GESTIÓN EN SALUD PÚBLICA: BioEdge: ‘I feel your pain!’ Really?

domingo, 4 de noviembre de 2018

BioEdge: ‘I feel your pain!’ Really?

BioEdge: ‘I feel your pain!’ Really?

Bioedge

‘I feel your pain!’ Really?

by Michael Cook | 3 Nov 2018 |

“I feel your pain,” Bill Clinton told an AIDS activist in the 1992 presidential campaign. Well, he probably didn’t. Pain is notoriously subjective and hard to measure. Some patients take the dentist’s drill without an anaesthetic; others would rather die.

In the 19th and early 20th Centuries doctors speculated why some groups were more sensitive. One popular theory was that less civilised groups were both less sensitive to pain and more expressive when they experienced it. Doctors contrasted stalwart, stoic Britons with degenerate, weeping dark-skinned people.

A contrasting theory was that civilisation was making people soft. The father of modern neurology, Silas Weir Mitchell, wrote in 1892 that “in our process of being civilized we have won, I suspect, intensified capacity to suffer. The savage does not feel pain as we do: nor as we examine the descending scale of life do animals seem to have the acuteness of pain-sense at which we have arrived.”

Today the opioid epidemic makes the study of differential rates of pain more urgent than it ever was. Current research seems to indicate that Americans in lower socio-economic groups experience more pain.

“If you’re looking at all pain – mild, moderate and severe combined – you do see a difference across socioeconomic groups. And other studies have shown that,” says University at Buffalo medical sociologist Hanna Grol-Prokopczyk. “But if you look at the most severe pain, which happens to be the pain most associated with disability and death, then the socioeconomically disadvantaged are much, much more likely to experience it.”

It’s also relevant in the debate over assisted suicide. Unbearable pain, or even the prospect of unbearable pain, is often regarded as sufficient reason to ask a doctor’s help in committing suicide.

Coming at this issue from a completely different perspective, linguistics expert David Johnson, of Kennesaw State University, in Georgia, found another answer in word usage. Writing in the Interdisciplinary Journal of Research on Religion he charted the frequency of the words pain and hurt since the year 1800 in four linguistic databases: Google Books Corpus, Corpus of Contemporary American English, Corpus of Historical American English, and Time Magazine Corpus. What he found was a sharp increase in “pain language” in American English since the 1960s.

Why? It is impossible to propose a definitive answer based on linguistic data, but Johnson’s investigation points at some intriguing lines of inquiry. His theory is that “this growth parallels the era when language related to the divine was in sharp decline”. In other words, a much greater willingness to talk about pain is correlated to a decrease in religious motivation for enduring pain.

... increasing American secularism plays a significant role. After all, the dilemma of the co- existence of pain and a good God is an eternal problem. To suffer in silence is lauded as the appropriate Christian response to pain. And there is a long Christian tradition of promoting suffering in silence ...
But with the increasing secularization in 20th and 21st century American society, notions of Christian stoic piety evaporated; thus, people discuss their pain more. And why not? If suffering in silence is not meritorious nor does it assist in religious redemption, then, like [the Greek mythological figure] Philoctetes, sufferers should complain all they want. If for no other reason, it might make them feel better. Interestingly, the data presented above does show an increase in pain, particularly since the 1960s in American English, which coincides with the same era when language related to the divine was in sharp decline.

Sunday, November 4, 2018

It happened so long ago that the exact details are dim in my mind, but I seem to remember that a nominee for the US Supreme Court nearly failed to score his dream job because of an alleged crime of attempted rape when he was a 17-year-old high school student. There was a huge controversy, wasn’t there? Demonstrations, twitterstorms, talking heads across the nation in a frenzy, politicians grandstanding...

Of course times were different way back then and public figures were held to a higher moral and legal standard. As the saying goes, "The past is a foreign country; they do things differently there." Nonetheless it is disturbing to read that the Democratic candidate for the governor of California, Gavin Newsom, casually told a journalist for The New Yorker that he assisted his mother to commit suicide in 2002. Assisting a suicide was a crime in California in 2002– and it still is if you are not a doctor. And at the time Newsom was not a callow teenager, but a member of the San Francisco Board of Supervisors.

The odd thing about this is that there has been almost no reaction. Assisting a suicide is just as much a crime as attempted rape and in this case Newsom has admitted that he did it. You would think that at least his Republican opponent would seize upon this blithe admission as a golden opportunity to knock off Newsom's Kennedy-esque halo.

But no one seems to care. What more do you need to show that assisted suicide has been normalised in California?