South African Journal of Psychiatry (Dec 2008)
Pain, madness and the limits of medicine
Abstract
The problem of pain poses questions pertaining to some of the assumptions that underpin modern medicine, including the conceptualisation and treatment of psychiatric disorders. Problematic issues, such as subjectivity and meaning, seem particularly critical in the domains of pain and madness, but have relevance in the broader ranges of medicine. Of central concern is the relation such issues bear to notions of scientific practice. The subjective experience of illness and the meanings attached to it need to be accounted for, and cannot be considered to lie beyond the scope of scientific thinking, as not being measurable or objectively verifiable: yet attempts to incorporate these intrinsic dimensions remain elusive, and shape some of the shifting limitations of the various definitions of what might be considered to be a scientific perspective.