Pain as a Subjective and Objective Phenomenon
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Abstract
Pain belongs to human life. Although pain is not a medical phenomenon per se, reflections on pain touch upon the philosophical foundations of medicine. Pain confronts us with basic questions such as the tension between an objective and a subjective approach, the concept of brain disease, human consciousness, and the relationship between body and mind. In this contribution, pain is placed in the context of the philosophy of medicine. Attention will be paid to some basic medical-biological and behavioral theories about pain and their underlying presuppositions. For about four decades, several holistic approaches of pain have existed. It appears that the meaning of pain is hard to understand from a scientific perspective. Pain is a sensory and emotional experience, the quality of which is difficult to express in words. Pain is a mystery; it cannot be explained as having just a signaling function. It has also an ontological and an existential dimension.
Keywords
Chronic Pain Palliative Care Pain Sensation McGill Pain Questionnaire Phantom Limb PainReferences
- Allan DB, Waddell G (1989) Understanding and management of low back pain. The history of low back disability. Low back pain and disability since World War II. Acta Orthop Scand 60(Suppl 234):1–23CrossRefGoogle Scholar
- Apkarian AV et al (2009) Towards a theory of chronic pain. Prog Neurobiol 87:81–97CrossRefGoogle Scholar
- Aristotle (1976) The Nicomachean ethics (trans: Thompson JAK). Penguin Books, LondonGoogle Scholar
- Bakan D (1976) Pain – the existential symptom. In: Spicker SF, Tristam Engelhardt H Jr (eds) Philosophical dimensions of the neuro-medical sciences. Reidel Publishing, Dordrecht/Boston, pp 197–207CrossRefGoogle Scholar
- Basbaum AI, Bushnell MC (eds) (2009) Science of pain, 1st edn. Elsevier, AmsterdamGoogle Scholar
- Baszanger I (1998) Inventing pain medicine: from the laboratory to the clinic. Rutgers University, New Brunswick/LondonGoogle Scholar
- Buytendijk FJJ (1962) Pain. Its modes and functions. The University of Chicago Press, ChicagoGoogle Scholar
- Buytendijk FJJ (1974) Prolegomena to an anthropological physiology. Duquesne University Press, PittsburghGoogle Scholar
- Cassell E (1991) The nature of suffering and the goals of medicine. Oxford University Press, New York/OxfordGoogle Scholar
- Cassell E (1995) Pain and suffering. In: Reich WT (ed) Encyclopedia of bioethics, vol 4. Simon & Schuster MacMillan, New York, pp 1897–1905Google Scholar
- Cervero F (2009) Pain theories. In: Basbaum AI, Bushnell MC (eds) Science of pain, 1st edn. Elsevier, Amsterdam, pp 5–10Google Scholar
- Chapman CR, Gavrin J (1999) Suffering: the contributions of persistent pain. Lancet 353:2233–2237CrossRefGoogle Scholar
- Charon R (2006) Narrative medicine: honoring the stories of illness. Oxford University Press, Oxford/New YorkGoogle Scholar
- Clark D (1999) ‘Total pain’, disciplinary power and the body in the work of Cicely Saunders, 1958–1967. Soc Sci Med 49:727–736CrossRefGoogle Scholar
- Cousins MJ et al (2004) Pain relief: a universal human right. Pain 112:1–4CrossRefGoogle Scholar
- de Moulin D (1974) A historical-phenomenological study of bodily pain in western man. Bull Hist Med 48:540–570Google Scholar
- Dekkers W (1998) Hermeneutics and experiences of the body. The case of low back pain. Theor Med Bioeth 19:277–293CrossRefGoogle Scholar
- Descartes R (1963) Le traité de l’homme. In: Descartes R (ed) Oeuvres philosophiques. Tome I. Garnier, Paris, pp 379–480Google Scholar
- Descartes R (1967) Méditations touchant la première philosophie. In: Descartes R (ed) Oeuvres philosophiques. Tome II. Garnier, Paris, pp 404–505Google Scholar
- Ehlich K (1985) The language of pain. Theor Med 6:177–187CrossRefGoogle Scholar
- Engel GL (1977) The need for a new medical model: a challenge for biomedicine. Science 196:129–136CrossRefGoogle Scholar
