In this paper we1 assess the potential for research on nonhuman animals to address questions about the phenomenology of painful experiences. Nociception, the basic capacity for sensing noxious stimuli, is widespread in the animal kingdom. Even rel- atively primitive animals such as leeches and sea slugs possess nociceptors, neurons that are functionally specialized for sensing noxious stimuli (Walters 1996). Vertebrate spinal cords play a sophisticated role in processing and modulating nociceptive signals, providing direct control of some motor responses to noxious (...) stimuli, and a basic capacity for Pavlovian and instrumental conditioning (Grau et al. 1990; Grau 2002). Higher brain systems provide additional layers of association, top-down control, and cognition. In humans, at least, these higher brain systems also give rise to the conscious experiences that are characteristic of pain. What can be said about the experiences of other animals who possess nervous systems that are similar but not identical to humans? (shrink)

Which nonhuman animals experience conscious pain?1 This question is central to the debate about animal welfare, as well as being of basic interest to scientists and philosophers of mind. Nociception—the capacity to sense noxious stimuli—is one of the most primitive sensory capacities. Neurons functionally specialized for nociception have been described in invertebrates such as the leech Hirudo medicinalis and the marine snail Aplysia californica (Walters 1996). Is all nociception accompanied by conscious pain, even in relatively primitive animals such as Aplysia, (...) or is it the case, as some philosophers continue to maintain, that conscious experiences are the exclu- sive province of human beings? What philosophical and scientific resources are presently available for assessing claims lying between these extremes? (shrink)

two-dimensional modal framework introduced by Evans [2] and developed by Davies and Humberstone. [3] This framework provides Chalmers with a powerful tool for handling the most serious objection to conceivability arguments for dualism: the problem of..

Functionalism cannot accommodate the possibility of mad pain—pain whose causes and effects diverge from those of the pain causal role. This is because what it is to be in pain according to functionalism is simply to be in a state that occupies the pain role. And the identity theory cannot accommodate the possibility of Martian pain—pain whose physical realization is foot-cavity inflation rather than C-fibre activation (or whatever physiological state occupies the pain-role in normal humans). After all, what it is (...) to be in pain according to the identity theory is to be in whatever state that occupies the pain role for us. (shrink)

Postulating the subcortical organization of human consciousness provides a critical link for the construal of pain in patients with impaired cortical function or cortical immaturity during early development. Practical implications of the centrencephalic proposal include the redefinition of pain, improved pain assessment in nonverbal humans, and benefits of adequate analgesia/anesthesia for these patients, which certainly justify the rigorous scientific efforts required. (Published Online May 1 2007).

According to the increasingly popular perceptual/representational accounts of pain (and other bodily sensations such as itches, tickles, orgasms, etc.), feeling pain in a body region is perceiving a non-mental property or some objective condition of that region, typically equated with some sort of (actual or potential) tissue damage. In what follows I argue that given a natural understanding of what sensory perception requires and how it is integrated with (dedicated) conceptual systems, these accounts are mistaken. I will also examine the (...) relationship between perceptual views and two (weak and strong) forms of representationalism about experience. I will argue that pains pose very serious problems for strong representationalism as well. (shrink)

This paper examines pain states (and other intransitive bodily sensations) from the perspective of the problems they pose for pure informational/representational approaches to naturalizing qualia. I start with a comprehensive critical and quasi-historical discussion of so-called Perceptual Theories of Pain (e.g., Armstrong, Pitcher), as these were the natural predecessors of the more modern direct realist views. I describe the theoretical backdrop (indirect realism, sense-data theories) against which the perceptual theories were developed. The conclusion drawn is that pure representationalism about pain (...) in the tradition of direct realist perceptual theories (e.g., Dretske, Tye) leaves out something crucial about the phenomenology of pain experiences, namely, their affective character. I touch upon the role that introspection plays in such representationalist views, and indicate how it contributes to the source of their trouble vis-à-vis bodily sensations. The paper ends by briefly commenting on the relation between the affective/evaluative component of pain and the hedonic valence of emotions. (shrink)

It can seem natural to say that, when in pain, we undergo experiences which present to us certain experience-dependent particulars, namely pains. As part of his wider approach to mind and world, John McDowell has elaborated an interesting but neglected version of this account of pain. Here I set out McDowell’s account at length, and place it in context. I argue that his subjectivist conception of the objects of pain experience is incompatible with his requirement that such experience be presentational, (...) rationalizing, and classificatory. (shrink)

Perceptualists say that having a pain in a body part consists in perceiving the part as instantiating some property. I argue that perceptualism makes better sense of the connections between pain location and the experiences undergone by people in pain than three alternative accounts that dispense with perception. Turning to fellow perceptualists, I also reject ways in which David Armstrong and Michael Tye understand and motivate perceptualism, and I propose an alternative interpretation, one that vitiates a pair of objections—due to (...) John Hyman—concerning the meaning of ‘Amy has a pain in her foot’ and the idea of bodily sensitivity. Perceptualism, I conclude, remains our best account of the location of pains. (shrink)

