‘Pain relief usually ends up at opioid analgesics’


From The American Scholar:

The notion that your doctor knows best, and will make decisions about your treatment with little attention to your desires, has been out of fashion for decades. There are many reasons. Among them are the erosion of authority and its replacement with an overconfident skepticism on the part of people not necessarily well informed; the influx of women into medicine and the unwillingness of some patients to view them as experts; the growth of medical journalism and its ability to disseminate information once confined to scientific journals; the arrival of the Internet, which provides medical “facts” often without statistical and physiological context; and the rise of “self-actualization,” which has turned personal choice into a civil religion.

In most ways, the decline of medical paternalism was a salutary trend, and an inevitable one. It took a few thousand years for Western medicine to learn that knowledge and choice aren’t conjoined twins. Patients may not know a lot, but that doesn’t diminish their right to have a say in their treatment. The trend, however, has gone too far.

This evolution is nowhere better illustrated than in how medicine views pain, a province where the patient now rules. Gone is the day when a doctor could ignore, question, or minimize a patient’s experience of pain. Gone, too, is a doctor’s reluctance to relieve it based on the belief that relief might cause greater hazard.

When all else fails, pain relief usually ends up at opioid analgesics.

“Opioids and Paternalism”, David Brown, The American Scholar