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I think the study Marissa brought up about the long term effects of circumcision on pain perception brings up some interesting issues.  First, I am not sure about the conditions of the study but I assume the parents of the child were able to choose whether or not to give their children anesthesia.  Therefore I think it is probably likely that the parent’s philosophy of pain influenced the child’s pain tolerance much more than the actual surgery.  This once again brings up the importance of the “beetle in the box” theory about pain.  I think someone’s perception of pain is composed from a variety of biological and environmental factors and is unique to each person.  I agree that the pain scales are then pretty much irrelevant except to protect the health care professionals from being accused of inadequately prescribing pain medicine.  However, I don’t have a better alternative except to explain the effects and strengths of the pain medicine available and then allow them to choose which best fits their desire for pain relief.  This brings me to another problem I have with the circumcision study and that is why does it matter whether someone’s pain tolerance is higher or lower?  It seems they are placing a value on higher pain tolerance which would be feeding into the common view in society that men should have a high pain tolerance and appear tough.  I don’t think someone’s tolerance to pain is really important, instead it is important to help them get relief from whatever intensity of pain they are feeling.  Whether someone’s tolerance is high or low, the pain is due to a physical injury or psychosomatic, the amount of pain someone feels should be treated as the person describes it because the pain is real to them and nobody else can really understand or judge their pain.