Cancer Therapeutics

The Cancer Problem ◽

10.1093/oso/9780198866145.003.0004 ◽

2021 ◽

pp. 65-97

Author(s):

Agnes Arnold-Forster

Keyword(s):

Cancer Therapeutics ◽

Palliative Surgery ◽

Close Attention ◽

Patient Pain ◽

Pain And Suffering

This chapter investigates the invention, application, assessment, and justification of palliative surgery through the work of two practitioners: Charles Bell (1774–1842) and James Young Simpson (1811–1970). As this chapter will show, close attention to patient pain and suffering was essential to surgeons’ assessments of the efficacy of palliative surgery. Bell and Simpson performed palliative procedures partly because they were concerned by their patients’ suffering and, as suggested in Chapter 2, partly because they wanted to present themselves as enlightened, improving gentlemen. Indeed, the texts analysed here—and the promotion of palliative surgery more generally—provide an alternative portrayal to that of the crude and dispassionate Victorian practitioner.

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2008 Update on the Medicare Exceptions Process

Perspectives on Administration and Supervision ◽

10.1044/aas18.1.10 ◽

2008 ◽

Vol 18 (1) ◽

pp. 10-16

Author(s):

Robert C. Fifer

Keyword(s):

Close Attention ◽

Submission Process ◽

Final Rule ◽

Fee Schedule

Abstract Since 1999 when Medicare caps first became effective, providers have had to pay close attention to the claims process. This article summarizes the Medicare Exceptions Process that, for 2007, underwent a number of changes. The Centers for Medicare and Medicaid Services (CMS) Physician Fee Schedule Final Rule of November 27, 2007 made three important changes. These changes addressed certification for patient plan of care, personnel qualifications for therapists, and a review of Part B policies and their application to Part A settings that are projected to go into effect in July of 2008. Particular attention was given to explanations of the manual submission process and the change in definitions of “complexities” and of a “therapist.”

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Clinical Update: Pain and Suffering

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2003.janfeb02 ◽

2003 ◽

Vol 8 (1) ◽

pp. 5-5

Author(s):

Sheila Wendler

Keyword(s):

Subjective Experience ◽

Personal Injury ◽

Treatment Interventions ◽

Medical Expenses ◽

Affective Component ◽

Pain Behaviors ◽

The Social ◽

Patient’S Experience ◽

Pain And Suffering ◽

And Training

Abstract Attorneys use the term pain and suffering to indicate the subjective, intangible effects of an individual's injury, and plaintiffs may seek compensation for “pain and suffering” as part of a personal injury case although it is not usually an element of a workers’ compensation case. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, provides guidance for rating pain qualitatively or quantitatively in certain cases, but, because of the subjectivity and privateness of the patient's experience, the AMA Guides offers no quantitative approach to assessing “pain and suffering.” The AMA Guides also cautions that confounders of pain behaviors and perception of pain include beliefs, expectations, rewards, attention, and training. “Pain and suffering” is challenging for all parties to value, particularly in terms of financial damages, and using an individual's medical expenses as an indicator of “pain and suffering” simply encourages excessive diagnostic and treatment interventions. The affective component, ie, the uniqueness of this subjective experience, makes it difficult for others, including evaluators, to grasp its meaning. Experienced evaluators recognize that a myriad of factors play a role in the experience of suffering associated with pain, including its intensity and location, the individual's ability to conceptualize pain, the meaning ascribed to pain, the accompanying injury or illness, and the social understanding of suffering.

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