Live data from Hacker News

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

nytimes.com

301–310 of 387 posts

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

#301

Earlier quoted context omitted.

And if doctors are worried, the first step should be doing actual tests to see if people are experiencing pain. Not making some judgement based on their cynical bias whether someone is lying or being truthful. It is amazing how much of the medical community states they believe in science, yet they seem entirely disconnected from it at times.

Sure, just like instead of prescribing anti-depressants, we should first do a depression test. Unfortunately, neuroscience is not at a level where we can actually perform these tests. There is no objective measure to see if someone is in pain, or depressed, or suffering many other psychological symptoms.

Actually, there are tests now for depression. And yes, you can do objective tests like brain imaging to see people's responses to stimuli among other things. What should not happen is for doctors to meet someone for 20 minutes, do nothing but talk to the person and say.. oh, I don't trust them they must be lying. Except, that is what doctors do all the time and there is no scientific basis for their decisions.

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

#302

Earlier quoted context omitted.

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…

> I grappled with the decision to have brises for my sons. I don't think it's possible to know or define how traumatic such a procedure is; is it worse than giving a 6-month old pierced ears? Yes, the foreskin doesn't grow back > Is it worse than travelling through the birth canal and having your umbilical cord severed? Yes, because travelling through the birth canal is required to live, and doesn't affect sex in lat…

> Yes, the foreskin doesn't grow back Lip and tongue ties don't grow back. Neither do teeth. Parents remove their kids' body parts if they think it's best for them. Are straight teeth healthy or just aesthetically pleasing? Is clear speech healthy or just valued in our culture?

> Yes, because travelling through the birth canal is required to live, and doesn't affect sex in later life. Also, it doesn't result in any amputations. How does circumcision affect sex in later life? If circumcision is amputation, what is removing an unsightly birthmark? Or as I've said, teeth, extra skin in one's mouth...

> We do. There's a ton of nerve endings there. Slicing of a particularly sensitive area (due to the concentration of nerve endings there) is going to be painful. Being birthed causes extreme trauma. That's why doctors measure a baby's oxygen and heart rate. So clearly some amount of pain is worth it if the gain outweighs the pain, no? Then you have to ask what is gained through ritual circumcision. The gain is religious and cultural value, so it's hard to measure precisely. But, you know, Christians give alcohol to kids every Sunday and no one's complaining.

> If you want to do it, you need to show some evidence that it is not, not throw your hands in the air and say "well, we don't know").

I'm suggesting that we consider not everything that seems obvious is in fact obvious. Should I keep my kid from having routine blood drawn or vaccination because the needle hurts? Stop clipping their nails or cutting their hair? These are all cultural practices, there's nothing intrinsically good about grooming in this way.

> I think your are deluding yourself - few doctors visits or trips to the park results in cutting off a very sensitive part of the body. I am trying not to delude myself. I am trying to clarify one thing for myself and one thing for others. For others, I want them to understand oral suction during a bris is basically unheard of outside of a fringe group. For myself, I'm trying to clarify if circumcision results in long term pain (psychological or physical)

> It is a fairly easy topic.

I think we agree. As I said, it should be easy to talk about and yet there are multiple factors one must weigh. This makes it compicated, but I'm happy we're talking about it.

> The question of "Should we amputate a part of a newborns body, one that affects future enjoyment, and known to be incredibly sensitive" is an easy one to answer.

I think the question is based on a false premise. How can one measure the joy of sex, and even if you could how would you say "this person gets less out of sex than if he had his foreskin." How can you say what the same person would feel in a hypothetical scenario? I'll just point out this very argument dates back to antiquity. Plutarch has a piece about Jews and discusses ritual circumcision - iirc he takes the stance that circumcision leads to more sexual activity and depravity because the penis is always uncovered. Greeks and Romans thought uncircumcised penises were vulgar, gross, and a sign of overt sexuality. So I would be fascinated to understand the opposite position, which you put forth, that circumcised men get less joy from sex.

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

#303
post #228

Earlier quoted context omitted.

And if doctors are worried, the first step should be doing actual tests to see if people are experiencing pain. Not making some judgement based on their cynical bias whether someone is lying or being truthful. It is amazing how much of the medical community states they believe in science, yet they seem entirely disconnected from it at times.

How can you, with an objective test, determine whether or not I am experiencing chronic pain, or if I'm just pretending to be experiencing chronic pain?

Brain imaging would be a good example, but there is cortisol screenings among several other tests that can help determine that someone is actually in pain.

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

#304
post #174

Earlier quoted context omitted.

It's sad you have to explain all of this. For some reason casual bigotry is now considered acceptable if it's for the sake of what they believe is a good cause. That's a shift I've noticed recently, as a member of a religion that gets a lot of hate. It portends sad things for our society

> casual bigotry is now considered acceptable It's not bigoted to be against mutilating boys. Don't hide behind religion to justify barbaric practices. Most Americans don't mutilate because of religious reasons. Somehow we all agree that female mutilation is horrible, but when it comes to boys it's controversial.

Is it ok to have your 12 year old's teeth pulled? Is it ok to get your toddler's fremulum removed? I can argue that the very idea that the body should remain intact is itself steeped in religiosity. The belief that the body we start with, we should end with, is tied to the idea of Resurrection and the Last Judgment.

