ABSTRACT
Many of the individuals who present for neuropsychological evaluation following acquired brain injury are experiencing considerable pain, and many are being treated with analgesic medication or are self-medicating with alcohol or illicit substances. As the authors of this chapter describe, pain, its treatment, and associated factors may have an effect on cognitive functioning and neuropsychological test results. However, determining the exact nature and extent of that effect for any given examinee can be extremely challenging for those experienced in working with this population, and may be impossible for those lacking such experience. As a result, professional competence in the ability to appropriately evaluate individuals experiencing acute or chronic pain is a primary ethical concern. In addition, since such evaluations are often performed in the context of personal injury litigation, the ability to maintain appropriate role boundaries and avoid engaging in multiple, conflicting relationships must be an area of focus for the examining or treating neuropsychologist. The authors examine these challenging ethical issues through the complexity of pain-related cases.
