Abstract
The object of pain treatment is always human being, which can also have and feel own ethical dilemmas connected with pain management. Even if ethical dilemmas of pain management treatment is common topic in today discussion between algesiologists, and also generally in medical community, personal ethic dilemmas of chronic pain patient are not always incorporated into pain treatment.
Personal ethical dilemmas of the patient influence especially suffering, which is complex experience (which involves the psychological response to pain). Suffering is also conceptualised as involving a community's ethical and social structures.
The individual is always living in society. Therefore considerable attention should be paid in pain management to the intentionally as well as the inadvertently cruel behaviors of nonpractitioners, which significantly contribute to the suffering of so many chronic pain patiens as well as adversely impacting society as a whole.
Personal ethical dilemmas are relevant to society and also relevant to ethical dilemmas of algesiologist. That is why we have dealt in the introduction of the article with connection among suffering, ethical dilemmas of the algeziologist and the individuality of ethical dilemmas of every patient (level of thinking, knowledge, language etc.).
Personal ethical dilemmas of every patient in article we have divided only for didactic reasons into four categories: the first is personal ethic, which influents definition of self and self-evaluation; the second is relation ethics, which defines the roles and importance of interpersonal relationships, philosophical ethics which affects the way of view on the world and the place of individual in it and last one is spiritual ethic. All dilemmas are blend together.
The basic ethical dilemmas from each category we describe then in more details. In the area of personal ethics we have targeted the ethical dilemmas which are related to the changes in comprehension of self, the loss of roles, self-evaluation, depersonalization of patient in medical system and looking for medical help.
In the area of relation and social ethic dilemmas we have targeted the basic ethical dilemmas of the chronic pain patient, ie. how to explain own subjective pain experience to other people; what actually can patient expect from other people; social isolation and mix in. In the third area relevant to philosophical and existencional ethic dilemmas we have described the ethical dilemmas in the form of questions often asked by the pain patients: "Why me?", "What can I do now?" and "What sense and meaning have the life with chronic pain?".
In the fourth area of spiritual ethics we have focused on the ethical dilemma of reevaluation of faith under the influence of chronicity of the pain. We wished to emphasize in that article, that individual ethical opinions of each individual will reflex how the patient will react to different types of treatment, how he/she will cooperate with algesiologist and team, how he/she will keep recommended treatment and what kind of contribution it will have to his/her feeling of goal and sense of life even with suffering and chronic pain.