A Clinical Ethics Approach to Opioid Treatment of Chronic Noncancer Pain.

We are writing both to respond to Ballantyne and Fleisher’s 2010 article on the ethics of opioid prescribing [1] and to join the authors in calling for continued progress in rational, ethical, and practical decision making surrounding the use of opioids in the treatment of patients with noncancer chronic pain. Given the current state of knowledge regarding long-term opioid treatment, we suggest that dilemmas associated with this treatment are best approached using patient-centered clinical ethics. We believe principle-based, deontological, and classical Hippocratic ethical approaches have less relevance in sorting out current controversies surrounding opioid treatment.