Artículo de ReÁexión DOLOR Y SUFRIMIENTO

$UWtFXORGH5HÁH[LyQ
Dolor y sufrimiento no son sinónimos pero son intrínsecos a la naturaleza humana
DOLOR Y SUFRIMIENTO NO SON SINÓNIMOS PERO
SON INTRÍNSECOS A LA NATURALEZA HUMANA:
UNA VISIÓN DEL DOLOR Y EL SUFRIMIENTO HUMANO
PAIN AND SUFFERING ARE NOT SYNONYMOUS BUT ARE INTRINSIC
TO HUMAN NATURE: A VISION OF PAIN AND HUMAN SUFFERING
Rubén Darío Camargo*
RESUMEN
(OGRORU\HOVXIULPLHQWRQRWLHQHQXQUHIHUHQWH
KLVWyULFRHQHOKRPEUH6RORGHVGHTXHHOKRPEUH
HV FRQVFLHQWH GH VX KXPDQLGDG VH SUHVHQWD HO
GRORU\HOVXIULPLHQWR(OKRPEUH\HOGRORUVLHPSUH
KDQH[LVWLGRVHVXIUHFXDQGRVHQDFH\VHVLHQWH
GRORUSURFHVRTXHVHUHSLWHHQFDGDUHVSLUDFLyQ
FHOXODUHQFDGDUHDFFLyQGHR[LUHGXFFLyQ%LROy
JLFDPHQWHHQ/DWtQ3$7,25 68)5,53$'(&(5
HVHOHVIXHU]RHQHUJpWLFRGHWRGRVHUYLYRSDUDVX
LQWHJUDFLyQIDFWRULDOFHOXODU
(Q OD PHGLFLQD HO GRORU WLHQH VX H[SOLFDFLyQ
DQDWyPLFD\¿VLROyJLFDHOGRORUKDFHUHIHUHQFLDD
ORVRPiWLFR\DOR¿VLROyJLFR(O'RORUDJXGRHVOD
FRQVHFXHQFLDLQPHGLDWDGHODDFWLYDFLyQGHOVLVWH
PDQRFLFHSWLYRJHQHUDOPHQWHSRUXQGDxRWLVXODU
VRPiWLFRRYLVFHUDOGHVDSDUHFLHQGRKDELWXDOPHQWH
FRQ OD OHVLyQ TXH OR RULJLQy (O 'RORU FUyQLFR HV
DTXHOTXHSHUVLVWHHQDXVHQFLDGHODOHVLyQSHULIp
ULFDLQLFLDO(QODHVHQFLDGHOD¿ORVRItDHOGRORUHV
LPSHQVDEOHHLQWHOLJLEOHVHVLHQWHVHPDQHMDVH
WROHUDSHURQRVHSLHQVDHQGRORU
'RORU\VXIULPLHQWRQRVRQVLQyQLPRVSHURVRQ
LQWUtQVHFRV D OD QDWXUDOH]D KXPDQD (O KRPEUH
FXDQGRH[SHULPHQWDHOGRORUVHHQFXHQWUDFRQVX
SURSLROtPLWHFRQVXSURSLDLPSRWHQFLDGHQRSRGHU
FDPELDUXQKHFKRUHDO(OVXIULPLHQWRKXPDQRHQOD
DWHQFLyQGLDULDGHOSDFLHQWHHQIHUPRQRORPDQHMD
PRVSRUVHUHVWHDOJRLQWDQJLEOHQRPRQLWRUL]DEOH
\PXFKRPHQRVPHGLEOH\FXDQWL¿FDEOH
(OGRORUGHOHQIHUPRQRHVOLEUHQLYROXQWDULRHV
SURGXFWRGHODIUDJLOLGDGGHVXPDWHULDHOGRORUGHO
TXHVXIUHGHVSLHUWDHQVXVIDPLOLDUHVODVROLGDULGDG
\7ROHUDQFLD
Palabra clave: 'RORUVXIULPLHQWRSDFLHQWH
0'0LHPEURGHOD$FDGHPLD1DFLRQDOGH0HGLFLQD3UHVLGHQWHGHO&DStWXORGHO$WOiQWLFR0HGLFLQD,QWHUQD&XLGDGRV,QWHQVLYRV
)LORVRItD8QLYHUVLGDGGH1DYDUUD(VSDxD'LUHFWRU&LHQWt¿FR&XLGDGRLQWHQVLYR&OtQLFD*HQHUDOGHO1RUWH%DUUDQTXLOOD&RORPELD
,661‡0(',&,1$%RJRWi9RO1R3iJV‡0DU]R
25
Rubén Dario Camargo
ABSTRACT
3DLQ DQG VXIIHULQJ KDYH QR KLVWRULFDO UHIH
