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    • Plenary Lecture: The Biology of Infant and Childhood Pain: It All Begins Here
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    • Plenary Lecture: In Pursuir of More Powerful Non-Pharmacologic Treatments for Musculoskeletal Pain with Centralized Features
    • Plenary Lecture: Taking Aim is Easier When You Know the Target: Moving Toward Mechanism-Based Pain Assessment
    • Plenary Lecture: Assessment and Management of Neuropathic Pain: Advances, Challenges, and Opportunities
    • Plenary Lecture: Spinal Mechanisms of Spinal Cord Injury-Induced Neuropathic Pain: Implications for Novel Therapeutic Targets
    • Plenary Lecture: Variability in the Pain Experience after Injury
    • Neurobiological Mechanisms Supporting Integrative and Mind-Body Therapies for Pain
    • Bottom-up vs. Top-down: The Search for Effective Mechanisms in Psychosocial Treatments for Chronic Pain
    • Novel Mechanisms Underlying Risk for Acute and Chronic Post-Surgical Pain: Role of Peripheral Pain Processing, Central Sensitization, and Genomics
    • Psychology Treatments for Chronic Pain: Who Benefits & Why?
    • Descending Modulation of Pain and the Endocannabinoid System: Sites, Mechanisms, and Therapeutic Potential
    • Muscle Pain Mechanisms: It’s Time to Dive Deep
    • Mechanism-Based Approach to Clinical Trial Design in Chemotherapy-Induced Peripheral Neuropathy
    • At the Intersection of Affect Regulation, Reward/Value Process, and Placebo: Altered Human Psychological, Neurobiological, and Opioidergic Systems in Chronic Pain
    • Putting the Spotlight on Social: An Innovative Multidisciplinary, Multi-Species Approach for Examining the Influence of Social Context in Pain
    • Migraine and Sleep Deficiency in Adolescents: Understanding Shared Mechanisms for Bench to Bedside
    • Novel Directions in Basic Science Research: Rita Allen Scholars
    • Exploiting Cellular and Molecular Mechanisms of Neuroinflammation for New Treatments of Chronic Pain
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      • 2015 CCOE Recipients
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      • American Pain Society’s Annual Scientific Meeting Convenes in New Orleans, May 8-11
      • Adolescent Chronic Pain Costs $19.5 Billion a Year in the United States
      • New Method Helps Doctors Check Pain Drug Compliance
      • New Study Assesses Benefits of Cognitive Pain Relief Methods
      • Pain Intensity Can Predict Head and Neck Cancer Survival
      • Study Estimates Persistent Pain Incidence at 19% of U.S. Adults
      • Study Examines How Doctors Use Prescription Drug Monitoring Programs
      • Low-Dose Vaporized Cannabis Improves Neuropathic Pain
      • American Pain Society Releases Pain Research Agenda for the 21st Century
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      • American Pain Society and Journal of Family Practice To Co-sponsor Pain Care Conference for Primary Care Physicians
      • American Pain Society Announces $150,000 Pain Research Grant Program
      • American Pain Society Establishes Private Pain Research Fund
      • American Pain Society Executive Selected as Mayday Fellow
      • American Pain Society Hosting Two Symposia at PAINWeek
      • American Pain Society Presents 2012 Achievement Awards
      • American Pain Society Presents 2013 Achievement Awards
      • American Pain Society Presents 2014 Achievement Award
      • American Pain Society Publishes New Clinical Practice Guideline on Methadone Safety
      • American Pain Society To Provide Grant Support for Pain Research Forum’s “Papers of the Week”
      • Anxiety and Pain Fear Before Surgery Predict Chronic Post-surgical Pain
      • Archived News Releases
      • Cannabinoid Shown Effective as Adjuvant Analgesic for Cancer Pain
      • Drug Treatments for Heroin Addiction Heighten Pain Sensitivity
      • Genetic Alteration Predicts Pain Recovery After Sexual Assault
