{"title":"痛苦不能(仅仅)是一个人所说的:对教条的批判。","authors":"Charles Djordjevic","doi":"10.1111/nup.12446","DOIUrl":null,"url":null,"abstract":"<p><p>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.</p>","PeriodicalId":49724,"journal":{"name":"Nursing Philosophy","volume":null,"pages":null},"PeriodicalIF":2.6000,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Pain cannot (just) be whatever the person says: A critique of a dogma.\",\"authors\":\"Charles Djordjevic\",\"doi\":\"10.1111/nup.12446\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>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.</p>\",\"PeriodicalId\":49724,\"journal\":{\"name\":\"Nursing Philosophy\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2023-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Nursing Philosophy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/nup.12446\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/5/3 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nursing Philosophy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/nup.12446","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/5/3 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}
Pain cannot (just) be whatever the person says: A critique of a dogma.
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.
期刊介绍:
Nursing Philosophy provides a forum for discussion of philosophical issues in nursing. These focus on questions relating to the nature of nursing and to the phenomena of key relevance to it. For example, any understanding of what nursing is presupposes some conception of just what nurses are trying to do when they nurse. But what are the ends of nursing? Are they to promote health, prevent disease, promote well-being, enhance autonomy, relieve suffering, or some combination of these? How are these ends are to be met? What kind of knowledge is needed in order to nurse? Practical, theoretical, aesthetic, moral, political, ''intuitive'' or some other?
Papers that explore other aspects of philosophical enquiry and analysis of relevance to nursing (and any other healthcare or social care activity) are also welcome and might include, but not be limited to, critical discussions of the work of nurse theorists who have advanced philosophical claims (e.g., Benner, Benner and Wrubel, Carper, Schrok, Watson, Parse and so on) as well as critical engagement with philosophers (e.g., Heidegger, Husserl, Kuhn, Polanyi, Taylor, MacIntyre and so on) whose work informs health care in general and nursing in particular.