Thinking the unthinkable:the clinician as perpetrator of elder abuse in patients in pain.

Some advocates for improved pain management have devised and had initial success utilizing a controversial new weapon-the elder abuse claim. In California, two recent cases have been brought under the state's elder abuse statutes against physicians and health care institutions. The first lead to a much publicized jury verdict against a physician, and the second was recently settled as to all defendants, with related disciplinary actions against a treating physician and a skilled nursing facility by their respective regulatory agencies. This commentary reviews the phenomenon of litigating cases of undertreated pain, analyzes the most recent cases, and considers the implications of invoking elder abuse statutes in such cases.