Philosophy & Ethics Special Interest Group

'All of us are people who all think deeply about our vocations in the wilderness of pain, a universal phenomenon that is poorly diagnosed, treated, and alleviated, despite the best and most dedicated efforts of compassionate clinicians, top of the line hospitals, research, and pharmaceutical products in some parts of the world.'
- Katherine Irene Pettus, Pain News 2014 12(3): 146-147.

Chair

Dr Tim Johnson

Secretary Dr Maureen Tilford
Communications Officer Betsan Corkhill
Transcript Officer Dr Peter Wemyss-Gorman
Council Liaison Officer Dr Ramanarayan Krishnamoorthy 
Year Formed 2004
Number of Members 116

Contents

  1. Contact
  2. About the group
  3. Meetings
  4. Transcripts
  5. Photo album and recommended reading
  6. Feedback
  7. Pain, Suffering and Healing (Book)
  8. Innovative approaches to Chronic Pain: understanding the experience of pain and suffering and the role of healing.

Contact

To contact the Philosophy& Ethics Special Interest Group, please e-mail in the first instance the Secretariat who will forward your message to the SIG Secretary Maureen Tilford.

 

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About the group

Our origins

Our origins lay in a conversation at the IASP Vienna conference in 1999 where, as usual on these occasions, we had been battered by science and the unremitting message from the drug industry that no effort or expense could be spared in the fight to defeat the evil of pain. There seemed to be little obvious relevance of much of this to the everyday realities of dealing with distressed human beings in the pain clinic, nor acknowledgement of the reality that we didn’t seem to be making much progress in winning the battle. So much of our time is spent on the practicalities of clinical pain medicine and the minutiae of research that we can rarely spare enough time to step back and reflect on our role in addressing suffering. We are so busy trying to answer 'how' questions that we fail to address the 'why' questions that trouble us and our patients the most. So it occurred to us that it might be useful to try to arrange some sort of meeting to reflect on what we were trying to achieve and should be realistically expecting to achieve, and how to accept and cope with our relative impotence in the face of so much unrelieved pain.

In the summer of 2001 a group of us got together at Scargill House in the Yorkshire Dales to tackle some of these questions – not perhaps expecting to find answers but at least to share some of our perplexities and anxieties. This conference, entitled 'The Inevitability of Pain?' was intended as a 'one–off' but the need for a forum for further discussion was immediately apparent and has resulted in a series of annual gatherings. The core group was recognised in 2004 as a Special Interest Group of the British Pain Society.

Our focus

Our meetings are different. Besides addressing topics not normally covered by major 'scientific' meetings, the programme is designed to maximise participation by the audience, and the remit of speakers is to stimulate rather than to inform debate which, both in full session and informal conversation, takes up a major proportion of our time.

The title of the SIG may give the impression that our deliberations are somewhat 'cerebral' and divorced from the realities of everyday clinical practice, but this would be a misleading picture. Although we have greatly benefitted from the guidance of philosophers, theologians and ethicists the participants are mostly those whose daily work is essentially clinical and practical. Their first priority is to try to relieve pain. But as well as the limitations of our ability to achieve this there are many ethical and other dilemmas involved in the practice of pain medicine which give rise to uncertainty and anxiety. These meetings provide a unique opportunity to share doubts and problems and to learn from the insights of colleagues from around the world.

 

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Meetings

Our annual three-day meetings are held alternate years at Rydal Hall in the Lake District and Launde Abbey in Leicestershire (both Diocesan retreat centres, although the meetings are not religious in content and open to those of all faiths and none), which being set in some of the loveliest landscapes in Britain, provide ideal surroundings for meetings of a reflective nature, as well as for the mental and physical recreation so much needed by people wearied by their daily work with human pain and distress. Time is set aside every afternoon for walking when - as well as in the pub in the evening! - we have many of the most fruitful conversations.

