Infants' sense of pain is recognized, finally (1987) • Hacker News Board

Re: Infants' sense of pain is recognized, finally (1987)

#181

Post by carpo » Wed, Jun 15, 2022, 4:09 AM UTC

Salgat wrote: post #157

BitwiseFool wrote: post #4

This is, I believe, one of the downsides of empiricism and the fixation on citation rather than observation and reason. The idea that a whole profession came to reject the idea that infants are able to feel pain is astonishing, especially considering anyone who has ever taken care of infants knows that these little human beings react to things which are known to be painful. Babies feeling pain is something that shoul…

The argument is not whether they react to stimulus we consider painful, but if they feel it in a way that mature humans understand as pain. Babies take months just to understand that they have hands, they're incredibly simple minded, so the question was whether they even had a real concept of pain beyond "stimulus and instinctual reaction". Similar to how an insect will react to pain but it's just doing what it's pro…

I don't think you need to understand what suffering is to feel it.

Re: Infants' sense of pain is recognized, finally (1987)

#182

Post by wutbrodo » Wed, Jun 15, 2022, 4:15 AM UTC

ajsnigrutin wrote: post #113

mike00632 wrote: post #75

Earlier quoted context omitted.

I'm afraid it's the case that most all surgeries on infants (circumcision) are elective and performed for aesthetic reasons. For males it's likely they only time they will go into shock from pain during their lives.

I find it sad, how people universally agree that female genital mutilation is bad, because cutting off parts for no medical reason is bad.... but then do the same thing to boys, "just because".

Most people don't have anything remotely close to what you'd call "beliefs", so no consistency is required between one pseudo-belief they might hold and another.

Re: Infants' sense of pain is recognized, finally (1987)

#183

Post by dang » Wed, Jun 15, 2022, 4:24 AM UTC

MisterMower wrote: post #170

lotsofpulp wrote: post #66

Earlier quoted context omitted.

And with all the regulation around healthcare in the US, male genital mutilation is not only perfectly legal, but also legal to be done by some with no medical certifications, outside of a medical setting, and it is legal for them to suck the blood from the mutilated area with their mouth, increasing risk of disease for the infant. https://en.wikipedia.org/wiki/Mohel Can you imagine a new cult starting today that beh…

Quoted post unavailable.

Could you please stop posting unsubstantive and/or flamebait comments to HN? You've unfortunately been doing a lot of that, and we're trying for a different sort of forum. We want curious conversation, not (for example) ideological battle, regardless of what you're battling for or against.

If you wouldn't mind reviewing https://news.ycombinator.com/newsguidelines.html and taking the intended spirit of the site more to heart, we'd be grateful.

Re: Infants' sense of pain is recognized, finally (1987)

#184

Post by parentheses » Wed, Jun 15, 2022, 4:29 AM UTC

BitwiseFool wrote: post #4

This is, I believe, one of the downsides of empiricism and the fixation on citation rather than observation and reason. The idea that a whole profession came to reject the idea that infants are able to feel pain is astonishing, especially considering anyone who has ever taken care of infants knows that these little human beings react to things which are known to be painful. Babies feeling pain is something that shoul…

SV and tech in general too often romanticize hyper-rational-ness. It's both good and bad. Bad in situations like this.

Re: Infants' sense of pain is recognized, finally (1987)

#185

Post by parentheses » Wed, Jun 15, 2022, 4:33 AM UTC

sydd wrote: post #6

It's fucking scary, that this was recognized in 1987. In the 80s and even in the 90s most places did complex operations on newborns without any kind of painkillers -- imagine a heart surgery without painkillers. Not to mention "simple" stuff like circumcision. Also by this time they knew this about animals too. I think people will look at us as barbarians that we ate them when we knew that they feel pain, can sense t…

(NOT advocating for baby pain here..)

Anesthesia is dangerous. It's easy to say "solve pain", but there are trade-offs.

Mothers giving birth need to be closely monitored when they're given pain meds. It's hard to believe that infants' frail bodies can handle strong pain-killers at the levels used in surgery. There's also a long-term damage to consider. Infants' bodies are growing and changing so rapidly. Similar to smoking or drinking while pregnant, a change to the chemistry of the body is a change that can have long-lasting and hard-to-study negative effects.

This type of hyperbolic commentary is not productive discussion.

Re: Infants' sense of pain is recognized, finally (1987)

#186

Post by kqr » Wed, Jun 15, 2022, 4:36 AM UTC

mcswell wrote: post #167

While I view the modern approach--give the infant some anesthetic--as best, here is another thought about not being able to remember the pain afterwards (reportedly babies that were operated on without anesthesia have no memory of it, even years later). I have had several colonoscopies, dating back 20 years or more. (Yes, I am that old, and get off my lawn.) For the first couple, I remember it as at best uncomfortabl…

Yeah, this is an interesting aspect of the problem for me. Is it unethical to hurt someone if you're doing it in a way that they definitely won't be able to remember later?

