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VIII.   Ethical and Legal Issues
This section includes materials related to ethical issues and end of life care in pain management, decision making and suffering.

       City of Hope Publications

  1. Laneader, A., Angelos, P., Ferrell, B. R., Kolker, A., Miner, T., Padilla, G., Swaney, J., Krouse, R., & Casarett, D. (2007). Ethical issues in research to improve the management of malignant bowel obstruction: Challenges and recommendations. Journal of Pain and Symptom Management, 34(Supl 1), S20-S27. DOI: 10.1016/j.jpainsymman.2007.04.007
  2. Ferrell, B. R. (2007). Beyond politics - the patient in painCenter for Practical Bioethics, 3(3), 10-15.
  3. Ferrell, B. R. (2006). Understanding the moral distress of nurses witnessing medically futile care. Oncology Nursing Forum, 33(5), 922-930.  DOI: 10.1188/06.ONF.922-930.     
  4. Ferrell, B. (2005). Ethical perspectives on pain and suffering. Pain Management Nursing. 6(3), 83-90.
    DOI: 10.1016/j.pmn.2005.06.001.
  5. Sullivan, M., & Ferrell, B. R. (2005). Ethical challenges in the management of chronic nonmalignant pain: Negotiating through the cloud of doubt. The Journal of Pain, 6(1), 2-9. DOI: 10.1016/j.jpain.2004.10.006.


       Recommended Publications

  1. Health Care Ethics: Critical Issues for the 21st Century, 2nd Edition
    - Morrison, E. E. & Furlong, B. (2013).  NM: Jones and Bartlett Publishers. ISBN #: 978-1449665357.
  2. The American Nurse. (2011). The practice of ethics, RNs learn and discuss issues.  MD: The American Nurse Association.
  3. Bernhofer, E. (2011). Ethics and pain management in hospitalized patients. Online Journal of Issues in Nursing, 17(1).              DOI: 10.3912/OJIN.Vol17No01EthCol01.
  4. Guide to Code of Ethics for Nurses: Interpretation and Application
     Fowler, D. M. (2010) MD: American Nursing Association, ISBN: 978-1558102583.     
  5. Clinical Ethics: A practical Approach to Ethical Decisions in Clinical Medicine, 7th Edition
     Jonsen, A., Siegler, M. & Winslade, W. (2010).  NY: McGraw-Hill.  ISBN: 13: 978-0071634144.
  6. Ethical Issues in Chronic Pain Management
    - Schatman, M. E. (2007). NY: Informa Healthcare. ISBN #: 0849392683.

  7. Moral Dilemmas in Community Health Care: Cases and Commentaries
    - White, B. & Zimbelman, J. (2005).  NY: Pearson Longman.  ISBN: 0321133552.
  8. Code of Ethics for Nurses with Interpretive Statements
    - American Nurses Association. (2001).  ISBN-13: 978-1558101760.
  9. Palliative Care Ethics: A Companion for All Specialties, 2nd Edition
    Randall, F., & Downie, R. S. (1999).  UK: Oxford University Press.  ISBN: 0192630687.  

  10. Suffering
    - Ferrell, B. R. (1996).  NM: Jones and Bartlett Publishers. ISBN #: 086720723.

       Educational Materials/Curriculum

  1. In the Face of Pain
    - Ethics and Pain Fact Sheet 

       Guidelines/Clinical Pathways

  1. Achieving Balance in State Pain Policy: A Guide to Evaluation Pain & Policy Studies Group, University of WI 
    Achieving Balance in State & Federal Pain Policy: A Guide to Evaluation Pain & Policy Studies Group, University of WI
  2. Achieving Balance in National Opioids Control Policy: Guidelines for Assessment - World Health Organization
    This 42 page document provides guidelines that can be used by governments and health professionals to assess the national
       opioids control policies and their administration of any country to determine if they contain the provisions, procedures and
       cooperation that are necessary to ensure the availability of opioid analgesics
     Available in 22 languages.

  3. Addressing State Policy Issues in End of Life Care - Robert Wood Johnson Foundation
    - Downloadable publications that advance balanced approaches to pain management policy, consumer protection and   
       professional development.
  4. Guide to Legal Issues in Life-Limiting Conditions - American Health Lawyers Association, Washington, DC
  5. Model Policy for the Use of Opioid Analgesics in the Treatment of Chronic Pain - Federation of  State Medical Boards of the United States, TX

      Other Organizational Links

         American Society for Bioethics and Humanities  

         American Society of Law, Medicine and Ethics (ASLME)

         American Society of Pain Management Nurses (ASPMN)

         American Society on Aging: Legal and Ethical Issues  
         BWH Office of Clinical Ethics   

         Caring Community ~ Wellness Through Life's End

         Center for Bioethics  
         Center for Ethics in Health Care       
         Center for Practical Bioethics  
         Clinical Ethics in Action  
         Code of Ethics for Nurses  

         Emerging Solutions in Pain  

         Ethical and Legal Issues: Aging in the Know  
         Pain & Policy Studies Group    
         The Center for Ethics and Human Rights ~ American Nurses Association  
         The Hastings Center  
         The Legal Side of Pain  

Key References

  1. American Society of Law, Medicine & Ethics
    A community of colleagues across three disciplines exploring the major health issues to protect public health; reduce racial,
       ethnic, and economic health disparities; promote patient safely and quality of care; and facilitate dialogue on emerging
      biomedical science and research. 

      Position Statements/Standards

       (see Position Statements/Standards in
III. Palliative Care)

  1. Ethics and Human Rights American Nurses Association       
  2. Promoting Pain Relief and Preventing Abuse of Pain Medications: A Critical Balancing Act  
    - Joint statement from 21 health organizations and the Drug Enforcement Administration. 
    The roles of both health
       professionals and law enforcement personnel in maintaining the balances between patient
    care and diversion prevention are


Website last modified: May 24, 2016