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Minerva Anestesiologica 1999 September;65(9):679-87

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: Italian

Scientific knowledge and the methodological problem of pain in medicine

Federspil G., Vettor R.

Università degli Studi - Padova, Dipartimento di Scienze Mediche e Chirurgiche, Cattedra di Medicina Interna

The ­paper dis­cuss­es the epis­te­mo­log­ical ques­tion of ­pain and the way ­this con­cept ­forms ­part of sci­en­tif­ic knowl­edge. The ­first ­part ­gives a rap­id over­view of the ­main ­aspects of mod­ern sci­en­tif­ic knowl­edge. In ear­li­er ­times Bacon, Galileo and Descartes ­felt ­that the new ­form of knowl­edge ­could ­head to a knowl­edge of ­truth and cer­tain­ty. Today, ­these ­ideals ­have ­proved unat­tain­able and sci­ence ­only ­takes the ­form of ­well found­ed, rig­or­ous and objec­tive knowl­edge. Moreover, the objec­tiv­ity of sci­ence is ­based on inter­sub­jec­tiv­ity. The sec­ond ­part of the ­paper exam­ines ­pain and under­lines ­that it is a sub­jec­tive phe­nom­e­non ­which can­not be ascer­tained by the doc­tor in the ­same way as com­mon­place ana­tom­ic and phys­io­log­i­cal phe­nom­e­na. Our sci­en­tif­ic knowl­edge of ­pain is ­based on oper­a­tions for ­which it is pos­sible to ­achieve an inter­sub­jec­tive knowl­edge: ­these oper­a­tions con­sti­tute the pro­to­col cri­te­ria on ­which it is pos­sible to ­base a sci­en­tif­ic knowl­edge of ­pain. In the ­last ­part of ­this ­paper, hav­ing ­stressed ­that ­pain is a con­cept belong­ing to ­many dis­ci­plines—sci­en­tif­ic, psy­cho­log­i­cal, phil­o­soph­i­cal, relig­ious—the empha­sis is ­placed on ­pain ­itself as ­opposed to suf­fer­ing. While the for­mer is a con­cept ­that ­belongs to sci­en­tif­ic med­i­cine, the lat­ter ­belongs to ­that ­area of med­i­cine ­which ­lies ­beyond the boun­dar­ies of sci­ence and con­cerns the activ­ity of a man who ­helps a fel­low ­human who is suf­fer­ing.