Would you like to go through extreme torture (without lasting physical damage) if you could get a guarantee that you wouldn't remember any of it once it's done?

Are we who we are now, or are we our memories of our past?

This is not just academical, it has practical polic consequences: our perception of how painful a procedure was is based primarily on two things: how painful it was at its worst, and how painful it was at the very end. So a procedure can seem a lot less painful if you subject the patient to pain over a longer time (instead of an intense peak) and end on a softer note.

But of course, that's when you're asked to judge the painfulness of the procedure after the fact -- not while you're undergoing it. When you're undergoing it, you might want it to end quickly, even if that means higher intensity pain.

Who should you satisfy? Patient on the table now, or patient tomorrow after a good night's sleep?

Re: Infants' sense of pain is recognized, finally (1987)

#187

Post by prvc » Wed, Jun 15, 2022, 4:36 AM UTC

natroniks wrote: post #90

lotsofpulp wrote: post #66

Earlier quoted context omitted.

And with all the regulation around healthcare in the US, male genital mutilation is not only perfectly legal, but also legal to be done by some with no medical certifications, outside of a medical setting, and it is legal for them to suck the blood from the mutilated area with their mouth, increasing risk of disease for the infant. https://en.wikipedia.org/wiki/Mohel Can you imagine a new cult starting today that beh…

I'm a circumcised male who has decided to have all 3 male children circumcised. As a Jew, if I may weigh on this, you have my background for an conflicts or biases. Also, maybe content warning is in order for genital mutiliation. 1) It is absolutely not common practice to allow a mohel to orally suck the blood out of an infant's penis. If it's practiced at all, it is only in extremely fringe groups of Jews, not just…

There is a more common version which uses a glass pipette for the suction stage, in order (presumably) to avoid direct contact between mouth and wound, but crucially, this offers little or no hygiene advantage compared to the full-on ritual. The prevalence of either version, however, is of little consequence, considering that they are both legally permitted and widely defended.

Re: Infants' sense of pain is recognized, finally (1987)

#188

Post by aaron695 » Wed, Jun 15, 2022, 4:40 AM UTC

BitwiseFool wrote: post #4

This is, I believe, one of the downsides of empiricism and the fixation on citation rather than observation and reason. The idea that a whole profession came to reject the idea that infants are able to feel pain is astonishing, especially considering anyone who has ever taken care of infants knows that these little human beings react to things which are known to be painful. Babies feeling pain is something that shoul…

No post body was provided.

Re: Infants' sense of pain is recognized, finally (1987)

#189

Post by antognini » Wed, Jun 15, 2022, 4:41 AM UTC

mcswell wrote: post #167

While I view the modern approach--give the infant some anesthetic--as best, here is another thought about not being able to remember the pain afterwards (reportedly babies that were operated on without anesthesia have no memory of it, even years later). I have had several colonoscopies, dating back 20 years or more. (Yes, I am that old, and get off my lawn.) For the first couple, I remember it as at best uncomfortabl…

My dad is an anesthesiologist and I've heard similar things from him. Anesthetics have three goals: 1. Elimination of pain; 2. Loss of consciousness; 3. Loss of memory. Of these, he was saying that the most important is the last. If you have no memory of the pain, in some sense it didn't really happen.

It does sort of make sense that they are okay with the patient experiencing some pain because anesthetics (at least those used for general anesthesia) are very dangerous drugs. There is a metric called the "therapeutic index" given to drugs, which is the ratio between the amount needed to get the medical benefit to the amount needed to kill you. Most drugs in medicine have a very high therapeutic index, like 1:100 or 1:1000. (Morphine is around 1:70 for instance.) But the drugs used for general anesthesia are closer to 1:2. So there's very little margin for error which means they try to provide lower doses if at all possible.

Re: Infants' sense of pain is recognized, finally (1987)

#190

Post by tomcam » Wed, Jun 15, 2022, 4:43 AM UTC

jnovek wrote: post #85

BitwiseFool wrote: post #4

This is, I believe, one of the downsides of empiricism and the fixation on citation rather than observation and reason. The idea that a whole profession came to reject the idea that infants are able to feel pain is astonishing, especially considering anyone who has ever taken care of infants knows that these little human beings react to things which are known to be painful. Babies feeling pain is something that shoul…

“Babies feeling pain is something that should be self-evident, shouldn't it?” I have yet to understand the historical underpinnings of this phenomenon, but as someone who deals with chronic pain, doctors don’t seem to be aware that people feel pain _in general_. I’m being sort of facetious, but any chronic pain community is full to the brim with stories of various medical professionals being skeptical of patients’ pa…

My stock joke is that if the doctor or nurse says it won’t hurt, it will hurt at least a little. If they say it will hurt a little, it will hurt a lot. If they say it will probably hurt, time for serious anesthesia.

Also, there’s pretty much no such thing as minor surgery except maybe skin tag removal.