Patient Advocacy, Drug Promotion, and the Feminist Paradox: An Analysis of the Canadian Pain Coalition
Bibliographic record
Abstract
Healthcare has changed significantly over the past few decades with the emergence of neoliberalism as a dominant ideology informing policy. This paper examines the Canadian Pain Coalition’s (CPC) conceptualization of chronic pain and its treatment in the context of neoliberalism. Through content analysis of the CPC’s online materials, we show how the advocacy group constructs pain as an individual’s responsibility and a physical disease that can be managed primarily with pharmaceutical medication. Drawing on insights from the social determinants of health and feminist literatures, we suggest that the CPC’s construction of pain as a physical disease, an individual responsibility, and its emphasis on pharmaceutical treatment is inadequate in addressing the complex social, economic, and physical needs of people living with chronic pain. Taking up Susan Markens’ concept of the “feminist paradox,” we suggest that there is a necessary tension in the construction of pain as disease. On the one hand, it is constructed in terms of providing access to treatments, while on the other, it potentially medicalizes people living with chronic pain. Finally, we discuss how the CPC does not adequately address the side of the tension concerning medicalization, given the strong association between the CPC and the pharmaceutical companies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.018 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.007 | 0.010 |
| Science and technology studies | 0.034 | 0.015 |
| Scholarly communication | 0.008 | 0.003 |
| Open science | 0.002 | 0.006 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.008 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".