Moral Disengagement of Medical Providers: Another Clue to the Continued Neglect of Treatable Pain?
40 Pages Posted: 10 Aug 2016
Date Written: 2013
The neglect of treatable pain is an ongoing reality for patients in all health care settings despite decades of research, education, institutional and organizational initiatives and regulatory reform. Most recently the Accountable Care Act and the Institute of Medicine have called for further work to understand and correct the continued inadequate treatment of pain. To date, research has identified a variety of barriers to treatment ― from educational deficits to biases to regulatory scrutiny ― with little change in practice. Yet, very little research has addressed the social cognitive mechanisms used by providers who continue to under-treat pain. This article explores the possible operation of the social cognitive mechanism of moral disengagement in the day to day treatment of patients in pain. Moral disengagement is one of the strongest predictors of unethical behavior and allows individuals to engage in immoral acts and still maintain an intact self image as a moral person. This article analyzes and applies existing pain research and public statements to the process of moral disengagement. While further study is warranted, this initial analysis indicates the operation of moral disengagement may, in part, explain the continued under-treatment of pain.
Keywords: Pain, Moral Disengagement, Opioids, Stigma, Health Disparities
Suggested Citation: Suggested Citation