      • Health Care Reforms Will Change How Pain Is Assessed and Treated
      • High-dose Opioid Treatment Associated with Mental Health and Medical Comorbidities
      • Inadequate Pain Research Funding Hampers Effort to Find Safer and More Effective Treatments
      • Injury Fears Can Predict Impairment in Low Back Pain Patients
      • Internalized Stigma Linked with Poor Self Esteem and Pain Self-Efficacy
      • Motives Assessed for Opioid Misuse Among Adolescents
      • Negative Physician Attitudes About Opioid Pain Meds Linked with Lower Prescribing
      • New SmartPhone Apps Help Doctors Manage Pain Patients
      • No Relief Yet for Brutal Oral Cancer Pain, but Cannabinoids May Offer Some Hope
      • One-fourth of Breast Cancer Surgery Patients Have Persistent Pain
      • Pain Research Funding Inadequate in the Face of Soaring Incidence and Treatment Costs
      • Pain Research Yielding Encouraging Discoveries, But Funding Cuts Threaten Future Advances
      • Positive Activities Administered Online Help in Pain Management
      • Primary Care Doctors Prefer NSAIDS for Chronic Pain Treatment
      • REMS Statement
      • Risk Factor Management Helps Prevent Migraine Attacks
      • Sedatives and Alcohol Increase Risk for Pain Medication Adverse Events
      • Study Shows Pain Drug Craving Occurs With or Without Risk for Misuse
      • Severe Pain in Sexual Assault Survivors Often Not Treated
      • Severity of Acute Low Back Pain Predicts Development of Chronic Pain
      • Spinal Manipulative Therapy Lessens Central Pain Sensitization
      • Study Assesses Differences in Physician and Patient Pain Assessments
      • Study Assesses Mood Disorders with TMJ Pain
      • Study Assesses Pain and Quality of Life in Ugandan HIV Patients
      • Study Assesses Role of Caregiver Anxiety on Children’s Pain
      • Study Examines Treatment Responses in TMD Patients
      • Study Explores Role of Impaired Sleep in Fibromyalgia Pain
      • Study Evaluates Frequency of Pediatric Pain Assessments
      • Study Links Pre-operative Breast Cancer Pain to Inflammatory Mechanisms
      • Study Shows Pain Coping Success with Acceptance and Commitment Therapy
      • Study shows Physiological Markers for Neonate Pain
      • Study Shows Predictors of Functional Change in Older Women with Recurrent Pain
      • The American Pain Society Presents Full-Day Program at PAINWeek 2012
      • Training the Brain Could Help Reduce Pain
      • University of Florida Psychologist Roger Fillingim, PhD, Becomes President of the American Pain Society
      • University of Washington Anesthesiologist Gregory W. Terman, MD PhD Becomes President of the American Pain Society
      • Yoga Shown Effective for Treating Chronic Neck Pain
      • Study Shows Links of Childhood Pain to Adult Chronic Pain and Fibromyalgia
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        • Study Shows Tai Chi Can Help Relieve Chronic Neck Pain
        • Post-surgical Pain Management Can Influence Progression to Chronic Pain
        • American Pain Society Presents 2017 Achievement Awards
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        • American Pain Society Scientific Meeting, April 3-6, Milwaukee
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      • Press Room – Meditation Can Reduce Chronic Neck Pain
      • Press Room – Link of Preexisting Mental Disorders
      • APS Scientific Meeting in Palm Springs
      • Nerve Involvement Explains Why Some Cancers are Very Painful
      • American Pain Society Presents 2014 Achievement Awards
      • American Pain Society Honors Clinical Centers of Excellence in Pain Management Award Recipients
      • Strong Evidence Still Lacking on Medical Marijuana for Pain
      • Fibromyalgia Has Central Nervous System Origins
      • Yoga and Chronic Pain Have Opposite Effects on Brain Gray Matter
      • Newsroom 2015 Releases
      • Patient-Centered Outcomes Studies Needed in Pain Management