UHQFH LQ PDQ 2QO\ VLQFH PDQ LV FRQVFLRXV RI
KLV KXPDQLW\ SDLQ DQG VXIIHULQJ 0HQ DQG SDLQ
KDYHDOZD\VFRH[LVWHG2QFHERUQWKHEDE\IHHOV
SDLQDSURFHVVWKDWLVUHSHDWHGLQHDFKFHOOUHV
SLUDWLRQR[LUHGXFWLRQUHDFWLRQ%LRORJLFDOO\LQODWLQ
3$7,25 VXIIHU LV WKH HQHUJHWLF HIIRUW RI HDFK
RIDOOOLYLQJEHLQJVIRULWVFHOOIDFWRULDOLQWHJUDWLRQ
3DLQKDVDQDWRPLFDODQGSK\VLRORJLFDOH[SODQDWLRQV
LQPHGLFLQHSDLQPDNHVUHIHUHQFHWRVRPDWLFDQG
SK\VLRORJLF,QWKHHVVHQFHRISK\ORVRSK\SDLQLV
XQWKLQNDEOHDQGLQWHOOLJLEOH,WLVIHOWPDQDJHGWR
OHUDWHGEXWRQHGRHVQRWWKLQNDERXWWKHUHVXOWWKH
SDLQUHIHUUHGWRWKHVRPDWLFDQGWKHSK\VLRORJLFDO
$FXWHSDLQLVWKHLPPHGLDWHFRQVHTXHQFHRIDFWLYD
WLRQRIWKHQRFLFHSWLYHV\VWHPXVXDOO\E\VRPDWLFRU
YLVFHUDOWLVVXHGDPDJHXVXDOO\GLVDSSHDULQJDORQJ
ZLWKLQMXU\FDXVLQJSDLQ&KURQLF3DLQLVRQHWKDW
SHUVLVWVLQWKHDEVHQFHRILQLWLDOSHULSKHUDOLQMXU\
,QWKHHVVHQFHRISKLORVRSK\SDLQLVXQWKLQNDEOH
DQG LQWHOOLJLEOH ,W LV IHOW PDQDJHG WROHUDWHG EXW
RQHGRHVQRWWKLQNDERXWSDLQ
3DLQDQGVXIIHULQJDUHQRWV\QRQ\PRXVEXWDUH
LQWULQVLFWRKXPDQQDWXUH0DQH[SHULHQFHVSDLQZKHQ
HQFRXQWHUVKLVRZQOLPLWDWLRQZLWKKLVRZQLPSRWHQFH
RIQRWEHLQJDEOHWRFKDQJHDIDFW:HFDQQRWKDQGOH
KXPDQVXIIHULQJLQGDLO\FDUHRIWKHLOOEHFDXVHLWLV
QHLWKHULQWDQJLEOHQRUPRQLWRUL]DEOHQRWPHDVXUDEOH
RUTXDQWL¿DEOH7KHSDWLHQW
VSDLQLVQRWIUHHRUYR
OXQWDU\LWLVWKHUHVXOWRIPDWWHUIUDJLOLW\$VXIIHULQJ
SDWLHQWDULVHVVROLGDULW\DQGWROHUDQFHLQKLVUHODWLYHV
KHUUDPLHQWDVGHPHGLFDPHQWRVTXHQRVGDUiQDOLYLR
DOGRORUItVLFRGHOSDFLHQWHSHURQRFRPSOHWDPHQWH
FXDQGRHVHVHUKXPDQRFRPSRQHQWHLQWHJUDOSVL
FRVRPiWLFRVXIUH
(OVXIULPLHQWRKXPDQRHQODDWHQFLyQGLDULDGHO
SDFLHQWHQRORPDQHMDPRVSRUVHUHVWHDOJRLQWDQJLEOH
QRPRQLWRUL]DEOH\PXFKRPHQRVPHGLEOH\FXDQWL
¿FDEOH3RUHVWDUD]yQQRVHHQFXHQWUDGHQWURGH
QXHVWURSODQGHPDQHMRSXHVWRTXHFRQVLGHUDPRV
TXHXQDEXHQDVHGDFLyQ\XQDEXHQDDQDOJHVLD
FRQWURODQ HO GRORU ItVLFR JHQHUDQGR D WUDYpV GH
VLQDSVLV \ TXLPLR UHFHSWRUHV SDUD OD HVWDELOLGDG
SVtTXLFDGHOVXIULPLHQWR
(QHOSUHIDFLRGHODREUDThe nature of suffering
and the goals of medicine (ULF-&DVVHOOHVFULELy
³/DSUXHEDTXHXQ VLVWHPDVDQLWDULRGHEHUtDVXSHUDU
HVVXLGRQHLGDG SDUDHQIUHQWDUVHDOVXIULPLHQWR´(VWH
OLEURSDUWHGHODSUHPLVDGHTXHODPHGLFLQD PRGHUQD
QRVXSHUDHVWDSUXHED'HKHFKR ODVEDVHVFHQ
WUDOHVHQTXHHVWiEDVDGDOD PHGLFLQDGHOVLJOR;;