Webinars

Although we were able to hold our first annual residential meeting since Covid lockdown at Rydal Hall this year we are resuming our succesful   series of monthly Zoom webinars  to discuss some of the issues and dilemmas that face us in managing chronic pain and explore  key areas or challenges in everyday clinical practice. The format is  a 30-minute plenary talk by an authority on the evening's topic  to stimulate 60 minutes of moderated discussion. These sessions  have been very well attended and highly commended by those taking port. The meetings  are  free and open to non-members of the BPS, and it has been  an unanticipated pleasure to welcome  participants from all over the world! 

Next meeting:

 3rd October 2022 at 19.30 

 'My Personal Experience'

Charles Balcombe

 

About me: In 2013, after developing some sciatic pain I had a microdiscectomy at L5/S1. There were complications with the surgery and I suffered a foot drop. This was the start of my relationship with chronic pain. From 2013-2018 I had 4 further spinal surgeries, became heavily dependent on Oxycodone and day by day saw everything I cared about and cared for fall apart. After one particularly close dalliance with suicide towards the end of 2018 I realised something had to change although at this time I had no idea what. By mid 2019 I had taught myself the basics of the science of pain and had started to make some changes to my lifestyle based on my understanding of this science. By early 2020 my pain levels had reduced to a level at which I was able to wonder whether I could create a product for others living with complex pain, to help them reduce or resolve their pain and hopefully prevent them from suffering for as long as I had. This is when I started working on Paind, which is really a movement towards a more pain-informed society and for now takes the form of an App. I am really excited to speak to the SIG, many of whom I met at Rydal Hall, because without the buy in of pain-informed and pain-inspired clinicians, no amount of championing from people like me will move the needle.

 I would like to talk about my journey and the pain-points (excuse the pun) along that journey which amplified my problems, so that the subsequent discussion can look at “how can we prevent others experiencing the same?”

 

 

 

 

 

 Requests for information and Zoom links for this and future meetings can be directed to the secretary, Dr. Maureen Tilford tilford.maureen@gmail.com. Numbers are limited and early application is recommended

 

This year's annual meeting: 

 

 

British Pain Society Summer Retreat

Hosted by the Philosophy and Ethics SIG

Rydal Hall, Cumbria 19th -22nd June 2022

Understanding pain in a complex world: thinking out of the box

Join us at our Summer retreat at the 17th Century mansion, Rydal Hall, Cumbria in the beautiful surroundings of the lake district from 19th to 22nd June. 

Our aim  is to enable everyone to reflect, recharge and relax. Our programme is structured around interesting speakers but formal and informal  discussion is an important feature of our meetngs. There is time off in the afternoons to enjoy the gardens, parkland and the surrounding hills and lakes, and some of the most fruitful  conversations  take place on walks in the glorious countriside.  Rydal water is a few minutes walk away so wild swimming is an option for the courageous! In the evening you might head off to the local hostelry, The Badger, where continuing discussion is lubricated  by  the excellent local beer !  

As an alternative to staying in one of the rooms some people  prefer to camp in the grounds or stay in one of the yurts. Partners are welcome. 

 

 

 

Past meetings

See details and reviews of previous meetings.

 

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Transcripts

All talks and discussion at our meetings are recorded and transcribed . You can download all previous transcripts, for free, here. Shortened versions of many talks have  also been  published in Pain News.

 

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Over the years members have taken countless photos to comemmorate our meetings and their beautiful surroundings. They have agreed to share some of them, which will be made available here.

Members have also formerly contributed to an e-mail circular of literature pertinent to the group's remit. We hope that including these links on this website will be a useful addition. The material can be accessed on this page.

 

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Feedback

Some key feedback from past meetings is presented below – we would like to thank all those who have taken the time to reflect on the meetings and provide their very useful thoughts and insights. If you have attended any of our meetings, we would really value your thoughts on how we can improve and further our aims.

