IOWA CITY, Iowa -- Many physicians withhold pain medication from patients in emergency situations because of informed consent issues or because the doctors believe the drugs may affect the accuracy of their diagnoses, a University of Iowa survey found.

However, withholding pain medication may actually be a barrier to informed consent and accurate diagnoses, said Mark A. Graber, M.D., associate professor of surgery and family medicine, and the study's principal investigator. The survey's results did not surprise Graber, an emergency room doctor who believes physicians should abandon this unnecessary caution against administering pain medication.

"Current training teaches that we should not use pain medication because it can affect a diagnosis and informed consent," Graber said. "However, current studies suggest that giving pain medication may actually result in fewer unnecessary surgeries. Although decisions about which and how much medication to administer should be done on a case-by-case basis, we should be more generous with pain medication."

The results of Graber's survey appeared in the March issue of the American Journal of Emergency Medicine.

In July 1996, Graber mailed a questionnaire to all 182 general surgeons practicing in Iowa. He wanted to determine their beliefs about the use of analgesics for acute abdominal pain and examine how these beliefs affect prescribing patterns. Of the 131 respondents, 78 percent considered the ability to obtain informed consent in their decisions to forgo pain medication. The survey also showed that 53 percent thought the amount of pain medication necessary to make patients comfortable would prevent the patients from signing a legally binding informed consent.

Informed consent is an important ethical and legal issue for all physicians. Valid informed consent requires patients act independently without coercion. The individuals must have re
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Contact: Jennifer Cronin
jennifer-cronin@uiowa.edu
319-335-9917
University of Iowa
9-Apr-1999