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Excerpt from Dying Well
Ira Byock, MD
The fact that many doctors and medical centers do not treat pain aggressively does not mean that physical pain is uncontrollable. Physical pain among the terminally ill exists because doctors lack the will, not the way. Deterred by opioid phobia or ambivalence about medication, doctors, patients, and families may step back from the firm commitment that is needed for assertive pain management. The current state of medical education, which does not train its practitioners to adequately evaluate or aggressively treat pain, further hampers such efforts. In the minds of too many people today, the answer to unbearable pain among the dying has become assisted suicide or euthanasia, as if effective pain treatment did not exist. Physical pain must be understood in its proper perspective, that is, as a single, readily manageable component of suffering. With strong resolve from patient and doctor, relief of physical suffering is always possible. I have found that suffering from personal, mental pain is a much more complex and thornier problem. (p. 60)
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