      • Improving Sleep Quality Has Pain Control Benefits
      • Use of Multiple Pharmacies Can Predict Opioid Overdosing
      • Inhaled Cannabis Shown Effective for Diabetic Neuropathy Pain
      • NIH Study Shows Prevalence of Chronic or Severe Pain in U.S. Adults
      • Physical Therapy for Carpal Tunnel Syndrome Pain Often As Effective as Surgery
      • Mental Disorders Increase Risk for Eventual Chronic Pain in Adolescents
      • Study Assesses Long-term Impact of Post-surgical Pain in Children
      • Newsroom 2016 News Releases
        • American Pain Society Publishes Clinical Practice Guideline for Post-surgical Pain Management
      • Study Assesses Impact of Opioid Risk Reduction Initiatives
      • American Pain Society Annual Scientific Meeting, Austin, May 11-14
      • Message CDC Guidelines
      • APS and Pfizer Grant Fund
      • Better Self Management Improves Outcomes for Chronic Pain Care
      • Politics of Pain Epitomizes U.S. Liberal-Conservative Divide
      • Psychological Flexibility Might Be the Key to Better Cognitive-Behavioral Interventions
      • APS Presents 2016 Achievement Awards
      • APS Honors Clinical Centers of Excellence in Pain Management Award Recipients
      • Evidence Shows Benefits of Psychological Care in Pain Management
      • American Pain Society Awarded Research Grant from Mayday Fund
      • American Pain Society Offers Guidance on Medical Marijuana for Pain
      • Study Shows Pain Often Improves in Older Veterans
      • Study showsDistress Intolerance Associated with Opioid Misuse
      • Brain Stimulation Technique Shown Effective in Phantom Limb Pain
      • Early Childhood Pain Can Predict Chronic Pain in Adolescence
      • American Pain Society Urges Congress to Oppose Steep Budget Cuts for National Institutes of Health
      • Newsroom 2017 News Releases
      • Holistic, Patient Centered Care Gaining Acceptance for Pain Management
      • Wearable Devices Communicate Vital Brain Activity Information
      • Practical Clinical Trials Can Help Find Alternatives to Opioids
      • Better Self-Management Improving VA Outcomes for Chronic Pain Care
      • Study Links Sleep Patterns with Pain Persistence After Pediatric Surgery
      • Study Shows Cognitive Behavioral Therapy Improves Functioning for People with Chronic Pain
      • American Pain Society’s 2018 Annual Meeting Features New, Single-theme Format
      • Pain Severity Leading Predictor of Prolonged Opioid Use After Surgery
      • American Pain Society Supports Passage of Marijuana Effective Studies Act
      • American Pain Society Selects Future Leaders in Pain Research Grant Recipients
      • Study Shows High Rate of Chronic Pain in Homeless Older Adults
      • Study Explores Patient-Doctor Communication About Opioid Tapering
      • American Pain Society Scientific Summit Explores Pain Mechanisms
      • American Pain Society’s 2018 Annual Meeting Explores Pain Mechanisms
      • Sleep Improves Pain and Post Traumatic Stress Disorder Symptoms in Youth
      • Effective Pain Assessments Achieved by Targeting Multiple Pain Mechanisms
      • Post-surgery Pain Resolution Mechanisms Can Explain Healing Variability
      • Babies Feel Pain Even if They’re Not Crying
      • Literacy Deficiencies Restrict Access to Cognitive-Behavioral Pain Therapy
      • American Pain Society Endorses NIH Initiative to Curb Opioid Addiction
      • William Maixner, DDS, PhD Elected American Pain Society President
      • American Pain Society Endorses Compromise Marijuana Studies Act
      • Improved Access to Alternative Care Is Best Option to Curb Opioid Misuse
      • Newsroom 2018 News Releases
      • Pain Rehab Programs without Opioids Proving Effective
      • American Pain Society Selects Tonya Palermo, PhD Treasurer and Three New Directors
      • Online Acceptance and Commitment Therapy Effective for Fibromyalgia
      • Newsroom 2019 News Releases
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Code of Ethics