QRSURSRUFLRQDQHOHPHQWRDOJXQRSDUDFRPSUHQGHU
HOVXIULPLHQWR3DUDHOPDQHMRGHOGRORUODGLVQHDX
RWURVSUREOHPDVItVLFRVDJXGRVRFUyQLFRVVHKD
UHDOL]DGRGHIRUPDPDJQt¿FDSDUDHOVXIULPLHQWRQR
INTRODUCCIÓN
(OVXIULPLHQWRGHEH DIHFWDULQHYLWDEOHPHQWHDO
LQGLYLGXRORVFXHUSRVQRVXIUHQODVSHUVRQDVVXIUHQ
/DVIUDVHVGH&DVVHOOGHMDQPHULGLDQDPHQWHFODUR
TXHHOVXIULPLHQWRYDPiVDOOiGHODSXUDDIHFFLyQ
ItVLFD\TXHQRGHEHKDFHUVHVLQyQLPRGHGRORUVH
SXHGHWHQHUGRORUVLQVXIULPLHQWR\VHSXHGHVXIULU
VLQGRORU7RGRHOORVXJLHUHTXHHOVXIULPLHQWRHV
XQDYLYHQFLDSVLFROyJLFDGLItFLOGHFRUUHODFLRQDUFRQ
OHVLyQItVLFDDOJXQD6LORVLQGLYLGXRVVXIUHQVyOR
ODFRPXQLFDFLyQGHFDGDXQRSXHGHFRQYHQFHUQRV
GHVXH[LVWHQFLD
(OGRORUItVLFRGHOSDFLHQWHVHFRPSUHQGHGHV
GHHOFRQRFLPLHQWRGHODDQDWRPtD\OD¿VLRORJtD
SRGHPRV LQWHUSUHWDUOR \ PDQHMDUOR 7HQHPRV ODV
(O FDUiFWHU VXEMHWLYR GHO VXIULPLHQWR VXSRQH
XQJUDYHLQFRQYHQLHQWHSDUDVXYDORUDFLyQ$SHVDU
GHTXHVHKDQGLVHxDGRLQVWUXPHQWRVGHREVHUYD
Keywords: 3DLQVXIIHULQJSDWLHQW
26
,661‡0(',&,1$%RJRWi9RO1R3iJV‡0DU]R
Dolor y sufrimiento no son sinónimos pero son intrínsecos a la naturaleza humana
FLyQ FRQGXFWXDO \ ¿VLROyJLFD H[LVWH XQDQLPLGDG
HQ FRQVLGHUDU OD GHFODUDFLyQ GHO SURSLR SDFLHQWH
DXWRYDORUDFLyQFRPRODIXHQWHPiVYiOLGD\¿DEOH
GHWDOLQIRUPDFLyQORTXHQRKDFHPiVTXHUHFR
QRFHUHOSUREOHPDGHODVXEMHWLYLGDGLQWUtQVHFDGH
ODHYDOXDFLyQGHOVXIULPLHQWR
(VWDVUHDOLGDGHVFRPRODVHQIHUPHGDGHVHQ
RFDVLRQHV WHUULEOHPHQWH ODUJDV \ GRORURVDV GH
PXHVWUDQODLQVX¿FLHQFLDGHODPDWHULDHQFXDQWR
VHU 3HUR OR FLHUWR HV TXH FUHDQ SDUD HO KRPEUH
VLWXDFLRQHVUHDOPHQWHGUDPiWLFDVHLQWHUURJDQWHV
DQJXVWLRVRV FXDQGR HO GRORU \ HO VXIULPLHQWR VH
YLYHQDOODGRGHOHQIHUPR
DOLOR Y SUFRIMIENTO
6XIULPRV HQ WRGR PRPHQWR \ D~Q FRQ PiV
UD]yQFXDQGRQRVHVWDPRVDGDSWDQGRDOPHGLRTXH
QRVURGHDPpGLFRSDFLHQWHIDPLOLDU'DGRTXHHO
PHGLRHVGLQiPLFRHOVXIULPLHQWRHVPiVLQWHQVR
FXDQWRPiVGLQiPLFRVHDHVWHHVGHFLUHOPHGLR(O
VXIULPLHQWRHVPHQRVLQWHQVRHQVLWXDFLRQHVTXH\D
WHQHPRVFRQWURODGDV&XDQGRVHQRVFDPELDXQD
UXWLQDVHJHQHUDQGLYHUVDVVHQVDFLRQHV$QVLHGDG
HVWUpVGHVHR
(OGRORU\HOVXIULPLHQWRKXPDQRKDQH[LVWLGR
GHVGHODSHUFHSFLyQGHOLQGLYLGXRFRPRKXPDQR
FRQYLYLHQGR FRQ VX PHGLR DPELHQWH 'HVGH XQ
SXQWRGHYLVWDUHOLJLRVR¿ORVy¿FRFLHQWt¿FRWHR
OyJLFRPpGLFRVLHPSUHVHKDSUHRFXSDGRSRUGDU
