Wednesday, September 14, 2011

If there's one thing I would do to relieve pain in America ...

Daniel S. Goldberg, JD, PhD

East Carolina University

I would do everything in my power to convince both providers and pain sufferers to rid themselves of the idea that one must be able to see and objectify pain in order for it to be legitimized and treated properly.

The capacity to correlate discrete, material pathologies with illness complaints is a phenomenon that is literally constitutive of Western allopathic medicine, from the early 19th century to the present. As the quintessential subjective experience, pain defies objectification, and the vast majority of chronic pain experiences are literally defined by the absence of a material lesion that can be so correlated.

Yet such clinical sight is simply not necessary either to validate the experiences of those who live with pain, or to use the various safe and effective remedies that exist to ameliorate such pain.

I also believe that this emphasis on objectification and visibility plays a role in the terrible prevalence and intensity of chronic pain stigma and inequities in diagnosing and treating pain, but laying out the argument is a subject for future posts . . .

Ultimately, the need to objectify and see pain, which has been documented among pain sufferers and caregivers as well as health care providers, is in my view a primary culprit in the devastating and inequitable undertreatment of pain.

Even though such a need is literally baked into the foundations of American medicine and science, we should reject it.

Link: Ethics and the Chronic Pain Stigma in Geriatric Populations, Daniel Goldberg, The Bioethics Channel



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