Ontological Collateral: The Entanglement of “Cancer Pain” and “Chronic Non-Cancer Pain” in Thailand

Abstract

Social scientists have long argued that medical objects (categories, bodily processes, and experiences) emerge in historically contingent ways. Based on ethnographic fieldwork in Thailand, I describe a special case of this: ontological collateral, the emergence of one medical object due to its entanglement with another. “Cancer pain” recently became a widely accepted category in Thailand to permit the administration of opioid pain medications for cancer patients dying at home. But the category has proven porous, leading many to claim that they now must treat “chronic non-cancer pain” with opioids as well. Others characterize chronic pain as a Western invention, claiming that recognizing it will harm Thai bodies and minds. The result has been an anti-ontological choreography, a dance of becoming and resistance based on a collective understanding that categories, bodies, and experiences are so intertwined that they risk cascading into one another.