Do Surrogates Have a Right to Refuse Pain Medications for Incompetent Patients?

Facilitated by: Dylan Manson, PhD 

Article for Discussion: Do surrogates have a right to refuse pain medications for incompetent patients? By Craig D. Blinderman. Journal of Pain and Symptom Management. 2012 Feb;43(2):299-305. doi: 10.1016/j.jpainsymman.2011.09.003. 

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.