Pain management at the end of life

This article reviews the problems which lead to less than adequate treatment of pain for patients at the end of life. The public has demonstrated a tremendous increase in concern about dying, the possibility for uncontrolled pain during the terminal stages of life, and the desire to assure dignity and control at the time of death. The concerns, particularly about uncontrolled pain, have helped drive the assisted-suicide discussions. Review of the current status of pain treatment and discussion of barriers to improved treatment are the first steps to improving patient care and providing meaningful reassurance to patients. Assisting clinicians to provide the best possible care, particularly adequate pain relief, and to overcome the barriers whenever they can is in the patient's best interest.