Unrelieved pain: an ethical and epistemological analysis of distrust in patients.
Bibliographic record
Abstract
Unrelieved pain is a serious clinical problem that has received little attention in bioethics. This paper contends that unrelieved pain is the result of distrust in patients that reveals both an ethical and epistemological failure on behalf of nurses and physicians. The analysis is conceptually framed in previous work on the articulation of trust in nursing. Specifically, an argument is made that clinicians do not trust patients' subjective experiences, distrust patients from marginalized and relatively less powerful groups, and resist entrusting themselves or becoming vulnerable to patients' pain and suffering. The authors discuss the need for awareness and critical examination of deeply entrenched societal beliefs and values that influence everyday decision-making in pain management.
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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 | 0.013 | 0.030 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.006 | 0.044 |
| Scholarly communication | 0.008 | 0.006 |
| Open science | 0.001 | 0.006 |
| Research integrity | 0.004 | 0.006 |
| Insufficient payload (model declined to judge) | 0.001 | 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".