Discussing Moral Issues of Pain Language With Children

The full impact of moral judgment on healthcare relationships between children and people who deal with their pain in professional settings, children’s patient outcomes, and children’s own wellbeing, is yet unknown. The education on pain language needs our attention in relation with teachers, parents and supports the private language of pain as Wittgenstein has mentioned it in his philosophical research. Pain communication in everyday life, education about empathy to adults, pain language as healthcare education, are important to our research with children at the teaching methodology. We focus to cultural attitudes of people about pain, ways that moral issues represent a blind spot that merits explanation and repair. What are the words that a professional or a family person will use to explain that death is a possible fact or a danger to a child? The private language of pain, as Halliday has mentioned to his linguistic research, gives a background of a scientific approach of this quality of language education.


Introduction
Education in Greece is connected to the value of preparing students in having all the necessary knowledge for their professional life in future and their well-being. Unfortunately, in times of crisis such as this that the Greek people faced mirrored educational needs for change in management of poverty, refugees' issues in class and discrimination, economical problems, social loss of security in everyday communication, criminality and children's violence at school and at home. This emergency case urged us to provide a methodological tool for teaching language based on how children communicate pain in health issues or out of the hospitals and the doctor's office.
The way that children remember painful situations and the way that they face and control their pain and the pain of others was the basic concern of building a vocabulary for the pain language capable to give to children the freedom to express themselves when they are in pain or the pain that they have lived in past (Halliday, 2010). Pain language as a questionnaire form to fill in their thoughts was abandoned soon. Since they preferred to draw how things happened and then describe in words and play games that was actually symbolic stimulus for them to start talking about the forbidden pain (bulling, abuse, body deformity, the stigma of the different in appearance, voice, behavior or a sickness symptom). In Greek the cultural values differ from other national environments as it is possible (Zborowski, 1952). When we want to talk about cancer we never tell the word because some people believe that talking about it with naming the problem it is making the sickness worse and the diseases stronger than the person in pain. The religion is another moral issue. Once you are in pain it is more wise to hide it such as you are responsible for the misfortune of the pain that other reasons than you have brought the problem of pain. Pain is the brave behavior of the saints that were tortured to death so as they gain the paradise. Opinions such as these are not realized facts of modern life in the Greek society but there is always a base of moral enrollment to how a person is educated to express or hide the pain. Ancient Greek authors such as Thucydides has taught that it is not nice to show your suffering emotions to your neighbor or to make others feel sorry for you or give them negative emotions. Modern Greek language, proverbs and songs are relevant to this moral attitude. This hidden pain that is not well adjusted to the global moral issues of the right to live in luxury, the potential and the success of avoiding pain with a single pill for a headache, for example, or the pain of pregnancy with a safe Caesarean section to prefer for a child's birth came to add another management and moral culture to the traditional culture of the Greek language of pain. Although these two voices, the one that says "just pretend everything is fine and hide your pain" and the other that says "just avoid it when you can" look different the one to the other , they both have a common characteristic of an immoral management of the pain of the self and the others, the loss of honesty to respect pain, to deal with it and educate people about pain language.
Words may be more painful than any problem itself. Fear of the pain can be even more painful as an idea instead of a fact. In education we use pictures to explain things, situations, ourselves (Boroditsky, 2001). This method could be useful to be used in class with categories of pain language issues. We can teach children how to produce sentences without producing pain to the others by saying exactly the same thing. Imagine that somebody is a doctor and somebody else is a patient in role-playing games that children play at home and at school. How can you give negative information without giving a hurt attack to the patient? It is a start of dealing with difficult issues from childhood. Childhood involves pain issues anyway. Adults do not explain all of them and not to all of them. This may cause immorality in pain issues for a society.
There are cases that the willing of a person to deal with a health problem is related with the hope to keep be positive. This is the reason that many countries have austere laws on the doctor's language behavior of communication painful information. For example it may not be legal to say that "you have that health problem and next year you will die, but it is legal to say that if you don't try hard you may not be with us next year because of your health problem". Even when we deal with children that do understand but are under 18 years old it is a moral issue to decide as a legal system, as practitioners, or professionals or just people who care for the certain children how many information we can give to them about their situation, how we communicate, avoid, feel their pain and what are our language educational tools to do so. "The search for studies on moral judgment in healthcare was largely disappointing, even within the literatures on empathy and caring. The literature on difficult clinical relationships is extensive, but moral judgment is at best a secondary focus in these studies" (Hill, 2010). Since everybody is going to find himself in the pain of a hospital environment school has to speak the moral language of pain.

