The US Department of Veterans Affairs (VA) is instructing physicians and nurses who treat veterans to regard pain as a "fifth vital sign" to be routinely assessed along with blood pressure, pulse, temperature, and respiration.
Numerous studies indicate that pain is often unrecognized or inadequately treated. The agency found that recent VA initiatives to improve end-of-life care for veterans revealed that pain management was not well addressed in dying patients.
Stephenson J. Veterans' Pain a Vital Sign. JAMA. 1999;281(11):978. doi:10.1001/jama.281.11.978