Arnaudo Elisa
Fondazione ISAL, Torre Pedrera di Rimini, Italy.
J Eval Clin Pract. 2017 Oct;23(5):1081-1086. doi: 10.1111/jep.12804. Epub 2017 Aug 4.
In the literature, the allegation to pursue approaches grounded on Cartesian dualism in medicine is widespread. In this paper, I argue that dualism informing biomedicine has not only to do with a Cartesian view of mind and body, but that multiple dualisms are at play in biomedical approach to disease, especially regarding complex pain conditions. A form of epistemological dualism entailing the primacy of the physician's model of knowledge on the patient's direct experience of suffering is pointed out as the source of the inadequate medical attitude towards pain, particularly in relation to its complex forms such as fibromyalgic syndrome. The analysis, in particular, pays attention to the way in which dualism underlies and reinforces the delegitimization of chronic pain patients and suggests that solutions have to be found in the material organization of the health care service.
在文献中，指责医学中采用基于笛卡尔二元论的方法是很普遍的。在本文中，我认为影响生物医学的二元论不仅与笛卡尔对身心的看法有关，而且多种二元论在生物医学对疾病的研究方法中起作用，特别是在复杂疼痛状况方面。一种认识论二元论形式，即医生的知识模型优先于患者对痛苦的直接体验，被指出是对疼痛采取不充分医疗态度的根源，尤其是在涉及纤维肌痛综合征等复杂疼痛形式时。具体而言，该分析关注二元论如何构成并强化慢性疼痛患者的失权状况，并建议必须在医疗服务的物质组织中找到解决方案。