Preamble

The American Pain Society strongly endorses the view that the professional activities of its members must be conducted in accordance with the highest ethical standards. Given the diversity of the membership, the standards advanced by the Society must specifically address animal research, clinical research, and clinical practice. To accomplish this, the Society recognizes the valuable contributions of other professional organizations whose published guidelines for ethical practice may apply to a large segment of the membership.

Reference is made to several documents below, and they may be reviewed for a fuller exposition of the ethical principles accepted by the American Pain Society.

Ethical Principles Endorsed by APS

Ethical Principles for Pain-Related Animal Research

The American Pain Society endorses the ethical guidelines for investigations of experimental pain in conscious animals published by the International Association for the Study of Pain and the guidelines for the use of animals published by the Society for Neuroscience. The fundamental principle guiding both these documents is that ethical animal research requires that the investigator attempt to minimize pain and avoid unnecessary distress or discomfort at all times. The acquisition and care of experimental animals should be performed in accordance with the guidelines published by the National Institutes of Health.

The American Pain Society is a national chapter of the International Association for the Study of Pain. The following guidelines, adopted by the International Association for the Study of Pain, are most relevant to the Society:

  1. It is essential that the intended experiments on pain in conscious animals be reviewed beforehand by scientists and lay persons. The potential benefit of such experiments to our understanding of pain mechanisms and pain therapy needs to be shown. The investigator should be aware of the ethical need for a continuing justification of his investigations.
  2. If possible, the investigator should try the pain stimulus on himself; this principle applies for most noninvasive stimuli causing acute pain.
  3. To make possible the evaluation of the levels of pain, the investigator should give a careful assessment of the animal’s deviation from normal behavior. To this end, physiological and behavioral parameters should be measured. The outcome of this assessment should be included in the manuscript.
  4. In studies of acute or chronic pain in animals, measures should be taken to provide a reasonable assurance that the animal is exposed to the minimal pain necessary for the purposes of the experiment.
  5. An animal presumably experiencing chronic pain should be treated for relief of pain, or should be allowed to self-administer analgesic agents or procedures, as long as this will not interfere with the aim of the investigation.
  6. Studies of pain in animals paralyzed with a neuromuscular blocking agent should not be performed without a general anesthetic or an appropriate surgical procedure that eliminates sensory awareness.
  7. The duration of the experiment must be as short as possible and the number of animals involved kept to a minimum.

Ethical Principles for Pain-Related Clinical Research

The ethics of research involving normal human volunteers or patients have been clarified by several international and national organizations. The American Pain Society endorses the principles enunciated by the World Medical Association, the World Health Organization and the Council for International Organizations of Medical Sciences, the American College of Physicians, and the American Psychological Association.

Several of the principles included in these documents are germane to pain-related research. Each pain practitioner involved in pain-related clinical research should observe the following principles:

  1. All planned clinical studies should be reviewed by an independent committee on human research prior to implementation. The committee, which should include scientists, healthcare practitioners, and lay persons, should evaluate the risks inherent in the research and the extent to which the significance of the potential results justifies the risks involved, even if minimal. The committee also should ensure that potential subjects have the opportunity to provide informed consent prior to participation.
  2. Informed consent implies that potential subjects are fully apprised of the goals, procedures, and risks of the study. Potential subjects must be able to decline, and those who consent must be able to withdraw prior to completion, without any risk of penalty.
  3. Those who may be incapable of giving fully informed consent, including children and adults who are not fully competent, should not be used in pain research unless it is essential to the goals of the experiment. In the latter circumstance, consent must also be obtained from an individual with legal responsibility for the welfare of the subject.
  4. In pain studies, the minimal intensity of noxious stimulation necessary to the goals of the experiment should be established beforehand and not exceeded during the study. Subjects should be able to stop the painful stimulus at will. In research on clinical pain, the use of placebos or sham treatments require that alternative methods of pain relief be available to those patients who require it.

Ethical Principles for Pain-Related Clinical Practice

The American Pain Society believes that the principles of medical ethics published by the American Medical Association should apply to all clinical disciplines engaged in pain therapy with patients. The following principles have each been altered so that the word “physician” has been replaced by the phrase “healthcare provider”:

  1. A healthcare provider shall be dedicated to providing competent medical service with compassion and respect for human dignity.
  2. A healthcare provider shall deal honestly with patients and colleagues, and strive to expose those healthcare providers deficient in character and competence or who engage in fraud or deception.
  3. A healthcare provider shall respect the law and also recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient.
  4. A healthcare provider shall respect the rights of patients, of colleagues, and of other health professionals, and shall safeguard patient confidences within the constraints of the law.
  5. A healthcare provider shall continue to study; apply and advance scientific knowledge; make relevant information available to patients, colleagues and the public; obtain consultations; and use the talents of other health professionals when indicated.
  6. A healthcare provider, in the provision of appropriate patient care, except in emergencies, shall be free to choose whom to serve, with whom to associate, and the environment in which to provide healthcare services.
  7. A healthcare provider shall recognize a responsibility to participate in activities contributing to an improved community.
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