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SCIENCE AND PAIN : RECONCILING THE OBJECTIVE AND SUBJECTIVE



Abstract

Science is an endeavour built on facts. Scientific methods discover facts, which have force because they are believed to be directly observable and exist independently of theory. Facts so discovered, constitute the solid and reliable foundations of scientific knowledge. Science is objective and rational because it predicts and explains outcomes that are valid and reliable. Applying scientific methods to medical practice is therefore thought to protect medical decision making from arbitrariness, bias, and error.

Pain presents a particular challenge to physicians seeking to base their practice on science. Pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. It is defined as subjective, because it is an internal phenomenon, not directly observable. It represents a quality, not a fact.

Tensions arise when scientific methods attempt to include subjective experiences within its objective framework. These tensions however, must be resolved if subjective phenomena, such as pain, are to be treated in a reliable and rational manner.

This paper presents a philosophical exploration of the tensions inherent in the study of subjective phenomena, such as pain, within an objective framework, based on contemporary models of rationality.

These abstracts were prepared by Dr Robert J. Moore. Correspondence should be addressed to him at Spine Society of Australia, Institute of Medical and Veterinary Science, The Adelaide Centre for Spinal Research, Frome Road, Adelaide, South Australia 5000.