The case study of Epione
Epione (in Greek Ηπιόνη), was in Greek mythology the wife of the God of Medicine Science, named Asclepius, she was the daughter of Meropas in Kos island. We gave this name to our educational language program of pain management as long as we enrolled to a research with healthy children at three cities in Greece, at public schools and their parents and teachers (children at grades of age 6 to 15). We also worked with special education teachers, children and other people of healthcare in schools at hospitals of three cities in Greece (2012Greece ( -2018. We interviewed children, parents, teachers, doctors, nurses, stretcher-bearers, friend and relatives of children in pain. In many cases we found ourselves listening to each person's private pain and memories, many times not in relevance with the child involved in our research. This gave us the knowledge that there is a lot of not communicated pain that needs to be heard and relieved. Another opponent of this situation is the immoral attitude of media that show pain of others as a product that shells emotional involvement and excitement and analgesia to the customers as victims of TV impression that pain of others is something that you do while you are eating your lunch at home, for example, or pain can be an athletic attitude at box games or a Taurus match show at the arena. Morality of respecting the pain of other creatures as much as our pain is another case we examined in the Greek society (Wittgenstein, 1989). There is a corpus of functions in language that are reflecting pain attitude, a cognitive schema or a grammatical metaphor. As a social implication of reference to the complexity of the pain issue: "Several factors have been identified as causes of uncontrolled and unnecessary pain, which deprive patients from receiving appropriate treatments that theoretically they have the right to access. Important factors include (with considerable regional, financial, and cultural differences) the following: (1) failure to identify pain as a priority in patient care; (2) failure to establish an adequate physician-patient relationship; or a teacher-student trust in communication; (3) insufficient knowledge regarding adequate language and behavior in pain issues; (4) concerns regarding "last-ditch" treatments of severe pain; and (5) failure to be accountable and equitable" (Carvalho et al., 2018). Findings such as these make us confront the reality of a pain identity for each language and nation, since pain is a global language for every human being to communicate and accept as an experience of the selfidentity (Czerwiec & Kopańska, 2012). Actually, this language answers questions such as who I am, what it means to be alive and well, etc.

Pain as love and compassion in Greek
In these terms of our research pain appears as an egocentric issue of the self rather than altruistic in human behavior, although as a theory it is respected from children and adolescents. The pain of physical catastrophes, such as conflagrations, loss of animals in a flood, is less important than the pain of human loss. These moral attitudes are always under consideration for each educational system and curriculum that is responsible to focus to humanities and the studies of a peaceful planet in well-being and respect for each other as much as that of ourselves as persons (Fabrega & Tyma, 1976;Te Boveldt et al., 2014). The value of a language education concentrated in empathy, sympathy (in Greek "sympathia" from "syn" and "pathos": passion: symponia means to be wounded together, to feel as you feel no matter what), is our suggestion through the research with children in the program and methodology named Epione in Greece. If children get educated to the vocabulary of pain, so as they can express themselves to the specialists and their familiar environment, there may be less cases of no co-operating patients and more successful doctors, less children at risk of every kind of pain. "Pain language" as Wittgenstein (1989) has mentioned at his Philosophical investigations and as the Australian linguist Halliday (2010) has defined in his linguistic applications, combine a secure theoretical framework which helped our program with children, and suggest a new methodology of evaluating well-being through the pain as a "friend" reminding us when something is physically or abnormally problematic. Pain is a procedure that is always with us from birth, through the crying baby scream, till the last breath of life. The moral identity of a school system is rather to explain this procedure as a positive experience and involve language experiences as a play -incidence among school mates. In Greek, the word "symponia" (to be together with pain -"ponos", derives from the verb "penomai", which means I am getting tired), for compassion names the moral opinion we try to apply as a global need for humanity on earth. In Greek language pain we should also mention that the verb I am in pain means that I do it, I do pain = ponao. It also means I love somebody -symponao, with the protheme se-you, se ponao, somehow I am in your pain -I adore you).

Implications: Teaching activities in pain language
Some teaching games-activities of pain language education that children can work in general strategies are also important to be accompanied by teaching tools -appropriate textbooks, with moral issues in teaching language, and those are applied at our research as described. We give some ideas of this case, as we found as best practices in pain language, such as the following: -Describe a pain that you have experienced or … somebody else. Can you imagine something that can be painful, if you can't find something else?
-What would you tell your pain to do so as you feel better with whatever hurts you?
-Draw your pain as an animal. What animal that would be? Give tree words that look like it.
-Who would you tell about your painful situation if you had any?
-What is the quality of a person that you would feel confident enough to talk about something that worries you?
-Find a painful story from the text that you read. Underline the phrases that show this pain (it can be in a study of real people and well known person's autobiographic painful moments in their life).
-What words would you use to say the same thing? How would you react to this problem (Discussion or diary writing) (Synonyms-antonyms, vocabulary enrichment).
-Role playing games: Separate in teams of a fiction story character that faces a realistic problem. Tell the story character what does well and what doesn't do well (reading experiential expressive language and theatre as a teaching tool).
-Argumentation and the rhetoric arts in decision making of the story character at certain crucial moments of his/her life. Debate language issues about pain in life, (figurative language in pain language semantics).
Moral issues need to be discussed among children, with children and between them: Examples -When the expression of the pain of others is a good thing but hurts us; -The respect of the other's feeling against our will; -The fear of loneliness against the need to talk about our problem; -When I know that somebody hurts somebody else, but I don't do anything to help although I could try; -When somebody talks in a way that hurts me, do I DO THE SAME to her/him? Or what do I do? -Should we compromise with painful situations in order to fulfill other aims? -To be or honest or to be kind? How can I be both without hearting the feelings of others? -Friends are just manipulative instruments for me and ways to pass my time nicely?
Moreover, when they are in trouble am I or not there for them? -Who is an altruist? Can you find a person that is and talk about him/her, behave like him/her? -What if you were the refugee of a war at a hostile country? -What if just by incidence, you are not in this case but the problem, any problem of pain is out there? -Is it ethical to be happy when somebody we don't like hurts?
-What kind of a person am I? Give names of qualities and moral dilemmas that your class would try to answer.