Advertisement

Pain pp 977-979 | Cite as

Benefit to Burden Ratio in Treating Cancer Pain

  • Jay Rajan
  • Keth Pride
  • Peggy Y. KimEmail author
Chapter

Abstract

When assessing and treating patients with cancer-related pain, it is important to consider the benefit to burden ratio whenever medical interventions or medications are offered. This will help ensure that every effort made to reduce pain is in line with the goals of care for each patient. As the patient’s disease progresses, goals of care may also change, and the perceived benefit to burden ratio may significantly evolve over time. The prevalence of pain nearly doubles from the early to late stages of cancer, and efforts to eliminate pain and suffering at later stages may not seem compatible with the traditionally perceived principles of medical care or acceptable norms. In these situations, pain physicians should discuss the intended positive outcomes and foreseeable negative outcomes with patients and/or their families to provide a pain management plan that is aligned with the patient’s goals of care.

Keywords

Benefit to burden ratio Physician assisted suicide Euthanasia Doctrine of double effect 

References

  1. 1.
    Portenoy RK, Ahmed E. Principles of opioid use in cancer pain. J Clin Oncol. 2014;32(16):1662–70.CrossRefGoogle Scholar
  2. 2.
    WHO Expert Committee on cancer pain relief and active supportive care. Cancer pain relief and palliative care: report of a WHO expert committee. World Health Organ Tech Rep Ser. 1990;804:1–75.Google Scholar
  3. 3.
    Everdingen MV, Rijke JD, Kessels A, Schouten H, Kleef MV, Patijn J. Prevalence of pain in patients with cancer: a systematic review of the past 40 years. Ann Oncol. 2007;18(9):1437–49.CrossRefGoogle Scholar
  4. 4.
    Olsen ML, Swetz KM, Mueller PS. Ethical decision making with end-of-life care: palliative sedation and withholding or withdrawing life-sustaining treatments. Mayo Clin Proc. 2010;85(10):949–54.CrossRefGoogle Scholar
  5. 5.
    Steck N, Egger M, Maessen M, Reisch T, Zwahlen M. Euthanasia and assisted suicide in selected European countries and US states. Med Care. 2013;51(10):938–44.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Anesthesia and Perioperative CareUniversity of CaliforniaSan FranciscoUSA
  2. 2.Department of AnesthesiologyUniversity of Wisconsin-Madison School of Medicine and Public HealthMadisonUSA

Personalised recommendations