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Culture, Subjectivity, and the Ethics of Patient-Centered Pain Care

Published online by Cambridge University Press:  01 January 2009

JAMES GIORDANO ,
JOAN C. ENGEBRETSON  and
ROLAND BENEDIKTER
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Extract

Even the most scientifically reductionist view of the individual reveals that we are complex systems nested within complex systems. These interactions within and among systems are based and depend on numerous variables of our (internal and external) environment(s). If we define ethics as a system of moral decision making, then it becomes clear that these decisions ultimately affect the situation(s) of managing our activities and relationships with others in our environment (in essence, our being in the world). Given that ecology literally means “a study or system of wisdom and reasoning about the interrelation of organisms in their environment or place of inhabitance,” Owen Flanagan's description of ethics as “human ecology” takes on considerable relevance and importance.

Type
Special Section: Open Forum
Information
Cambridge Quarterly of Healthcare Ethics , Volume 18 , Issue 1 , January 2009 , pp. 47 - 56
Copyright
Copyright © Cambridge University Press 2009

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References

1. Kelso JAS. Dynamic Patterns: The Self-Organization of Brain and Behavior. Cambridge, MA: MIT Press; 1995.

2. Kagan S. Normative Ethics. Boulder, CO: Westview Press; 1998.

3. Merriam-Webster's Collegiate Dictionary. 11th ed. Springfield, MA: Merriam-Webster Inc.; 2004. Ecology; p. 394.

4. Flanagan O. The Problem of the Soul: Two Visions of Mind and How to Reconcile Them. New York: Basic Books; 2003.

5. Merriam-Webster's Collegiate Dictionary. 11th ed. Springfield, MA: Merriam-Webster Inc.; 2004. Culture; p. 304.

6. Foster GM, Anderson BG. Medical Anthropology. New York: Knopf; 1978.

7. See note 6, Foster, Anderson 1978.

8. Purves D. Body and Brain: A Trophic Theory of Neural Connections. Cambridge, MA: Harvard University Press; 1988.

9. Ridley M. Nature via Nurture: Genes, Experience and What Makes Us Human. New York: Harper Collins; 2003.

10. Edelman GM. Wider Than the Sky: The Phenomenal Gift of Consciousness. New Haven, CT: Yale University Press; 2004.

11. Mogil JS. The Genetics of Pain. Seattle, WA: IASP Press; 2004.

12. Giordano J. Understanding pain as disease and illness—Part one. Practical Pain Management 2006;6(6):70–3; Manchikanti L, Giordano J, Boswell MV, Fellows B, Manchukonda R, Pampati V. Role of psychological factors as predictors of opioid abuse and illicit drug use in chronic pain patients. Journal of Opioid Management 2007;3(2):89–100.

13. Rey R. The History of Pain. Cambridge, MA: Harvard University Press; 1995.

14. Zborowski M. Cultural components in responses to pain. Journal of Social Issues 1952;8:16–30.

15. Bates MS, Rankin-Hill L, Sanchez-Ayendez M. The effects of cultural context of health care on treatment of, and response to chronic pain and illness. Social Science and Medicine 1997;45(9):1433–47; Bates MS, Edwards WT, Anderson KO. Ethnocultural influences on variation in chronic pain perception. Pain 1993;52:101–12; Edwards RR, Moric M, Husfeldt B, Buvanendran A, Ivankovich O. Ethnic similarities and differences in the chronic pain experience: A comparison of African-American, Hispanic, and White patients. Pain Medicine 2005;6:88–98.

16. Kroeber AL. The Nature of Culture. Chicago, IL: University of Chicago Press; 1952.

17. Tylor EB. Primitive Culture. Vol VII. London: Burns and Company; 1871.

18. Good BJ. Medicine, Rationality, and Experience: An Anthropological Perspective. Cambridge: Cambridge University Press; 1994.

19. Engebretson JC, Monsivais D, Mahoney JS. The meaning behind the words: Ethical considerations in pain management. American Journal of Pain Management 2006;16:21–8.