UHVSXHVWDDOGRORU\VXFRQVDELGRVXIULPLHQWR
7RGDVODVSHUVRQDVDORODUJRGHVXYLGDH[
SHULPHQWDQ HO GRORU \ HO VXIULPLHQWR HQ GLYHUVDV
RFDVLRQHV 7RGRV KHPRV VHQWLGR DOJXQD YH] OD
HQIHUPHGDG OD VROHGDG HO IUDFDVR HWF 1DGLH
HVWi D VDOYR GHO VXIULPLHQWR QL VLTXLHUD DTXHOODV
SHUVRQDVTXHVHVLHQWHQIHOLFHV\DIRUWXQDGDV\D
TXHHVWHIRUPDSDUWHGHQXHVWUDYLGDHVLQKHUHQWH
DOVHUKXPDQR
/RVGRORUHVItVLFRVGHOSDFLHQWHSRUORJHQH
UDOQRGHSHQGHQGHVXOLEHUWDGQLGHVXYROXQWDG
6REUHYLHQHQFRPRFRQVHFXHQFLDGHODIUDJLOLGDG
GHOVHUPDWHULDOSRUODHQIHUPHGDGRWUDXPDTXH
SDGH]FDRULJLQDGRXQDVYHFHVHQIRUPDGHFDWiV
WURIHVRWUDVSRUHQIHUPHGDGHVDJXGDVRFUyQLFDV
/DHGXFDFLyQHVODIRUPDTXHWLHQHHOKRPEUH
GHDGDSWDUVHDOVXIULPLHQWR'DLJXDOODIRUPDHQOD
FXDOVHQRVKD\DHGXFDGRSXHVQRHVWDPRVH[HQWRV
GHHQFRQWUDUQRVFRQVLWXDFLRQHVTXHQRVOOHYHQD
QXHVWURV OtPLWHV OR YHUGDGHUDPHQWH LPSRUWDQWH
HVTXHODSDUWHUDFLRQDOQRVFDSDFLWDPHMRURSHRU
SDUDDIURQWDUHVRVFDPELRV
ANTROPOLOGÍA DEL DOLOR
Y EL SUFRIMIENTO
1R H[LVWH XQ RULJHQ KLVWyULFR GHO GRORU XQ
PRPHQWRWHPSRUDOGHWHUPLQDGRHQTXHSXHGDFR
,661‡0(',&,1$%RJRWi9RO1R3iJV‡0DU]R
27
Rubén Dario Camargo
ORFDUVHVXDSDULFLyQHQHOPXQGR$PHGLGDTXHOD
FLHQFLDKLVWyULFDHQVDQFKDHOKRUL]RQWHGHOSDVDGR
KXPDQRVHGHVFXEUHODSUHVHQFLDFRQWLQXDGHOGRORU
\QXQFDXQSHULRGRIHOL]\PHQRVXQDHGDGGHRUR
FDUDFWHUL]DGDSRUVXDXVHQFLD/RTXHFRPLHQ]D
\FHVDVRQIRUPDVFRQFUHWDVGHOGRORUQXQFDWRGR
HOVXIULPLHQWR
<HVRKDVWDHOSXQWRGHTXHODLGHDGHDXVHQFLD
WRWDOGHGRORU\VXIULPLHQWRHVSDUWHLQWHJUDOGHOD
QRFLyQWHROyJLFDGHSDUDtVR
(O VXIULPLHQWR IUHQWH DO GRORU HV XQ YRFDEOR
DEVWUDFWRHQFLHUWRPRGRLQFRQPHQVXUDEOHGHELGRD
TXHQRWLHQHTXHYHUFRQHOFXHUSRHQWUDHOGRPLQLR
GHORHVSLULWXDO(OGRORU\HOVXIULPLHQWRHVWiQSUHVHQ
WHVHQODGLPHQVLyQHVSLULWXDO\FRUSRUDOGHOKRPEUH
HVGHFLUVRQLQWUtQVHFRVDVXQDWXUDOH]DKXPDQD
(OGRORUHVGH¿QLGRFRPRXQDVHQVDFLyQGHVD
JUDGDEOH SURGXFLGD SRU XQ HVWLPXOR GH FDUiFWHU
SHUMXGLFLDO+DFHUHIHUHQFLDDORVRPiWLFR(OVX
IULPLHQWRPRUDOHVGRORUGHODOPDHVHQHIHFWRGH
WLSRHVSLULWXDO\QRODGLPHQVLyQSVtTXLFDGHOGRORU
TXHDFRPSDxDDOVXIULPLHQWRPRUDO
(OKRPEUHFXDQGRH[SHULPHQWDHOVXIULPLHQWR
OROOHYDDODGHVRULHQWDFLyQ\DSHUGHUODFODULGDGGHO
SHQVDPLHQWR6HHQFXHQWUDFRQVXSURSLROtPLWH
FRQVXSURSLDLPSRWHQFLDGHQRSRGHUFDPELDUXQ
KHFKRUHDO
