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[医学中疼痛的科学知识与方法学问题]

[Scientific knowledge and the methodologic problem of pain in medicine].

作者信息

Federspil G, Vettor R

机构信息

Dipartimento di Scienze Mediche e Chirurgiche, Università degli Studi, Padova.

出版信息

Minerva Anestesiol. 1999 Sep;65(9):679-87.

Abstract

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.

摘要

本文探讨了疼痛的认识论问题以及这一概念构成科学知识一部分的方式。第一部分快速概述了现代科学知识的主要方面。在早期,培根、伽利略和笛卡尔认为新的知识形式能够通向对真理和确定性的认识。如今,这些理想已被证明无法实现,科学仅呈现为有充分依据、严谨且客观的知识形式。此外,科学的客观性基于主体间性。本文的第二部分审视了疼痛,并强调它是一种主观现象,医生无法像确定普通解剖学和生理学现象那样来确定它。我们对疼痛的科学知识基于一些操作,通过这些操作能够达成主体间性的认识:这些操作构成了能够作为疼痛科学知识基础的协议标准。在本文的最后一部分,在强调疼痛是一个属于诸多学科——科学、心理学、哲学、宗教——的概念之后,重点转向了疼痛本身而非痛苦。虽然前者是科学医学中的一个概念,但后者属于医学中超出科学边界的领域,涉及帮助受苦同胞的人的活动。

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