IntroductionThe practice and study of pain management pose myriad ethical challenges. There is a consensual opinion that adequate management of pain is a medical obligation rooted in classical Greek practice. However, there is evidence that patients often suffer from uncontrolled and unnecessary pain. This is inconsistent with the leges artis, and its practical implications merit a bioethical analysis. Several factors have been identified as causes of uncontrolled and unnecessary pain, which deprive patients from receiving appropriate treatments that theoretically they have the right to access. Important factors include (with considerable regional, financial, and cultural differences) the following: 1) failure to identify pain as a priority in patient care; 2) failure to establish an adequate physician–patient relationship; 3) insufficient knowledge regarding adequate prescription of analgesics; 4) conflicting notions associated with drug-induced risk of tolerance and fear of addiction; 5) concerns regarding “last-ditch” treatments of severe pain; and 6) failure to be accountable and equitable.ObjectiveThe aim of this article was to establish that bioethics can serve as a framework for addressing these challenging issues and, from theoretical to practical approaches, bioethical reflection can contextualize the problem of unrelieved pain.MethodsThis article is organized into three parts. First, we illustrate that pain management and its undertreatment are indeed ethical issues. The second part describes possible ethical frameworks that can be combined and integrated to better define the ethical issues in pain management. Finally, we discuss possible directions forward to improve ethical decision making in pain management.DiscussionWe argue that 1) the treatment of pain is an ethical obligation, 2) health science schools, especially medical training institutions, have the duty to teach pain management in a comprehensive fashion, and 3) regulatory measures, which prevent patients from access to opioid treatment as indicated in their cases, are unethical and should be reconsidered.ConclusionDeveloping an ethical framework for pain management will result in enhanced quality of care, linking the epistemic domains of pain management to their anthropological foundations, thereby making them ethically sound.

The Questionário ESEU and the PD are clear, precise, comprehensible and well-aligned in terms of measuring aspects of personhood. This measure could add additional value to the patient-healthcare provider relationship, allowing a new perspective on how healthcare professionals perceive patients in suffering, ensuring they acknowledge not just patienthood, but critical dimensions of personhood.

Objective: This paper aims to analyse parents' and health professionals' discourse, regarding four main areas: (1) the experience of care; (2) communication among all stakeholders;(3) ethical issues; (4) and ethical decision-making. Methodology: The authors collected 62 narratives from health professionals and parents whose newborns have been hospitalized for at least 15 days in the neonatal intensive care unit (NICU). We carried out a qualitative content analysis with the support of NVivo software version 12 Pro. Results: The feelings/emotions are present in a high percentage of narratives (mostly negative ones). Parents´ learning emphasizes coping strategies. Most narratives focus on communicational aspects. Decision-making is referred to in almost half of the narratives. The ethical issues and questions mentioned are mainly related to decision-making. Conclusion: The present study emphasizes narrative relevance in the alignment of parents´ and health professionals´ perspectives to promote therapeutic relationships.