Ethics in pain medicine: good for our health, good for the public health.

This issue of Pain Medicine is devoted to examining ethical challenges posed by the practice and research of pain. We are indebted to our colleagues from New York University Medical Center—Dr. Allen Lebovits, who so capably guided the papers in this issue, and Dr. Michel Dubois, Editor of the Ethics Forum, for their leadership in bringing these matters before us. Ethics affect our daily clinical behavior in many obvious ways, such as when society encodes ethical values into laws that regulate our behavior as clini-cians, or when our personal values or economics unduly influence clinical or research decisions. We are challenged by the papers herein to bring ethics into the mainstream conversations of our clinics, teaching rounds, and research in accordance with its importance to the quality and outcomes of our work and to our personal satisfaction with our work. The editors hope that this volume will serve as a " primer " of medical ethics for clinicians and investigators in the pain field, and for those interested in exploring the uniquely human dimensions of the encounter between a doctor and a person suffering in pain. One desired result would be heightened interest in ethics as a formal course of study and training. Many of us take business courses to learn how to cope with the current environment. We should consider carefully the benefits from formal ethics training as well. Training may provide tools for solving some of the hidden and more obvious professional dilemmas that we accumulate daily, un-resolved. If we are lucky, occasionally we have the opportunity to share these problems with others, which may give us courage to do the " right thing, " or insight about practical solutions to moral dilemmas. However, this is a " hit or miss " proposition. I suspect that training in how to maintain a continuing ethics dialogue in practice, much like our discussions of new medications or diagnoses, might provide an emotional return and peace of mind that would buffer our professional stress considerably. These papers suggest that we should study the distribution of ethical concerns within our professions and the effects of ethics training, much as we study the effects of other educational endeavors. Will ethics training help us solve practice dilemmas, help us manage the daily emotional burden of treating pain and suffering, and give us the skills and courage to fight for the rights of our patients …