Annals of Health Law
INTERVENING AT THE RIGHT POINT
wish to have a significant impact in reducing overall burdens of pain and
compressing pain inequities across the globe, L&P interventions must be
targeted higher up the causal pathway, at the social and economic
conditions that determine global pain.115 L&P interventions targeted at
increasing access to medical treatments for pain leave these conditions
unaddressed; yet the policy difficulty may be that such interventions are
dearly-bought and that broader, more far-reaching policy initiatives on the
SDOH are simply unlikely on the geopolitical scale.
There is likely no magic bullet solution to this quandary. The central
claim of this paper is that avoiding the problem by reaching for the low-hanging fruit is unacceptable. The practical problems posed in assessing
the root causes of global pain and in developing L&P interventions that
stakeholders are justified in believing can reduce overall burdens of pain
and compress pain inequities are of course quite real. The fact that global
pain is worsening suggests the difficulty of identifying, producing, and
implementing successful interventions. But intervening at points in the
causal pathway which we have no reason to believe will materially assist in
ameliorating global burdens of pain is no answer at all.
115. Indeed, I assume without argument that this is what we ought to do. The detailed
ethical justification for this normative claim awaits future work.