Infants, Pain and What Health Care Professionals Should Want to Know Now – An Issue of Epistemology and Ethics

Butler, Nance Cunningham

doi:10.1111/j.1467-8519.1989.tb00339.x

Cited by 12 publications

(6 citation statements)

References 23 publications

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“…We now recognize that these concerns are spurious and can lead to failure to provide adequate treatment or to long term destructive consequences (3). The capacity to empathize or to be child-centred (able to take the perspective of the child) remains important, irrespective of the nature of one's interaction with the child (48). Cunningham (49) has addressed in broad terms how belief systems lead to doubts, denial and discounting of infant pain and resistance to changes in practice.…”

Section: Consciousness As An Attribute Of Other Peoplementioning

confidence: 99%

Implications of Concepts of Consciousness for Understanding Pain Behaviour and the Definitiion of Pain

Craig

1997

Pain Research and Management

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Judgements of the nature and severity of pain others may be experiencing are heavily influenced by an observer's preconceptions about the nature of the experience. Our personal sense of conscious experience dictates a search for consciousness characterized by the state of awareness found in competent adults, including constructive memories and thoughts, images and feelings. People incapable of verbally articulating experiences akin to those reported by competent older children and adults are at risk of having other evidence of pain denied, minimized or ignored. Despite substantial behavioural evidence for pain in the neonate and infant, and findings indicating destructive immediate and long term consequences if pain is not controlled, pain in infants and children often continues to be discounted. An alternative perspective on infant consciousness of pain focusing upon sensory and emotional components is presented. The current prominent definition of pain supports the prejudice favouring adult conceptions of consciousness by emphasizing the importance of self-report in assessing pain. Explanatory notes accompanying this definition also perpetrate the misguided belief that the experience of pain emerges as a product of early life experiences. The case for using nonverbal as well as verbal expression in the process of inferring states of pain is presented. As well, the proposition is supported that there should be explicit recognition that the experience of pain is an inherent quality of life present in all viable newborns, with the nature of the experience and its expression changing in the course of maturation and as a result of exposure to life experiences related to tissue injury.

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Section: Consciousness As An Attribute Of Other Peoplementioning

confidence: 99%

Implications of Concepts of Consciousness for Understanding Pain Behaviour and the Definitiion of Pain

Craig

1997

Pain Research and Management

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“…37 Does another being have conscious experience like our own? The problem of other minds is most acute for those who are unable to communicate, including human newborn infants 5, 13, 38 and fetuses, 39 severely brain-injured adults 37 and non-human animals. 40, 41 It has particular ethical significance when we are trying to understand whether or not a being is suffering or in pain.…”

Section: Philosophical Questionsmentioning

confidence: 99%

“…2, 3 Practice differed dramatically from older children or adults, in part because of a pervasive belief that newborn infants did not feel pain, and in part because of a fear of the side effects of analgesics. 4, 5 However, several factors converged to change this mindset including accumulating evidence of improved short term outcome with better intraoperative analgesia 6, 7 , the measurement of reproducible physiological and behavioural responses following painful events 8-10 , evidence of long-term neurodevelopmental consequences of pain in the newborn period, (eg. altered sensory processing 11, 12 ), as well as vocal complaints from infants’ parents.…”

Section: Introduction: the Changing Face Of Neonatal Pain Managementmentioning

confidence: 99%

Sugaring the Pill

Wilkinson¹,

Savulescu²,

Slater³

2012

Arch Pediatr Adolesc Med

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Sucrose is widely used for the management of procedural pain in newborn infants, including capillary blood sampling, venepuncture and vascular cannulation. Multiple randomised controlled trials have demonstrated that sweet-tasting solutions reduce behavioural responses to acute painful stimuli. It has been claimed that sucrose should be a standard of care in neonatal units, and that further placebo-controlled trials of sucrose are unnecessary and unethical. However, recently published neuroscientific studies cast doubt on the analgesic properties of sucrose. We review this new evidence and analyse the philosophical and ethical questions that it raises, including the “problem of other minds”. Sugar may be better understood not as an analgesic, removing or relieving pain, but as a compensating pleasure. There is a need for further research on the mechanism of sucrose’s effect on pain behaviour and on the long-term effects of sucrose treatment. Such trials will require comparison with placebo or with other interventions. Given uncertainty about the benefit of sucrose it may be wise to use alternative analgesics or non-pharmacological interventions where these are available and appropriate. Sucrose may not be the answer to procedural pain in newborns.

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“…Every nurse workswithin and/or copes with several sets of values. These include but are not limited to societal as well as personal values (Mackie, 1977;Rorty, 1982), medical and medical socialization values (Konner, 1987), professional nursing values (Styles, 1982), informal though powerful nursing socialization values (Myers, 1982), culturaivalues of the unit or setting (Bogdan, Brown & Foster, 1982;Butler, 1986Butler, , 1989Guillemin & Holmstrorn, 1986;Hutchinson, 1984), hospital-specific values (Simendinger, 1985) and researchvalues (ANA, 1985b;Eisner, 1981;Silverman, 1985;Wilson, 1989). Though each set of values provides a paradigm through which an individual nurse or unit might andvze a situation.…”

Section: Myth #4 Values Reflected In Ethical Pn'nciples Should Make mentioning

confidence: 99%

Myths in Health Care Ethics

Cunningham

Hutchinson

1990

Image: the Journal of Nursing Scholarship

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Infants, Pain and What Health Care Professionals Should Want to Know Now – An Issue of Epistemology and Ethics

Cited by 12 publications

References 23 publications

Implications of Concepts of Consciousness for Understanding Pain Behaviour and the Definitiion of Pain

Implications of Concepts of Consciousness for Understanding Pain Behaviour and the Definitiion of Pain

Sugaring the Pill

Myths in Health Care Ethics

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