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Since the time of Hippocrates, pain management has been regarded as being an important priority of the physician. However as knowledge of disease processes rapidly advanced, the emphasis moved to diagnosis and treatment of underlying cause, as the main imperative in patients presenting with pain. Renewed focus on pain management per se
re-emerged because of humanitarian aspects, improved outcome after surgery and trauma, enhanced rehabilitation in patients with persistent pain and potentially improved survival in patients with cancer pain. Standards and practice guidelines have been developed in parallel with substantial improvements in management of all forms of pain [1-4]. Effective pain management usually requires assessment of physical, psychological and environmental factors in each patient; the aim of such assessment is to enable planning of pain management strategies that will improve physical and mental functioning, in order to restore quality of life as rapidly and completely as is possible in the circumstance of each patient.

ANZCA recognises that severe unrelieved pain can have severe adverse physical and psychological effects on patients, with associated emotional, social and spiritual effects causing suffering in patients, their families and those close to them [2]. At times severe pain can be extremely difficult to treat and management must be subject to the availability in each health care setting of appropriate, safe and effective methods. However ANZCA recognises the following rights of patients to management of acute pain, cancer pain and persistent non-cancer pain:

1.   The right to be believed, recognising that pain is a personal experience and that there is great variability among people in their response to different situations causing pain (see IASP) [1]

2.   The right to appropriate assessment and management of pain; patients and their families have a key role in working with the health care team to develop realistic goals for pain management.

3.   The right to have the results of assessment regularly recorded in a way that assists in adjusting treatment to achieve effective and ongoing pain relief

4.   The right to be cared for by health professionals with training and experience in assessment and management of pain, and who maintain such competencies by all necessary means. Where such competencies are unavailable, the patients should be referred appropriately.

5.   The right to appropriate effective pain management strategies. These must be supported by appropriate policies and procedures and must be appropriate for use by the health professionals employing them.

6.   The right to education about effective pain management options for their particular problem; families should also be included in such education.

7.   The right to appropriate planning for pain management after discharge from immediate care.

Footnote: IASP Definition of Pain

“An unpleasant sensory and emotional experience, associated with actual or potential tissue damage, or described in terms of such damage”.

References

1.   IASP Task Force on Taxonomy Classification of Chronic Pain. 2^nd Edition IASP Press, Seattle 1994 pp 210

2.   NHMRC Acute pain management: scientific evidence NHMRC 1998

3.   Cousins MJ. Relief of acute pain: a basic human right? MJA 2000;172:3-4

4.   Joint Commission on Accreditation of Healthcare Organizations. USA 1999

5.   In NZ there is a related document “The Code of Health and Disability Services – Consumers’ Rights

COLLEGE PROFESSIONAL DOCUMENTS

College Professional Documents are progressively being coded as follows:

TE Training and Educational

EX Examinations

PS Professional Standards

T Technical

POLICY – defined as ‘a course of action adopted and pursued by the College’. These are matters coming within the authority and control of the College.

RECOMMENDATIONS – defined as ‘advisable courses of action’.

GUIDELINES – defined as ‘a document offering advice’. These may be clinical (in which case they will eventually be evidence-based), or non-clinical.

STATEMENTS – defined as ‘a communication setting out information’.

This document has been prepared having regard to general circumstances, and it is the responsibility of the practitioner to have express regard to the particular circumstances of each case, and the application of this document in each case.

Professional documents are reviewed from time to time, and it is the responsibility of the practitioner to ensure that the practitioner has obtained the current version. Professional documents have been prepared having regard to the information available at the time of their preparation, and the practitioner should therefore have regard to any information, research or material which may have been published or become available subsequently.

Whilst the College endeavours to ensure that professional documents are as current as possible at the time of their preparation, it takes no responsibility for matters arising from changed circumstances or information or material which may have become available subsequently.

Promulgated: 2001

Date of current document: Dec 2001

© This document is copyright and cannot be reproduced in whole or in part without prior permission.

College Website: http://www.anzca.edu.au/