Pain and dualism: Which dualism?

Abstract

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.

Keywords: chronic pain; dualism; fibromyalgia; medically unexplained; pain.