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From the Department of Psychiatry & Behavioral Sciences, Wayne State University School of Medicine (Dr Leleszi), and Children's Hospital of Michigan (Drs Leleszi and Lewandowski), in Detroit; Bon Secours Cottage Health Services in Grosse Pointe, Mich (Drs Leleszi and Lewandowski); and Hospices of Henry Ford Health (Dr Lewandowski) in Detroit, Mich.

Address correspondence to Jimmie P. Leleszi, DO, Department of Psychiatry/Psychology, Children's Hospital of Michigan, 3901 Beaubien, Detroit, MI 48201-2119.E-mail: jleleszi{at}med.wayne.edu

Pain management in end-of-life care presents a unique set of opportunities for patients and physicians. Physicians will encounter patients at the end of life regardless of type of specialty practice. Symptom relief is the concern of all physicians. Knowledge of "total pain" concepts along with basic end-of-life pain management offers much to patients and their families. Osteopathic principles and treatment philosophy complement quality pain management in end-of-life care. Physicians providing supportive care can assist patients and their families with comfort at the end of life. Good pain management at the end of life enhances the patient-physician relationship.