20. Giordano J. Pain, the patient and the physician: Philosophy and virtue ethics in pain medicine. In: Schatman M, ed. Ethics Issues in Chronic Pain Management. New York: Informa; 2007:1–18; Leder D. The Absent Body. Chicago: University of Chicago Press; 1990; Svenaeus F. Phenomenology of health and illness. In: Toombs SK, ed. Handbook of Phenomenology and Medicine. Amsterdam: Kluwer; 2001:87–108.

21. See note 20, Giordano 2007, Leder 1990, Svenaeus 2001; see also Giordano J. A big picture: Neurogenesis, pain, and the reality and ethics of pain medicine. Practical Pain Management 2007;7(2):37–52.

22. Scarry E. The Body in Pain: The Making and Unmaking of the World. New York: Oxford University Press; 1985.

23. Giordano J. In the patient's voice. American Journal of Pain Management 2006;16:34–5; Ciccone D, Just N, Bandilla E. Non-organic symptom reporting in patients with chronic non-malignant pain. Pain 1996;68:329–41.

24. Hyland MA. Brief guide to extended network entanglement theory as a theory of healing and its empirical predictions. Forschende Komplementärmedizin und klassische Naturheilkunde 2003;10:201–6.

25. Augustine. Confessions and Selected Works. New York: Penguin Books; 1961.

26. See note 22, Scarry 1985.

27. Morris D. The Culture of Pain. Berkeley: University of California Press; 1991.

28. Giordano J. Competence and commitment to care. Pain Practitioner 2006;16(2):10–6.

29. Giordano J. Pain as disease and illness: Part two: Structure and function of the ethics of pain medicine. Practical Pain Management 2006;6(7):65–8.

30. Lacan J. The Four Fundamental Concepts of Psycho-analysis. Harmondsworth, UK: Penguin Books; 1979.

31. Lackoff G, Johnson M. Philosophy in the Flesh: The Embodied Mind and Its Challenge to Western Thought. New York: Basic Books; 1999; Popper KR, Eccles JC. The Self and Its Brain: An Argument for Interactionism. Berlin: Springer; 1977.

32. Best S, Kellner D. The Postmodern Turn. New York: Guilford Press; 1997.

33. Csordas TJ. Embodiment and cultural phenomenology. In: Weiss G, Fern Haber H, eds. Perspectives on Embodiment: The Intersections. New York: Routledge; 1999:143–64.

34. Amanzio M, Benedetti F. Neuropharmacological dissection of placebo analgesia: Expectation-activated opioid systems versus conditioning-activated specific subsystems. Journal of Neuroscience 1999; 19: 484–494; Benedetti F, Mayberg HS, Wager TD, Stohler CS, Zubieta J-K. Neurobiological mechanisms of the placebo effect. Journal of Neuroscience 2005;25(45):10390–402.

35. Giordano J, Boswell MV. Pain, placebo and nocebo: Epistemic, ethical and practical issues. Pain Physician 2005;8:331–3; Giordano J. Placebo and placebo effects: Practical considerations, ethical concerns. American Family Physician 2008;77(9) 1–4; Moerman DE, Jonas WB. Deconstructing the placebo effect and finding the meaning response. Annals of Internal Medicine 2002;136(6):471–6.

36. Brody H. The lie that heals: The ethics of giving placebos. Annals of Internal Medicine 1982;97(1):112–8.

37. Hegel GWF. Philosophy of Mind. Wallace W, trans. Oxford: Oxford University Press; 1973.

38. See note 35, Giordano, Boswell 2005; see also Hahn RA. The nocebo phenomenon: Scope and foundations. In: Harrington A, ed. The Placebo Effect: An Interdisciplinary Exploration. Cambridge, MA: Harvard University Press; 2000:56–76.

