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Physicians need to be especially careful when managing chronic pain with opioid medications. Medical practices often seek risk management advice when they suspect a patient is misusing prescription medications, is not complying with treatment, or when the patient is making unreasonable demands for more opioids. If a patient suffers harm as a result of opioid medication use, a physician may become the target of a lawsuit alleging negligent treatment of chronic pain.

A comatose, ventilator-dependent, car accident victim lies in an intensive care unit while her husband and her parents discuss her future quality of life and argue about what type of care she would have wanted. This scenario may initially come to mind when the average person hears the term medical ethics. However, the concept of medical ethics is much more common in everyday practice than a dramatic ICU clash is.

In the U.S., there is broad ethical consensus supporting disclosure of known medical errors, but even so, the physician who must acknowledge a mistake faces a daunting situation. Disclosing medical errors is the theme of this physician-patient interaction resulting in a medical liability lawsuit.

In this interaction, the involved physicians avoided disclosing important information to the patient during the informed consent process. An informed consent exchange that is not truthful and complete violates standards of medical ethics.

The pediatrician in this interaction worked to build a therapeutic alliance with the mother of her minor patient. The mother responded. Later, the mother’s anxiety for her son’s condition caused her to discount the shared decision-making process and to cast blame on the pediatrician. The pediatrician’s documentation of her discussions with the mother clarified the events in this case, helping to get the lawsuit dismissed.