The problem of undermedication of pain in health care is widely recognized and acknowledged; however, there is an obvious lack of exploration of this problem from an ethical perspective. When undermedication is raised as a moral concern, the underlying premise is that a patient may experience harm or not benefit from ineffective pain management practices. I will argue that the harm is of a particular type, that is, moral negligence. My intention is to increase nurses’ awareness of both the type (...) of moral harm they are causing, and their professional and moral duties to provide appropriate medication, more particularly to avoid undermedication. I hope that this heightened awareness will be incorporated into practice. As a nurse, I chose to focus on nursing for this article, but my claims are applicable to other health professions, such as medicine. (shrink)

This paper examines the potential limitations of professional wisdom alongside those of society more generally with respect to upholding the well-being of vulnerable and marginalized people. It presents the dangers, referring to four well-documented illustrations of professional failure, that services and service systems pose when both professionals and society at large do not demonstrate sufficient measures of positive values and ethics to ensure the protection of vulnerable people within care systems. While it argues that reform of service systems and the (...) repair of such breaches are always possible, even such system reform may fail if it is not ultimately guided by wisdom not only from professionals but society itself. Several recent international examples of this wisdom are noted. It sees such wisdom as being located in the inherited values and social ethics of a society and the power of these to guide human conduct in the face of the profound and ongoing limitations of human nature. (shrink)