[Verified Answer]: A 69-year-old terminally ill female patient…

A 69-year-old terminally ill female patient cries out for help from her intensive care room. She tells the nurse that her pain is unbearable. She says, “I need more pain medicine, it hurts too much, I can’t sleep, I can’t stand it any longer.” She seems very anxious and irritable. The nurse asks the patient to rate her pain on a scale from 0 for no pain to 10 for the worst pain, and the patient says her pain is a 9. The nurse knows the physician ordered a placebo to be alternated with a low-dose pain medication. She approaches the physician with her concerns about the patient’s poorly managed pain. He walked her to his desk and showed her a picture on his computer. The picture was of a man who was carrying another man, over his shoulder, as a means to get him to the hospital. He said, “In my country, one has to tolerate much more pain than Americans do, and no one complains. Here in America, there is so little tolerance for pain.” He also said, “She has a history of being a drug addict, which is the real reason she wants these drugs. And I would hasten her death if I gave her as much pain medication as she wants.” The nurse suggests he replace the placebo with pain medication; he rejects her suggestion. The doctor tries to reassure her that research has proven that placebos are effective in alleviating pain. He said, “The placebo works on the psychological part of the pain.” The physician’s final decision was not to order an increase in her pain medication or replace the placebo. The nurse followed through with his orders for pain management.*