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Pain cannot (just) be whatever the person says: A critique of a dogma.

Charles M Djordjevic
Published in: Nursing philosophy : an international journal for healthcare professionals (2023)
McCaffery's definition of pain has proven to be one of the most consequential in nursing and healthcare more generally. She put forward this definition in response to the persistent undertreatment of pain. However, despite raising her definition to the status of a dogma, the undertreatment remains a real problem. This essay explores the contention that McCaffery's definition of pain elides critical aspects of it, aspects that demand consideration when treating pain. In section I, I set the stage. I discuss how McCaffery's definition and her understanding of pain science interrelate. In section II, I raise three problems for this understanding. In section III, I argue that these problems stem from an incoherency in her definition. Finally, in section IV, I draw from hospice nursing as well as philosophy and the social sciences to redefine 'pain' so that an intersubjective feature of it is foregrounded. I also briefly discuss one implication this redefinition has for pain management.
Keyphrases
  • pain management
  • chronic pain
  • healthcare
  • neuropathic pain
  • mental health
  • public health
  • spinal cord injury
  • deep learning
  • health insurance
  • neural network