Above all else do no harm: an ethical evaluation of paediatric nurses management of children's pain

Simons, Joan (2011). Above all else do no harm: an ethical evaluation of paediatric nurses management of children's pain. In: Brykczynska, Gosia M. and Simons, Joan eds. Ethical and Philosophical Aspects of Nursing Children and Young People. Oxford: Wiley-Blackwell, pp. 155–164.

URL: http://bookshop.blackwell.co.uk/jsp/id/Ethical_and...


Pain is a critical, ethical issue because of its capacity to dehumanise the human person (Lisson 1987). Acute pain is one of the most common adverse stimuli experienced by children, occurring as a result of injury, illness and necessary medical procedures (American Pain Society 2001).

For many years, the body of research on children's pain lagged behind that of studies on adult pain. However, more recently we have reached a situation where there is sufficient evidence-based knowledge to deliver good quality, effective pain management to children. Despite this improving situation, evidence shows pain in children is still often inadequately assessed and treated. In 2005, the International Association for the Study of Pain, Special Interest Group produced a position statement on Pain in Childhood, stating that pain relief is a human right (International Association for the Study of Pain 2005). Children undergo pain from the many procedures and investigations used by doctors and nurses to investigate and treat disease. Children remember pain, and may avoid future medical care because of painful experiences in a hospital or clinic. This chapter will review the evidence on the management of children's pain through the use of Beauchamp and Childress' ethical principles (2008) of non-maleficence, justice, autonomy and finally beneficence.

Two facts about pain assessment and management are uncontroversial - first, health-care professionals have an ethical obligation to relieve pain experienced by their patients, and second, this obligation has been largely neglected (Blacksher 2001).

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