39. Heidegger M. Building, Dwelling, Thinking. In: Basic Writings, New York: Harper Collins; 1993.

40. Giordano J. On knowing: Domains of knowledge and intellectual virtue in practical pain management. Practical Pain Management 2006;6(3):65–7.

41. Pellegrino ED, Thomasma DC. For the Patient's Good: The Restoration of Beneficence in Health Care. New York: Oxford University Press; 1987; Giordano J. Changing the practice of pain medicine writ large and small through identifying problems and establishing goals. Pain Physician 2006;9:283–6.

42. Pellegrino ED. The healing relationship: Architectonics of clinical medicine. In: Shelp EE, ed. The Clinical Encounter: The Moral Fabric of the Physician-Patient Relationship. Boston: Reidel; 1983; Manchikanti L, Boswell MV, Giordano J. Evidence-based interventional pain management: Principles, protocols, potential and applications. Pain Physician 2007;10:329–56.

43. Maricich Y, Giordano J. Pain, suffering, and the ethics of pain medicine: Is a deontic foundation sufficient? American Journal of Pain Management 2007;17:130–8.

44. Giordano J. Moral agency in pain medicine: Philosophy, practice and virtue. Pain Physician 2006;9:41–6.

45. See note 43, Maricich, Giordano 2007.

46. Ryder RD. Painism: A Modern Morality. London: Centaur Press; 2001.

47. See note 20, Giordano 2007; see note 44, Giordano 2006; see also Giordano J. Agents, intentions and actions: Moral virtue in pain medicine. Practical Pain Management 2006;6(4):76–80.

48. Niebroj LT, Jadamus-Niebroj D, Giordano J. Toward a moral grounding of pain medicine: Consideration of neuroscience, reverence, beneficence, and autonomy. Pain Physician 2008;11:7–12.

49. Dogra N, Giordano J, France N. Teaching medical students about uncertainty: The findings of a qualitative study focusing on cultural diversity. BMC Medical Education 2007;7(8):

50. See note 41, Giordano 2006.

51. See note 19, Engebretson et al. 2006; Fulford KWM. Facts/values: Ten principles of values-based medicine. In: Radden J, ed. The Philosophy of Psychiatry: A Companion. Oxford: Oxford University Press; 2004:205–36; Waters D, Sierpina VS. Goal-directed health care and the chronic pain patient: A new vision of the healing encounter. Pain Physician 2006;9(4):353–60.

52. Brandt RB. Ethical relativism. In: Edwards P, ed. The Encyclopedia of Philosophy Vol 3. New York: Macmillan; 1972:75–8.

53. Rice PB. On the Knowledge of Good and Evil. New York: Knopf; 1955.

54. Cutter MAG. Expert moral choice in medicine: A study of uncertainty and locality. In: Rasmussen L, ed. Ethics Expertise: History, Contemporary Perspectives, and Applications. Dordrecht: Springer; 2005:125–38.

55. Kant I. Groundwork of the Metaphysics of Morals. Gregor M, ed. Cambridge: Cambridge University Press; 1998.

56. Momeyer RW. What conception of moral truth works in bioethics? Journal of Medicine and Philosophy 2002;27:403–16.

57. Moreno JD. Deciding Together: Bioethics and Moral Consensus. New York: Oxford University Press; 1995.

58. Lyotard JF. The Differend. Phrases in Dispute. Minneapolis: University of Minnesota Press; 1988.

59. Baier AC. Moral Prejudices: Essays on Ethics. Cambridge, MA: Harvard University Press; 1996; Perpich D. From the caress to the world: Transcendence and the feminine in the philosophy of Emmanuel Levinas. In: Chanter T, ed. Feminist Interpretations of Emmanuel Levinas. University Park: The Pennsylvania State University Press; 2001:28–52.

60. Giordano J. The necessity and possibility of a meta-ethics of pain medicine. In: Giordano J, ed. Maldynia: Multi-disciplinary Perspectives on the Illness of Chronic Pain as Suffering. New York: Informa; 2009 (forthcoming).