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In this book, public health ethicist Daniel S. Goldberg sets out to
characterize the subjective experience of pain and its
undertreatment within the US medical establishment, and puts
forward public policy recommendations for ameliorating the
undertreatment of pain. The book begins from the position that the
overwhelming focus on opioid analgesics as a means for improving
the undertreatment of pain is flawed, and argues instead that
dominant Western models of biomedicine and objectivity delegitimize
subjective knowledge of the body and pain in the US. This general
intolerance for the subjectivity of pain is part of a specific
American culture of pain in which a variety of actors take part,
including not only physicians and health care providers, but also
pain sufferers, caregivers, and policymakers. Concentrating
primarily on bioethics, history, and public policy, the book brings
a truly interdisciplinary approach to an urgent practical ethical
problem. Taking up the practical challenge, the book culminates in
a series of policy recommendations that provide pathways for moral
agents to move beyond contests over drug policy to policy arenas
that, based on the evidence, hold more promise in their capacity to
address the devastating and inequitable undertreatment of pain in
the US.
In this book, public health ethicist Daniel S. Goldberg sets out to
characterize the subjective experience of pain and its
undertreatment within the US medical establishment, and puts
forward public policy recommendations for ameliorating the
undertreatment of pain. The book begins from the position that the
overwhelming focus on opioid analgesics as a means for improving
the undertreatment of pain is flawed, and argues instead that
dominant Western models of biomedicine and objectivity delegitimize
subjective knowledge of the body and pain in the US. This general
intolerance for the subjectivity of pain is part of a specific
American culture of pain in which a variety of actors take part,
including not only physicians and health care providers, but also
pain sufferers, caregivers, and policymakers. Concentrating
primarily on bioethics, history, and public policy, the book brings
a truly interdisciplinary approach to an urgent practical ethical
problem. Taking up the practical challenge, the book culminates in
a series of policy recommendations that provide pathways for moral
agents to move beyond contests over drug policy to policy arenas
that, based on the evidence, hold more promise in their capacity to
address the devastating and inequitable undertreatment of pain in
the US.
This progressive resource places concepts of social determinants of
health in the larger contexts of contemporary health ethics and the
evolution of social reform. It provides needed analysis of the
larger causes behind the immediate causes of illness and epidemics,
particularly injustice, systemic inequities, and the cumulative
effect of compound disadvantages. This moral approach to collective
and individual responsibilities-on the part of practitioners as
well as the public-supports a sound blueprint for finding answers
to longstanding global and local concerns. Readers are challenged
to recognize the critical role of social determinants to their
perception of health issues, controversies, and possibilities as
the book: * Details the epidemiologic evidence regarding social
determinants of health. * Key ethical implications of the evidence
regarding social determinants of health. * Considers the role of
risky health behaviors in determining population health outcomes. *
Addresses ethical questions of priority-setting at the policy and
practice levels. * Translates social determinants of health into
health policy goals. Half textbook, half monograph, Public Health
Ethics and the Social Determinants of Health Is geared toward
students in MPH programs as well as public health professionals in
diverse contexts such as local health departments and non-profit
organizations. It informs public health scientists and scholars,
and can also serve as an introductory text for students in public
health ethics, or as part of a general applied ethics course.
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