The normative and epistemological status of pain experiences in modern health care

This article explores the concept of ‘pain’ and the relation between abstract, detached knowledge and patient experiences and ‘first person perspectives’. Pain can be handled as the correlate of a neurological finding (for example in a professional practice) and as an experience in a patient’s life. Sometimes patients articulate experiences impossible to link to an objective trace. In such situations it is often claimed that we are left with a choice between dealing with pain and suffering as abstract, detached public conceptions or as private inaccessible entities. In this paper I argue that this is an unappetizing choice, and that we can develop a better understanding of ‘first person perspectives’ if we look at them in the light of contexts, stories and practices regulated by public exemplars. Discourses for handling pain as a phenomenon in a person’s life exist, and it is an epistemological as well as a normative problem if such perspectives are not recognized. The argument is elaborated through a discussion of, amongst others, Martha Nussbaum, Marx Wartofsky, Amartya Sen, and Ludwig Wittgenstein.