> Somehow we all agree that female mutilation is horrible, but when it comes to boys it's controversial

FGM is something that affects their body's function. What is the function of the male foreskin? What malfunction arises after circumcision?

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

#305

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".

If you want something even more shocking, ask them how they feel about docking a dog's ears or its tail, then ask them how they feel about routine infant circumcision. For maximum cognitive dissonance, inform them that docking ears and tails is done for both aesthetic and purported hygiene reasons.

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

#306
post #281
post #95

Earlier quoted context omitted.

It's not so simple. Circumcision in neonate males is a medical prophylactic. The evidence for harm is weak as well. https://slatestarcodex.com/2019/12/10/acc-is-infant-circumci...

>medical prophylactic The whole point of circumcision is to control the actions of the person later in life. This is extremely harmful, as you are removing another individual's agency for your own religious beliefs (or even worse, the mere notion "I was circumcized and I don't want my son to look different", which is pure vanity). Genital mutilation is abhorrent. It should be illegal to perform on any infant or child…

> The whole point of circumcision is to control the actions of the person later in life.

How so? According to Judaism, the whole point of circumcision is to bear the mark of the promise between God and Abraham. But if you ask me, a modern non-orthodox Jew, circumcision is a rite of passage just like Communion, or Bar Mitzvahs, or any other non-natural step in growing up. It's different for everyone and no one has asked me why it is important. But I think that's really what it comes down to, Circumcision in Judaism is a physical and indelible representation of our belonging to a community whose practices have shifted and adapted over the millennia. One of the very few practices that is described in the Torah and is also carried out today is the brit milah. So, it's carrying on tradition. It is a connection (membership?) to a rather diverse group of people. It transcends geography and time, culture and language. It may be arbitrary - maybe Jews could've figured out another way to achieve all this. But I still don't understand the harm caused by circumcision. At least, no more harm than is caused by a huge number of medical procedures all types of kids may undergo as minors.

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

#307

Earlier quoted context omitted.

It’s because people lie for many reasons. So? The first response should always be to take folks seriously. Always. Even if they are really searching for opioids. No doctor should assume folks are lying upfront. Even if that means that a couple people are getting off work when they don't need it. And I'd much rather have a disability system that occasionally gives the wrong people benefits than to withhold benefits fr…

Spitballing, but maybe the problem is that no doctors wants to be the guy in town who's the most generous with opioid prescriptions, as then he'll get swamped by people seeking opioids? People who look at the statistics after that, finding our doctor prescribing a significant amount of all opioids in the community, are liable to think that he's some sort of unscrupulous stooge of a pharmaceutical company. That'd caus…

Was being given opioids for chronic pain (nerve pain from autoimmune). but not consistently, so I'd often run out.

I was constantly pushing doctors to try alternate treatments so I can deal with actual issue rather then take pain meds. They had no interest. Took me 3 years to finally get a prescription to LDN, which finally worked for me.

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

#308
post #241

Earlier quoted context omitted.

Lucky you, if you dont have genetics were anesthesia do not work properly. Then find a doctor, who accepts that problem and gets it over with painful but fast. The hardest part is if you have a dentists that insist on anesthesia must work, but it wont, so you must act your ass off to prentend to not be in pain, so he wont push syringe after syringe, doing nothing and waiting for 15 minutes in between while your tooth…

So you’re one too. No dental anesthetics work on me. I have to go under general anesthesia, where you’re knocked out so deep a machine has to take over your breathing. So every procedure starts at about $10,000 and that’s not counting the dental work. All out of pocket. No insurance coverage.

Did you try nitrous oxide?

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

#309
post #112

Earlier quoted context omitted.

Yes. To make matters worse, the opioid epidemic is real; regardless of the cause, it’s not just war on drugs hysteria. It ends up that opioids are terrible drugs. Aside from the obvious habit forming stuff, there’s things like hyperalgesia and central sensitization — long-term opioid use can screw up how your brain processes pain. I witnessed the decline of opioids in the latter-half of the 2010s firsthand from the p…

> It ends up that opioids are terrible drugs. Opioids ruin lives. Opioids restore lives. People die from taking them. People are functionally dead when they're unobtainable. The most false thing about opioids is that they are any one thing. I've used hydrocodone for months at a time. It's addictive so there are protocols that need to be followed. Stick with the dose and taper when done. However, that was in the past.…

Fully agree. Spent 5 years going on and off Tramadol. If I found myself craving it I would stop for a month. I was basically in bed in pure agony during those weeks off. I've seen others that literally kidnap their own mothers to get opioids.

Eventually found LDN and that stopped the pain.

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

#310
post #261

Earlier quoted context omitted.

My wife has sleep apnea and her BMI is 19. So, not necessarily.

Congrats I guess? Your wife is an exception to a very well established norm. Losing weight is a treatment so good (as in, effective, safe, cheap) that most doctors will recommend it as the number 1 step in treating sleep apnea. "What is becoming increasingly clear is that we need to continue to strongly advocate weight loss for all our patients, regardless of the severity of their OSA or adherence to our other therap…

Saying "congrats", whether ironic or not, comes off as insensitive at best.
Post reply on HN