[elliekelly]

That was really surprising to me. I’m not a doctor but it seems easy enough to assume that patients in a vegetative stage can feel pain and medicate them accordingly. The risk of over medicating in that situation seems to be outweighed by the risk of someone having to suffer in silence.

The assumption that someone who can’t communicate pain is unable to feel pain seems misguided at best.

[nonbel]

This type of thing is standard in healthcare. Doctors only began saying babies felt pain in the late 1980s, and only then because a mom made a big fuss in the media about it when she discovered on accident that her baby received open heart surgery without anesthesia.

All of a sudden the decades of research that had been interpreted as showing babies didn't feel pain was overturned and new research showed they did.

Medical research really is mostly a series of fads.

[adrianN]

I can imagine that there are legitimate reasons not to use anesthesia on babies who show no signs of remembering the pain when they've become able to communicate. Anesthesia is not without risk, probably doubly so for a developing brain.

[nonbel]

So? Does that mean babies don't feel pain? Because that is what the medical profession concluded. Here is a good overview: http://nocirc.org/symposia/second/chamberlain.html

[scotty79]

You are in an accident and have to be operated on, but using anesthesia would drop probability of survival from 90% to 10%. They can give you instead a drug that will prevent you from remembering pain that has no influence on probability of success operation.

What would you chose?

I'm not saying that this is the exact case with infants. Just trying to illustrate there might be valid reasons to inflict temporary pain to save health.

[adrianN]

Technically we don't know whether general anesthesia actually prevents you from feeling pain, or whether it just prevents you from forming memories. As far as I know at least.

[falsedan]

General anesthesia is usually a combination of multiple drugs. We know exactly what each drug does, medical science isn’t so good at explaining why the drugs have these actions. anesthetists combine these drugs to suit the requirements of the procedure and the patient

Anesthesia usually includes drugs with distinct, separate actions, like an analgesic (to block pain receptors), muscle relaxants (so patients can be moved/organs accessed), CNS depressants (to prevent unexpected spasms disturbing the surgeon), coma-inductors (so patients don’t chat with the staff and freak them out after practicing on cadavers for years), and amnesia-inductors (because surgery is kind of gross).

[mattkrause]

I guess that's technically correct, in that it's difficult-to-impossible to "know" about someone else's subjective experiences.

On the other hand, painful stimuli tend to (e.g.) increase a person's heart rate and blood pressure, and that the proper anesthetic plane blocks those responses, so it's clearly doing something in the moment. What we don't know every well is the mechanism of action for general anesthetics.

[wycy]

I would imagine that we must know that by now. We should be able to just see on a brain scan whether the pain centers are lighting up in response to pain.

[qwsxyh]

I would choose the anesthesia, obviously.

[nonbel]

I would clearly choose to have doctors believe that I could feel no pain... That way there is no trade off.

[gekkeboom]

death for sure.

[b_tterc_p]

I would rather suffer pain as a baby than permanent brain damage from anesthesia. It’s not a simple choice.

[roywiggins]

It seems like a case of motivated reasoning. Doctors needed to operate on babies; anesthetizing them would be hard. So they decided that babies can't feel pain and never investigated methods of anesthesia on babies.

[dsfyu404ed]

More like anesthetizing them would be risky and they're not gonna remember it so it's not worth the increased risk to their life since infants are already fairly fragile and saving their life is the primary goal.

It's not just "it's hard and we're lazy so lets make up an excuse" like you seem to be implying.

Edit: Since apparently it wasn't clear, we're talking about the timeline when this issue was hashed out, so the 1980s. Anesthesia carried substantially more risk then because back then we didn't understand it nearly as well.

[roywiggins]

We anesthetize infants fairly often now[1]. It's still a bit risky, but it's fairly common. It's gotten less risky because we do it a lot and have gotten quite good at it. If we'd never revised the science on infant pain, we never would have even bothered to try. Turns out, it's possible to do it fairly safely.

It's one thing to say, we're not going to use anesthesia because it's too much risk, it's another to say that they don't feel pain at all so let's not worry about it.

[1] http://europepmc.org/abstract/med/26958696

[roywiggins]

We're better at anesthesia now, but would we have ever gotten good at anesthetizing babies if we kept believing that they didn't feel pain in the first place? Why bother working out how to do it if we think they don't feel pain?