Ethics
Another look at pain in ob-gyn, beyond labor and delivery
Telling patients “this might sting” can be disingenuous and undermine trust. Get more tips to improve communication with patients.
Many ob-gyn procedures—even those that happen outside the context of labor and delivery—can be uncomfortable. A doctor’s ability to discern a patient’s needs and then accurately and charitably interpret their pain responses is therefore essential.
The February issue of AMA Journal of Ethics® (@JournalofEthics) examines acute nonlabor and delivery ob-gyn pain and why inadequate or callous approaches to it should not be tolerated—socially, culturally or professionally.
The AMA Journal of Ethics is an editorially independent, peer-reviewed journal devoted to helping students and clinicians navigate ethical decisions in service to patients and communities. The February issue of the journal includes the following articles.
“How We Lie About Pain.”
- The phrase “This might sting” is perhaps the one that best captures the inspiration behind this issue of AMA Journal of Ethics.
“Treating Patients in Non-Labor and Delivery OB-GYN Examinations and Procedures.”
- Respecting a patient’s privacy is a prerequisite for ensuring that a fundamental trust exists between patient and physician. The AMA Code of Medical Ethics provides ethical and clinical guidance.
“How Should IUD Placement Pain Be Described and Managed?”
- Recent publicity draws attention to pain with intrauterine device (IUD) insertion.
“Learning to Communicate With Patients About Potentially Painful Gynecologic Procedures.”
- Patients’ pain experiences are subjective and diverse and can be based on trauma, adverse childhood events and previous labor.
Listen and learn
The journal’s February “Ethics Talk” podcast features a conversation with Wendy Kline, PhD, a medical historian at Purdue University, about the hidden history of the pelvic exam and how stigma and shame obscure clinical purpose.
The February issue also features seven author-interview podcasts. Listen to previous episodes of the “Ethics Talk” podcast or subscribe in iTunes or other services.
Also, CME modules drawn from this month’s issue are collected at the AMA Ed Hub™ AMA Journal of Ethics webpage.
The next issue of the journal will focus on regret in the moral psychology of surgical professionalism. Apply to be an AMA Journal of Ethics editorial fellow or senior editorial fellow and design a theme issue with us.
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