I was appalled to read the recent article on “the fifth vital sign”1 as well as the invited critique and found them to be scientifically unsound and socially irresponsible.
This article published in the May issue of Archives moves the advances in relief of pain back at least 20 years. The authors' dismissal of the subjective report of pain as a vital sign disregards critical national guidelines, evidence-based practice, and strong consensus by the Joint Commission, the National Consensus Project for Quality Palliative Care, the American Pain Society, the National Comprehensive Cancer Network, and dozens of other national scientific and professional organizations, all who strongly endorse using pain as the fifth vital sign.
Ferrell B. Pain Assessment Is Vital. Arch Surg. 2008;143(1):98-99. doi:10.1001/archsurg.2007.24