Papers by Isabelle Baszanger
Sciences sociales et santé, 1991
ABSTRACT
Traité de bioéthique, 2010
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Cahiers de sociologie et de démographie médicales
Chronic pain is defined by its length (more than six months) and its resistance to conventional t... more Chronic pain is defined by its length (more than six months) and its resistance to conventional therapies. It has been studied for about a decade in France. The outpatient departments devoted to chronic pain are pluri-disciplinary. They are likely to pave the way for a transversal specialization encompassing many conventional medical specialties. Moreover, chronic pain is nowadays considered not only the consequence of a lesion but also an independent entity, to be cared for itself. In the first conception, the struggle against pain is merely a stage in an overall treatment involving neuro-surgeons, anasthesiologists and medical specialists. In the second conception, the patient's behavior is rigorously monitored by all the caring team, who analyze his reactions to stimuli that generate pain. This (second) emerging pain conception creates tensions among physicians. The problem is how to adopt it without breaking down the professional cohesion. Another issue is the variation of the therapeutic procedure. The latter does not involve the same actors in every case, and this is an additional challenge.
Social Science & Medicine
Sciences sociales et santé, 2000
ABSTRACT
Unraveling Practices, Techniques, and Bodies, 2012
Santé, Société et Solidarité, 2010
Santé, Société et Solidarité, 2010
Sciences sociales et santé, 1989
ABSTRACT
Techniques & culture, 1996
Symbolic Interaction, 1998
Sociology of Health and Illness, 1992
Chronic pain is a problematic reality at least for two reasons. First, pain is a person's private... more Chronic pain is a problematic reality at least for two reasons. First, pain is a person's private experience, to which no one else has direct access. Second, chronic pain is lasting proof of a failure that questions the validity of actions and explanations, both past and future, of all involved. Because pain is a private sensation that cannot be reduced by objectification, it cannot, ultimately, be stablised as an unquestionable fact that can serve as the basis of medical practice and thus organise relations between professional and lay persons. This fragile factuality increases the work a physician has to do to decipher a patient's pain. The aim of this paper is to examine how physicians specialising in pain medicine work at this deciphering. Because of these characteristics of pain, physicians are forced to work on the elusive information provided by patients so as to bring into being something called chronic pain. When doing this they tap various, nearly incompatible, resources. I shall study the way these multiple resources are put to use by physicians as they form judgements about cases. By using as a field experiment two pain centres with opposite conceptions and practices, it can be shown how physicians in each centre determine patients' pain situations and formulate advice to them, how the characteristics of this work involve physicians in specific systems of relations with patients, and how these systems are related to dimensions of this work: either to a justification of physicians' actions or else to a confirmation, or realignment, of the initial doctor-patient agreement.
Sociologie du Travail, 2000
Social Science & Medicine, 2012
During the past few years, debates have frequently erupted in oncology journals regarding the que... more During the past few years, debates have frequently erupted in oncology journals regarding the question of whether to prolong or end treatment. These debates have been informed by developments from both within and outside the field. Within Bioethics, some writers have put forward a number of principles for judging the legitimacy of medical interventions, notably that of patient autonomy. Broad social and political developments have also profoundly affected medical practices at the end of life. Though therapeutic options have evolved, whether to stop or to pursue treatment in the face of certain death has been a central issue in medical oncology since the early 1950s. A critical appraisal of the history of this issue can help us to better understand the tangled relationship(s) between innovation, "cure," death, and the symptoms and subjective experiences of sufferers. This paper addresses an aspect of this complex problem, namely how limits are established regarding both treatment and therapeutic innovation near the end of life. Utilizing a grounded theory and situational analysis approach it traces how the issues at stake were defined and the ways in which the dilemma was progressively transformed as a result of the combined effects of a proliferating number of stakeholders, molecules, instruments, and techniques. It discusses three different moments, as they epitomize how the links between chemotherapy and palliation were construed through the evolving forms of clinical research and innovative therapies.
Social Science & Medicine, 1995
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Papers by Isabelle Baszanger