and Consultation / Q000639:trends; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000517:prevention & control; D000078329:Workforce
chemical_list: D004338:Drug Combinations; D009292:Narcotic Antagonists; C083640:acetaminophen, hydrocodone drug combination; D000082:Acetaminophen; D006853:Hydrocodone