Justice

In the context of pain management, the ethical principle of justice refers not only to a person’s right to have their pain treated, but also the right to be respected, believed, informed, and to be treated with dignity. Specific elements of justice in the context of pain care include ensuring access to care and associated resources, equity in treatment, honest communication to facilitate optimal decision-making, and awareness of potential biases that could impact care, such as those related to diversity, gender, and social determinants of health. This chapter discusses the ethical application justice in pain care, describes the “Pain Patient Bill of Rights”, and the differences between individual justice and societal justice, distributive justice, and social justice. Additionally, autonomy and justice are contrasted to illustrate both their differences and similarities they share. An example is provided where societal justice-related concerns led to the removal of an opioid analgesic from the market by the U.S. Food and Drug Administration, despite the drug’s utility to certain patients with pain. Overriding themes include dignity, equity, and respect.