Abstract

Effective pain control is perhaps the most serious issue in health care. The problem is not that there is a lack of available pharmacological or surgical techniques proven to reduce or eliminate pain. In fact, it is possible to treat the majority of patients who are complaining of pain. Nevertheless, a staggering amount of pain is mismanaged. We submit pain is poorly controlled for one of three reasons: inadequate knowledge or a misunderstanding of the physiological and psychological mechanisms involved in pain; inability to translate knowledge into practice; and, lack of empathy for patients experiencing pain. ;The goal of this dissertation is the successful resolution of these three problems. To effect this goal, we structure the dissertation to reflect the conditions necessary for successful management of pain. First we explain the nature of pain. We critically review and then set aside specificity approaches to pain that consider pain to be primarily sensational in nature. We take direct aim at the notion of pain being understood and treated as though it is purely---or even predominantly---sensational in nature. In lieu of a specificity approach, we present pain as a multifaceted phenomenon that includes dimensions of sensation, cognition and affect. In order to treat pain effectively, all of its dimensions must be understood and addressed. ;Second, we explain the nature of empathy. Empathy is understanding what another is experiencing from that person's perspective. It involves putting ourselves into the orientation of the other in order to grasp what she is experiencing. For purposes of pain management, empathizing with a patient who is in pain necessitates understanding what the patient's pain sensations are like, what the pain means to her, and how she is affected by it. By analyzing empathy and related, but different, phenomena, we show that it is possible to understand what a patient is experiencing. Only if we can understand the patient's pain---from her orientation---can we treat it. ;In our final section, we bring together the nature of pain and the nature of empathy in such a way as to solve the problem of pain-management. Physicians can control or eradicate their patients' pain only if they have the correct understanding of pain, the skill to treat it, and the ability to take on their patients' perspectives of their pain