(O KRPEUH HQ VX VXIULPLHQWR HV XQ PLVWHULR
LQWDQJLEOH TXL]i QLQJXQD RWUD FRVD H[LJH HQ VX
UHDOLGDG REMHWLYD VHU WUDWDGR HQ OD IRUPD GH XQ
H[SOtFLWRSUREOHPD
FILOSOFÍA DEL DOLOR Y EL SUFRIMIENTO
(O GRORU HV LQWHOLJLEOH LPSHQVDEOH HO GRORU
QRHVVXVWDQFLDQRHVDFFLGHQWH\DTXHQRWLHQH
28
HVHQFLDHV$QXODFLyQGHDFWLWXG(681*5,(7$
(1 /$ 3(5621$ 3HUR HV SUHFLVR SURIXQGL]DU
PiV¢HOGRORUHVDOJRVXVWDQFLDORDOJRDFFLGHQWDO
HQHOKRPEUH"(OGRORUQRHVVXVWDQFLDQLHVDFFL
GHQWH3DUHFHHQWRQFHVTXHODSUHJXQWDSODQWHDGD
QRWLHQHFRQWHVWDFLyQ\HVLQ~WLOIRUPXODUOD3HUR
¢QRSXHGHDFDVRSUHJXQWDUVHOHJtWLPDPHQWHTXp
HVHOGRORU"
(OGRORUHVUHIUDFWDULRDHVWDSUHJXQWDSXHVWR
TXHHOGRORUQRHVLQWHOLJLEOHSHURQRVRORGHKHFKR
VLQRHQDEVROXWRDOPHQRVHQHOSODQRKXPDQR
&RQRWUDVSDODEUDVHOGRORUQRHVWiIXHUDGHOSHQ
VDPLHQWRFRPRXQDHVSHFLHGHFRVDHQVtDODTXH
HOSHQVDPLHQWRQROOHJD(OGRORUQRHVLQWHOLJLEOH
\ DO SUHVHQWDUVH D OD FRQFLHQFLD FRPR VLQ GXGD
DFRQWHFHVHHQFXHQWUDHQHOODFRPRLPSHQVDEOH
(OGRORUHVDQWHWRGRXQDVLWXDFLyQSHUVRQDO
(OKRPEUHHVWiDWHQD]DGRHQWXPHFLGRHQHOGRORU
DOJR GH VX DFWLYLGDG H[LVWHQFLDO HVWi TXHEUDGR \
SDUDOHODPHQWHLQpGLWR(OGRORUFRPROtPLWHLQIUDQ
TXHDEOH HV DQXODFLyQ GH DFWLWXG HQ WDQWR GXHOH
SUHFLVDPHQWHPLVHUQRVHGHVSOLHJDQRVH\HUJXH
VREUHVt(OGRORUHVJULHWDGHODSHUVRQD
(Q OD GLPHQVLyQ KXPDQD FRUSRUDO WHQHPRV
GRORUORVHQWLPRVVXIULPRVRDJXDQWDPRVORTXH
QRFDEHHVSHVDUOR(OOXJDUGHDVHQWDPLHQWRSUL
PDULRGHOGRORUHQQRVRWURVQRHVHOSHQVDPLHQWR
SHURORGHFLVLYRHVTXHQRSRGHPRVHQWHQGHUORDO
WUDVODGDUORDpO
'RORU\VXIULPLHQWRQRVRQVLQyQLPRV$XQTXH
VHXVDQFRPRVLQyQLPRVHOVXIULPLHQWRItVLFRLQ
GLFDFXDOTXLHU©GRORUGHOFXHUSRª\HOVXIULPLHQWR
PRUDOHO©GRORUGHODOPDªHVHVWH~OWLPRXQGRORU
GHWLSRHVSLULWXDO\QRVyORODGLPHQVLyQ©SVtTXLFDª
GHOGRORUTXHDFRPSDxDWDQWRHOVXIULPLHQWRPRUDO
FRPRHOItVLFRGLVWLQFLyQHQWUHVXIULPLHQWRItVLFR\
VXIULPLHQWRPRUDO
,661‡0(',&,1$%RJRWi9RO1R3iJV‡0DU]R
Dolor y sufrimiento no son sinónimos pero son intrínsecos a la naturaleza humana
/DFDXVDPiVIUHFXHQWHGHVXIULPLHQWRHVHO
GRORUItVLFRSHURGRORU\VXIULPLHQWRQRVRQVLQy
QLPRV(OGRORUHVXQDVHQVDFLyQ¿MD\WtSLFDGHOR
GHVDJUDGDEOHGHGLIHUHQWHJUDGRGHLQWHQVLGDG(O
GRORUKDFHUHIHUHQFLDDORUGHQGHORVRPiWLFRGH
OR¿VLROyJLFR\VHSXHGHGH¿QLUFRPRODVHQVDFLyQ
GHVDJUDGDEOHSURGXFLGDSRUODDFFLyQGHHVWtPXORV