- Gracely RH, Eliav E (2009) Psychophysics of pain. In: Basbaum AI, Bushnell MC (eds) Science of pain, 1st edn. Elsevier, Amsterdam, pp 927–959Google Scholar
- IASP (2014) http://www.iasp-pain.org/Education/Content.aspx?ItemNumber=1698. Accessed 4 Oct 2014
- Kleinman A et al (1992) Pain as human experience: an introduction. In: DelVecchio Good M-J et al (eds) Pain as human experience: an anthropological perspective. University of California Press, Berkeley, pp 1–28Google Scholar
- Lee MC, Tracey I (2010) Unravelling the mystery of pain, suffering, and relief with brain imaging. Curr Pain Headache Rep 14:124–131CrossRefGoogle Scholar
- Leriche R (1937) La chirurgie de la douleur. Masson, ParisGoogle Scholar
- Loeser JD (1991) What is chronic pain? Theor Med 12:213–225CrossRefGoogle Scholar
- Loeser JD (2000) Pain and suffering. Clin J Pain 16:S2–S6CrossRefGoogle Scholar
- Loeser JD, Melzack R (1999) Pain: an overview. Lancet 353:1607–1609CrossRefGoogle Scholar
- Mehta A, Chan LS (2008) Understanding of the concept of “total pain”. A prerequisite for pain control. J Hosp Palliat Nurs 10:26–32CrossRefGoogle Scholar
- Melzack R (1973) The puzzle of pain. Penguin, HarmondsworthGoogle Scholar
- Melzack R (1996) Gate control theory. On the evolution of pain concepts. Pain Forum 5(1):128–138CrossRefGoogle Scholar
- Melzack R, Wall P (1988) The challenge of pain, 2nd edn. Penguin, HarmondsworthGoogle Scholar
- Morris DB (1993) The culture of pain. University of California Press, Berkeley/Los AngelesGoogle Scholar
- Morris DB (2002) Narrative, ethics, and pain: thinking with stories. In: Charon R, Montello M (eds) Stories matter: the role of narrative in medical ethics. Routledge, New York, pp 196–218Google Scholar
- Morris DB (2012) Narrative and pain: towards an integrated model. In: Moore RJ (ed) Handbook of pain and palliative care: biobehavioral approaches for the life course. Springer, New York, pp 733–751Google Scholar
- Moscoso J (2012) Pain. A cultural history. Palgrave Macmillan, BasingstokeGoogle Scholar
- Nelkin N (1986) Pains and pain sensations. J Philos 83:129–148CrossRefGoogle Scholar
- Noble B et al (2005) The measurement of pain, 1945–2000. J Pain Symptom Manage 29:14–21Google Scholar
- Perl ER (2011) Pain mechanisms: a commentary on concepts and issues. Prog Neurobiol 94:20–38CrossRefGoogle Scholar
- Porter R (1999) Western medicine and pain: historical perspectives. In: Hinnells JR, Porter R (eds) Religion, health and suffering. Kegan Paul International, London, pp 364–381Google Scholar
- Price DD, Hirsh A, Robinson ME (2009) Psychological modulation of pain. In: Basbaum AI, Bushnell MC (eds) Science of pain, 1st edn. Elsevier, Amsterdam., pp 975–1002Google Scholar
- Pullman D (2002) Human dignity and the ethics and aesthetics of pain and suffering. Theor Med 23:75–94CrossRefGoogle Scholar
- Resnik DB, Rehm M, Minard RB (2001) The undertreatment of pain: scientific, clinical, cultural, and philosophical factors. Med Health Care Philos 4:277–288CrossRefGoogle Scholar
- Saunders C (1967) The management of terminal illness. Hospital Medicine Publications, LondonGoogle Scholar
- Scarry E (1985) The body in pain. The making and unmaking of the world. Oxford University Press, New York/OxfordGoogle Scholar
- Seymour J et al (2005) Pain and palliative care: the emergence of new specialties. J Pain Symptom Manag 29:2–13CrossRefGoogle Scholar
- Sullivan MD et al (2013) What does it mean to call chronic pain a brain disease? J Pain 14:317–322CrossRefGoogle Scholar
- van den Berg JH (1963) Leven in meervoud. Een metabletisch onderzoek. Callenbach, NijkerkGoogle Scholar
- van Dijkhuizen JF, Enenkel K (2009) Introduction: constructions of physical pain in early modern culture. In: van Dijkhuizen JF, Enenkel KAE (eds) The sense of suffering. Construction of physical pain in early modern culture. Brill, Leiden, pp 1–17Google Scholar
- WHO. http://www.who.int/cancer/palliative/definition/en. Accessed 4 Oct 2014