Ethical Challenges in Managing People Living With Chronic Pain: A Scoping Review

Introduction: Chronic pain management presents significant ethical challenges for a large portion of the global population receiving treatment. This scoping review aims to identify these challenges and suggest recommendations for addressing them. Methods: The review was conducted following JBI methodology for scoping reviews and adhered to the PRISMA-ScR guidelines. It was registered on OSF with the DOI 10.17605/OSF.IO/3JRA7. The inclusion criteria comprised English-language studies focusing on chronic pain, defined as pain lasting longer than three months. Results: Eligible publications ranged from July 2004 to July 2024 and included original peer-reviewed articles, qualitative and quantitative studies, case reports, and discussions that explore ethical issues related to chronic pain management among healthcare professionals, patients, caregivers, and other stakeholders. Of 2,899 records, 27 studies met the inclusion criteria after a thorough screening process. The majority were qualitative (55.6%), including case studies, interviews, and focus groups, while quantitative studies accounted for 44.4%, comprising cross-sectional, observational, and experimental research. Most studies (92.5%) originated from high-income countries. The review identified four primary ethical challenges, namely professionalism, balancing patient autonomy with risk and benefit, disparities in access to care, and deception in medicine. Conclusion: This review underscores the pressing ethical challenges in chronic pain management, advocating for robust collaboration among clinicians, institutions, and policymakers to uphold ethical standards and enhance patient well-being.