GHFDUiFWHUSHUMXGLFLDO(OVXIULPLHQWRHQFDPELRHV
XQDPDQLIHVWDFLyQGHODHVSLULWXDOLGDGGHODSHUVRQD
GHVXDQKHORGHIHOLFLGDG(QFRQVHFXHQFLDHVWD
GLVWLQFLyQWLHQHFRPRIXQGDPHQWRODGREOHGLPHQ
VLyQGHOVHUKXPDQRHLQGLFDHOHOHPHQWRFRUSRUDO
\HVSLULWXDOFRPRORVVXMHWRVLQPHGLDWRVRGLUHFWRV
GHOGRORU\GHOVXIULPLHQWRUHVSHFWLYDPHQWH(OGRORU
WLHQHXQVHQWLGRItVLFR\HOVXIULPLHQWRXQVHQWLGR
PHWDItVLFR(OSULPHURQRVLQYLWDDUHÀH[LRQDUVREUH
HOFXHUSRHOVHJXQGRVXVFLWDSUHJXQWDVPiVSUR
IXQGDV\H[LVWHQFLDOHVVRORHOVXIULPLHQWRQRVDEUH
ODVSXHUWDVGHOFRQRFLPLHQWRSURIXQGRGHODYLGD
BIOLOGÍA DEL DOLOR
/RVUHFHSWRUHVSDUDHOGRORUVHHQFXHQWUDQHQ
ODSLHOHQODVHVWUXFWXUDVP~VFXORHVTXHOpWLFDV\HQ
ODVYtVFHUDV/RVUHFHSWRUHVFXWiQHRVWHUPLQDFLRQHV
QHUYLRVDV OLEUHV WUDGXFHQ HVWtPXORV PHFiQLFRV
WpUPLFRV R TXtPLFRV HQ XQ WUHQ GH SRWHQFLDOHV
HOpFWULFRVTXHVHWUDQVPLWHQSRUVXVD[RQHVKDFLD
ODPpGXODHVSLQDO
/RV FXHUSRV FHOXODUHV GH ORV QRFLFHSWRUHV
SHULIpULFRV VH HQFXHQWUDQ HQ ORV JDQJOLRV GH OD
UDt]GRUVDO\ODSULPHUDVLQDSVLVVHUHDOL]DDQLYHO
GHODVWDGRUVDOGHODPpGXODHVSLQDOWDQWRFRQODV
LQWHUQHXURQDVORFDOHVFRPRFRQODVQHXURQDVGH
SUR\HFFLyQ TXH OOHYDQ OD LQIRUPDFLyQ QRFLFHSWLYD
KDFLD FHQWURV VXSHULRUHV HQ HO WURQFR FHUHEUDO \
HQHOWiODPR(QWRQFHVVHSXHGHGHFLUTXHHOGRORU
KDFHUHIHUHQFLDDORVRPiWLFR\DOR¿VLROyJLFR
,661‡0(',&,1$%RJRWi9RO1R3iJV‡0DU]R
29
Rubén Dario Camargo
(Q OD ,QWHUQDWLRQDO$VVRFLDWLRQ IRU WKH
6WXG\RI3DLQ,$63GH¿QHHOGRORUFRPR"Una
experiencia sensorial y emocional desagradable
asociada con una lesión hística real o potencial, o
que se describe como ocasionada por dicha lesión"
GRORUVLQRTXHIUHFXHQWHPHQWHRWURVWLSRVGHVX
IULPLHQWRVRQGHVFULWRVHQWpUPLQRVGHWDOGRORUOR
FXDOSXHGHFRPSOLFDUHODQiOLVLVGHXQSDFLHQWHDO
LQYROXFUDUQRVHQVXGLPHQVLyQSVLFROyJLFDVRPiWLFD
GHOFXHUSRRVRPiWLFDGHODOPD
(VWD GH¿QLFLyQ VXSXVR HQ VX PRPHQWR KLV
WyULFRXQFDPELRFRQUHVSHFWRDODVDQWHULRUHVDO
LQWURGXFLU GRV QXHYRV FRQFHSWRV HO GRORU QR HV
XQDH[SHULHQFLDSXUDPHQWHQRFLFHSWLYDVLQRTXH
HVWi LQWHJUDGD SRU FRPSRQHQWHV HPRFLRQDOHV \
VXEMHWLYRVHQVHJXQGROXJDUSXHGHSURGXFLUVHVLQ
FDXVDVRPiWLFDTXHODMXVWL¿TXH
(OHVWtPXORGRORURVRSURGXFHXQDUHVSXHVWD
JOREDOGHOLQGLYLGXRGHVFULWDFRPRFRQGXFWDGRORURVD
FRQMXQWRGHDFWLYLGDGHVTXHUHDOL]DXQSDFLHQWH
