Explaining Unexplained Chronic Pain: Epistemic and Ethical Challenges

During good clinical encounters, patients and clinicians seek a wide range of goals. One frequent goal is to provide an explanation of illness. That is to say, they seek to answer the question “Why am I sick?” Standard models of medical explanation focus on causation: what made things go wrong? These causal-centered approaches are unhelpful—or worse—when medical science doesn’t know what caused the problem. Typical examples include fibromyalgia, TMJ, or irritable bowel syndrome. In this paper Dr. DeCoster problematizes traditional accounts of medical explanation in cases of chronic pain. He asks, for instance, about the role of the patient in generating explanations, and highlights the moral implications for patient care of competing explanatory projects. Rather than giving up on the goal of disease explanation, Dr. DeCoster argues for rethinking our explanatory strategies and resources.
Barry DeCoster, PhD
Visiting Instructor in Lyman Briggs College at MSU
Recorded February 16, 2011