Principles & Practice of Pain Medicine > Part V. Pain Syndromes > C. Pain in the Terminally Ill > Chapter 47. Pain Management in End of Life: Palliative Care Lachlan Forrow and Howard S. Smith

Pain Management in End of Life: Palliative Care: Introduction

"Basic principles of the diagnosis and management of pain syndromes are similar across all clinical settings. Details of the application of these principles, however, can vary significantly depending on the clinical context. One context that is especially important is the care of patients with incurable, progressive, and ultimately fatal illnesses who are in or approaching the terminal phase. This is sometimes referred to as the context of "palliative care," and that term, while not fully satisfactory,¹ is used throughout most of the discussions in this chapter. The range of pain syndromes that arise in these situations include most of the acute and chronic pain syndromes addressed in detail in other chapters in this text, and their management primarily involves the same diagnostic and therapeutic strategies and skills. Nonetheless, pain management in the "end-of-life" or "palliative care" setting often raises clinical and ethical issues that are at least somewhat different from those in other settings. This chapter focuses primarily on those differences...."