  • ‘The whole meeting gave me a great deal of food for thought and I find myself reviewing my notes. I think the most interesting thing was the opportunity to be an outsider, as it were, to jump the fence and look at situations from a different standpoint. Doctors – not unnaturally – tend to regard cancer, for example, as primarily a medical situation and themselves as the primary agents in its treatment. But actually many patients do not think like that.’
  • ‘I’m really glad I attended. If there’s a space, then I would be very interested in attending again.’
  • ‘It was one of the most stimulating meetings I have attended for many years and gave us all an opportunity to escape from the “medical tramlines” in which most of us are trapped for most of the time. I came away with some new ideas, new thoughts and an intention to put some of them into action with respect to the developing countries programme.’
  • ‘It is unique! I felt totally recharged by the week.’
  • ‘… the most holistic group of mainstream practitioners that exists today.’
  • ‘… such a refreshing change to any other educational meeting I've been to before. The setting was quite beautiful too. I'm looking forward to next year already.’
  • ‘The Philosophy and Ethics SIG has become a real treasure within the Pain Society. … Long may it continue.’
  • ‘This was again an excellent meeting well organised and executed! The subject was down to the point and relevant to everyday practice. It was very nice to see how over the progress of the meeting all speakers where able to connect with the previous content. Loads of learning points to take away!’
  • (From John Loeser. co-founder with John Bonica of IASP)  This has been a fascinating experience for me and I greatly appreciate the invitation to join you. The chance to participate in less than formal presentations and discussions is relatively rare. I have been to plenty meetings in my life and heard many plenary lectures and attended workshops etc. but you have a lovely format that is very satisfying for people to participate in. 

 

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Pain, Suffering and Healing (Book)

Pain, Suffering and Healing: insights and understanding is a book published in 2011. It contains 11 essays by past speakers at our meetings on the issues of unsatisfactory relief of chronic pain, the inadequacy of scientific biomedicine in offering answers, and ethical problems arising in pain medicine. It is edited by Peter Wemyss-Gorman and has a foreword by John D Loeser.

 

Since the doctors who write here work largely in pain clinics, they often confront long-term pain that has not yielded to ordinary treatments. As they point out, these cases call for a much wider kind of thinking, a background conceptual map that must be very different from the blank division between mind and body that informs the accepted dualist approach. When the obvious physical remedies have already been tried, a new paradigm is needed – one that really takes on the person as a whole. As they show, understanding that person’s problems can sometimes directly relieve the pain. And, even where it does not, it may still make it possible to manage it more effectively.

- Mary Midgley, Moral Philosopher, book review Pain News 2012 10(1): 53.

 

Reference: Wemyss-Gorman P (ed). Pain, Suffering and Healing: Insights and Understanding. London: Radcliffe Publishing, 2011. The book is available in paperback (ISBN 978-1-84619-326-2).

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Innovative approaches to Chronic Pain: understanding the experience of pain and suffering and the role of healing.

Editor Peter Wemyss-Gorman. 2020

This book sets out to restore the concept of healing to its place within and beyond pain medicine, in chapters authored by keynote speakers to the British Pain Society's Philosophy and Ethics Special Interest Group. Exploring psychological, spiritual and creative approaches, contributors reflect on therapeutic avenues ranging from the deliberate use of the placebo response and the importance of a caring relationship between patient and practitioner, to the use of knitting as a therapeutic tool. Barriers to the flow of healing such as practitioners' careless use of language and cultural attitudes are identified and contrasted with the need to understand the first-person perspectives of people who are suffering. This book will provide hope and inspiration both to people who have become disillusioned with conventional medical approaches to the relief of their pain, and to health professionals sadly aware of the frequent inadequacy of their efforts to help them.

This valuable book addresses two key dilemmas. First, chronic pain is always more than a signal of tissue damage, which is why standard biomedical approaches fail. Second, multidisciplinary treatments (focused on a narrow band of the cognitive-behavioural spectrum) are not multidisciplinary enough. A holistic approach, by contrast, opens our understanding and treatments to the physical, mental, emotional, and social lived experience of chronic pain. It holds important resources for physicians, therapists, patients, family members, and anyone seeking a better way.

David B. Morris, author of The Culture of Pain, Illness and Culture in the Postmodern Age and Eros and Illness

 Wemyss-Gorman P. (ed)   Innnovative Approaches to Chronic Pain Jessica Kingsley Publishers  Paperback / ISBN-13: 9781787751873

 

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