FRPR UHVSXHVWD D OD SUHVHQFLD GH GRORU OR FXDO
OOHYDDFXDOTXLHUREVHUYDGRUDODFRQFOXVLyQGHTXH
HOLQGLYLGXRHVWiH[SHULPHQWiQGROR\UHSUHVHQWDHQ
UHDOLGDGHO~QLFRtQGLFHFOtQLFRREVHUYDEOHGHGRORU
\VXIULPLHQWR
(OGRORUDJXGRHVODFRQVHFXHQFLDLQPHGLDWDGH
ODDFWLYDFLyQGHOVLVWHPDQRFLFHSWLYRJHQHUDOPHQWH
SRUXQGDxRWLVXODUVRPiWLFRRYLVFHUDOGHVDSDUH
FLHQGRKDELWXDOPHQWHFRQODOHVLyQTXHORRULJLQy
(OGRORUFUyQLFRHVDTXHOTXHSHUVLVWHHQDXVHQFLD
GHODOHVLyQSHULIpULFDLQLFLDO
+R\SRUKR\HVFODURTXHHOGRORU\HOVXIUL
PLHQWRQRSXHGHQVHUDQDOL]DGRVFRPRODH[FOXVLYD
H[SUHVLyQ GH XQD HVWLPXODFLyQ QRFLFHSWLYD \ UH
TXLHUHQHQSURSRUFLyQDVXFRPSOHMLGDGXQDQiOLVLV
GHODVGLPHQVLRQHVKXPDQDV\D~QVRFLDOHVTXH
FRQGLFLRQDQVXSHUVLVWHQFLDGHQWURGHXQPRGHOR
TXHFRQWHPSODDVSHFWRVELROyJLFRVSVLFROyJLFRV
VRFLDOHVSHUVSHFWLYDELRSVLFRVRFLDO\KXPDQRV
7RGRHVWHSURFHVRGHVFULWRHQODSHUFHSFLyQGHO
GRORU\HQODFRQGXFWDGRORURVDSXHGHVHUPRGL¿FDGR
SRUGRVGLPHQVLRQHVODVHQVRULRGLVFULPLQDWLYDHQ
ODFXDOSUHGRPLQDQORVHYHQWRVVRPiWLFRV\QHXUR
¿VLROyJLFRVWDQWRQRUPDOHVFRPRDQRUPDOHV\OD
GLPHQVLyQDIHFWLYRHPRFLRQDOGRQGHSUHGRPLQDOD
DFWLYDFLyQGHIHQyPHQRVDIHFWLYRV\FRJQRVFLWLYRV
TXHFRQWURODQODFRQGXFWDREVHUYDEOHGHOLQGLYLGXR
VHGHEHH[DPLQDUWDQWRHOPHFDQLVPRRUJiQLFRGH
OD SURGXFFLyQ GHO GRORU FRPR DTXHOORV DVSHFWRV
FRQFHSWXDOHVGHH[SHULHQFLDVSUHYLDVPRWLYDFLR
QDOHV\DIHFWLYDVDOUHGHGRUGHODVLWXDFLyQGRORURVD
HQ WRGR HQIHUPR FXDQGR VH DQDOL]D HO DVSHFWR
SVLFROyJLFRGHOGRORU
PSICOLOGÍA DEL DOLOR
Y EL SUFRIMIENTO
SUFRIMIENTO EN LA FAMILIA
DEL ENFERMO
(O GRORU HQ OD SHUVRQD DO SHUFLELUOR VHQWLUOR
\ PDQLIHVWDUOR JHQHUD XQD UHVSXHVWD DIHFWLYD
HPRFLRQDOGHFDUiFWHUQHJDWLYRDODFXDOOODPDPRV
VXIULPLHQWR &RQMXQWR GH UHDFFLRQHV DIHFWLYDV \
RUJiQLFDV QHJDWLYDV TXH VH SURGXFHQ FRPR UHV
SXHVWDDODSUHVHQFLDGHXQHVWLPXORQRFLFHSWLYR
(OVXIULPLHQWRHQODSHUVRQDQROHHVH[FOXVLYRDO
(O VXIULPLHQWR GH ORV IDPLOLDUHV GHO HQIHUPR
SRVLELOLWDHQHOORVHOHMHUFLFLRGHODFRPSUHQVLyQ
GHODWROHUDQFLDGHODD\XGDGHOVDFUL¿FLRGHOD
JUDWXLGDG\VREUHWRGRGHODPRUTXHHVHOIDFWRU
PiV SHUVRQDOL]DQWH (VWH HV HO VHQWLPLHQWR TXH
GHVSLHUWDDVXVIDPLOLDUHVHOGRORU\VXIULPLHQWRGH
TXLHQHVWiVXIULHQGR
30
,661‡0(',&,1$%RJRWi9RO1R3iJV‡0DU]R
Dolor y sufrimiento no son sinónimos pero son intrínsecos a la naturaleza humana
