In pain and symptom control at the end of life, which statement is supported?

• A. Pain must be ignored to avoid distress
• B. Pain cannot be controlled in elderly patients
• C. Physicians should manage pain, with no patient input
• D. Fear of pain/suffering may be greater than fear of death itself

Answer: (D)

In end-of-life care, the priority is comfort and relief from distress, and the idea being tested is that fear of pain or suffering can be greater than fear of death itself. When patients are worried about ongoing pain, addressing that pain becomes a central part of preserving dignity and quality of life. This means proactive assessment and management of symptoms, using appropriate medications and nonpharmacologic strategies, and tailoring plans to the patient’s goals and values with their input. Including the patient and family in decisions helps ensure that the chosen approach aligns with what matters most to the person at the end of life.

Pain must be ignored to avoid distress is not supported because untreated pain increases suffering and undermines comfort and dignity. Pain cannot be controlled in elderly patients is incorrect; age alone does not prevent effective pain relief, though dosing and monitoring must be careful. Physicians should manage pain, with no patient input ignores autonomy and patient-centered care; patients or their surrogates should be involved in decisions about treatment goals and comfort measures.