ANA Position Statement

The Ethical Responsibility to Manage Pain and the Suffering it Causes

Liz Stokes, JD, MA, RN


Online J Issues Nurs. 2019;24(1) 

In This Article


  • Nurses have an ethical responsibility to provide clinically excellent care to address a patient's pain. Clinically excellent pain management considers clinical indications, mutual identification of goals for pain management, ongoing reassessment with the patient of the efficacy of pain relief interventions, interprofessional collaboration, and awareness of professional standards for the assessment and management of different types of pain.

  • Nurses should ensure that each patient experiencing pain has an individualized pain management plan with appropriate monitoring to avoid under-treatment, over-treatment, or addiction.

  • Nurses have an ethical obligation to assess and address the factors in themselves and their practice environments that constrain their ability and willingness to relieve pain and the suffering it causes.

  • Nurses may experience moral distress when external constraints keep them from optimally managing their patients' pain. Nurses need to preserve their professional and personal integrity by developing the moral courage and resilience necessary to reduce moral distress when managing pain.

  • Nurse researchers should further explore the correlations between opioid use and addiction as well as strategies for promoting optimal pain management.

  • Education on current, best comprehensive pain management practices must be provided for patients, nurses, and the interprofessional teams who address pain and the suffering it causes. The time for such education must be built into systems of treatment and care.

  • Nurses need to collaborate with those who provide and/or promote accessible, affordable, and effective treatment resources for all persons who suffer from substance use disorder.

  • Nurses have an obligation to participate in the development and evaluation of relevant policies and legislation impacting pain management.