/DVDFWLWXGHVGHOIDPLOLDUGHOSDFLHQWHIUHQWH
DOGRORU\VXIULPLHQWRSXHGHQVHU
$FHSWDFLyQ1RUPDOPHQWHDQWHXQDPDODQR
WLFLDRXQDFRQWUDULHGDGTXHVXSRQJDGRORUGHVX
IDPLOLDUQHFHVLWDQWLHPSRSDUDDVLPLODUOR\DFHSWDUOR
FRQVHUHQLGDG\FRQDSORPR
5HFKD]R 7UDWDQ GH HYLWDU \ GHVFRQRFHU HO
GRORU\VXIULPLHQWRTXHRFDVLRQDXQDPDODQRWLFLDR
FRQWUDULHGDGTXHVXSRQHQVXIULPLHQWRHQVXIDPLOLDU
TXHHVWiVXIULHQGRQRGHEHPRVGXGDUHQD\XGDUOH
1XHVWUDVRODSUHVHQFLDFRQHODPRUTXHOHSRGHPRV
GDUSXHGHKDFHUOHHVWHWUDQFHPiVOOHYDGHUR
(OVXIULPLHQWRFRQGXFHDXQDPDGXUDFLyQGH
ODSHUVRQDOLGDG(QODVGLIHUHQWHVIRUPDVHQTXHVH
SXHGHSUHVHQWDUQRVSURGXFHXQSHVDU\XQGRORU
TXHQRVKDFHUHÀH[LRQDUVREUHQRVRWURVPLVPRV
\VREUHQXHVWUDSURSLDYLGD\DFXHVWLRQDUQRVHO
SRUTXpGHWRGRORTXHQRVDFRQWHFH
REFERENCIAS
'HVHVSHUDFLyQ(VQRUPDOTXHFXDQGRXQD
SHUVRQDHVWiVXIULHQGRSRUSUREOHPDVGHHQIHUPHGDG
GHVXIDPLOLDUVHVLHQWHFRQXQDSURIXQGDWULVWH]D
(VQRUPDOSRUWDQWRTXHSURWHVWHOORUHJULWHRVH
HQIDGH6LQHPEDUJRORTXHQRSXHGHRFXUULUHV
TXHHOVXIULPLHQWRVHDFRQVWDQWH
3DUDD\XGDUHVPHMRUWUDWDUGHHVFXFKDUDHVD
SHUVRQDSRQHUQRVHQVXOXJDUSDUDFRPSUHQGHUOD
VHQWLU VX VXIULPLHQWR VX WHPRU \ VX UDELD SHUR
VREUHWRGRHVWDUFRQHVWDSHUVRQDFRPSDUWLHQGR
ORVPRPHQWRVGRORURVRVSRUORVTXHHVWiSDVDQGR
FXLGiQGROD \ WUDWDQGR GH DOLYLDUOH OD SHQD HQ HO
PRPHQWRGHODHQWUHYLVWD\HQFXHQWURVVXFHVLYRV
(OVXIULPLHQWRVDFDORPHMRUGHQRVRWURVPLVPRV
3RUHVRFXDQGRYHPRVDXQDPLJRRXQIDPLOLDU
'H(PSDLUH<DQHV*'LOHPDVHQODWRPDGHGHFLVLRQHV
HQHOSDFLHQWHFULWLFR&XDGHUQRVGH3URJUDPD Re
JLRQDOGH%LRpWLFD206
&DVVHOO (- The nature of suffering and the goals of
medicine. 2[IRUG2[IRUG8QLYHUVLW\3UHVV
,$636XEFRPPLWWHHRQ7D[RQRP\3DLQWHUPVDOLVWZLWK
GH¿QLWLRQVDQGQRWHVRQXVDJHPain
)XQGDPHQWRVGHFXLGDGRFULWLFRHQVRSRUWHLQLFLDO6R
FLHGDGGH0HGLFLQD&UtWLFD$XWRUHV9DULRV3ULPHUD
HGLFLyQHQHVSDxRO$UJHQWLQD(GLWRULDO&RODERUDGRUHV
S
- )LQOD\ +XPDQLGDGHV 0pGLFDV 9RO 1R 0D\R $JRVWR
7XUQHU/%LRHWKLFVLQSOXUDOLVWLFVRFLHWLHV0HG+HDOWK
&DUH3KLORV
3HGUR)%HMDUDQR&RQFHSWRVVREUHHOGRORUGHOVtQWRPD
DODHVSHFLDOLGDGPpGLFD
-RVp ÈQJHO *DUFtD &XDGUDGR$QWURSRORJtD )LORVy¿FD
(816$
7RPDV0HOHQGR,QWURGXFFLyQDOD)LORVR¿D(816$
Fecha de recibido: Noviembre 17 de 2011
Fecha de aprobado: Diciembre 15 de 2011
,661‡0(',&,1$%RJRWi9RO1R3iJV‡0DU]R
31