A legacy of silence: Bioethics and the culture of pain

Ben A Rich

Research output: Contribution to journalArticlepeer-review

35 Scopus citations


For over 20 years the medical literature has carefully documented the undertreatment of all types of pain by physicians. During this same period, as the field of bioethics came of age, the phenomenon of undertreated pain received almost no attention from the bioethics literature. This article takes bioethicists to task for failing to recognize the undertreatment of pain as a major ethical, and not merely a clinical, failing of the medical profession. The nature and extent of the problem of undertreated pain is examined, as well as possible reasons for its disregard by bioethicists. The factors contributing to undertreated pain in the clinical setting are considered, as well as the hazards posed by recent failures to address ethically questionable clinical practices. Finally, suggestions are offered for refocusing the attention of bioethicists to this significant problem.

Original languageEnglish (US)
Pages (from-to)233-259
Number of pages27
JournalJournal of Medical Humanities
Issue number4
StatePublished - 1997
Externally publishedYes

ASJC Scopus subject areas

  • Health Policy
  • Health(social science)
  • Philosophy
  • Public Health, Environmental and Occupational Health


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