Problemas éticos en el manejo del dolor. Estudio cualitativo mediante entrevista de reflexión abierta.

Abstract

Introduction: The medical practice in the area of pain associates ethical problems in the care of patients with a disease that causes a functional deterioration, with an uncertain prognosis for their labor reintegration, and a great consumption of family and social resources. After the creation of a working group on bioethics within the Spanish Society of Pain (SED), an attempt is made to analyze these problems. Objective: To know which are the ethical problems that identify professionals (clinical practice, environment and institutions) which concerns SED members; encouranging an ethical reflection. Methodology: Qualitative study, based on a semi-structured, open interview, sent to members of the SED (n░=░1035), through electronic access, on 4 bioethical aspects: the problems detected in clinical practice, the problems of the work environment, the problems in the work organizations, and possible suggestions. These are grouped as they refer to the indications (beneficence and non-maleficence), justice (understood as equity), autonomy (information and preferences). Results: A total of 6░% professionals participated in the interview (n░=░62/1035). A panel was prepared with the 10 main issues identified (Top10). They emphasize the uncertainty in the taking of decisions in the therapeutic, the limitation of the therapeutic effort, the conditioning of the sanitary system, the relations with the pharmaceutical industry and the search of the excellence. Conclusions: This qualitative study allows identifying ethical problems that interest professionals dedicated to pain. It is convenient to confirm and size them through quantitative studies.