The pain case can appear to undermine the radically intentionalist view that the phenomenal character of any experience is entirely constituted by its representational content. That appearance is illusory, I argue. After categorising versions of pain intentionalism along two dimensions, I argue that an “objectivist” and “non-mentalist” version is the most promising, provided it can withstand two objections: concerning what we say when in pain, and the distinctiveness of the pain case. I rebut these objections, in a way that’s available (...) to both opponents and adherents of the view that experiential content is entirely conceptual. In doing so I illuminate peculiarities of somatosensory perception that should interest even those who take a different view of pain experiences. (shrink)

Daniel Kahneman and his colleagues have made an interesting discovery about people's preferences. In several experiments, subjects underwent two separate ordeals of pain, identical except that one ended with an added amount of diminishing pain. When asked to evaluate these episodes after experiencing both, subjects generally preferred the longer episode--even though it had a greater objective quantity of pain. These data raise an ethical question about whether to respect such preferences when acting on another's behalf. John Broome thinks that it (...) is wrong to add extra pain in order to satisfy a person's preference for a better ending. His explanation for this intuition is that pain is intrinsically bad. I argue against this explanation, and raise several doubts about the moral intuition Broome endorses. In doing so, I offer alternate interpretations of Kahneman's data, and show that these each yield different values which are relevant to the ethical question. (shrink)

The most cursory examination of the history of artificial intelligence highlights numerous egregious claims of its researchers, especially in relation to a populist form of ‘strong’ computationalism which holds that any suitably programmed computer instantiates genuine conscious mental states purely in virtue of carrying out a specific series of computations. The argument presented herein is a simple development of that originally presented in Putnam’s (Representation & Reality, Bradford Books, Cambridge in 1988 ) monograph, “Representation & Reality”, which if correct, has (...) important implications for turing machine functionalism and the prospect of ‘conscious’ machines. In the paper, instead of seeking to develop Putnam’s claim that, “everything implements every finite state automata”, I will try to establish the weaker result that, “everything implements the specific machine Q on a particular input set ( x )”. Then, equating Q ( x ) to any putative AI program, I will show that conceding the ‘strong AI’ thesis for Q (crediting it with mental states and consciousness) opens the door to a vicious form of panpsychism whereby all open systems, (e.g. grass, rocks etc.), must instantiate conscious experience and hence that disembodied minds lurk everywhere. (shrink)

: This paper considers whether a physician is criminally liable for administering a dose of painkillers that hastens a patient's death. The common wisdom is that a version of the doctrine of double effect legally protects the physician. That is, a physician is supposedly acting lawfully so long as the physician's primary purpose is to relieve suffering. This paper suggests that the criminal liability issue is more complex than that. Physician culpability can be based on recklessness, and recklessness hinges on (...) whether a physician has taken an unjustifiable risk of hastening death. The authors identify three conditions of justifiability. Their analysis helps to explain the distinction between euthanasia, which is legally banned, and the use of risky analgesics, which is permitted in limited circumstances. (shrink)

Pain is not a primitive sensory event but rather a complexperception and a process by which a person interacts with theinternal and external environments, constructs meaning, andengages in action. Because folk beliefs are central to meaning,folk concepts of pain play multiple causal roles in a painpatient's interaction with health care providers and others.In every case, the notion of pain is linked to a goal-directedbehavior that is useful to the person. The wide variation inconcepts of pain across individuals suffering with painunderscores (...) the richness and complexity of the pain experience.In some cases involving chronic pain, the patient may form amaladaptive cluster of behaviors around the concept of pain.Patient beliefs and expectations are an important part of manychronic pain syndromes, and patients can benefit fromintervention directed at revising the individual's folk model of pain. Memetics offers a framework for identifying the memesthat patients hold and determining whether patient memes fitor clash with provider memes. (shrink)

Pain is an important focus for consciousness research because it is an avenue for exploring somatic awareness, emotion, and the genesis of subjectivity. In principle, pain is awareness of tissue trauma, but pain can occur in the absence of identifiable injury, and sometimes substantive tissue injury produces no pain. The purpose of this paper is to help bridge pain research and consciousness studies. It reviews the basic sensory neurophysiology associated with tissue injury, including transduction, transmission, modulation, and central representation. In (...) addition, it highlights the central mechanisms for the emotional aspects of pain, demonstrating the physiological link between tissue trauma and mechanisms of emotional arousal. Finally, we discuss several current issues in the field of pain research that bear on central issues in consciousness studies, such as sickness and sense of self. (shrink)

The facial expression of pain is the end product of a complex process that is, in part, emotional. The evolutionary study of facial expression must account for the social nature of human consciousness and should address the questions of why empathy exists, the adaptive importance of empathy, and whether facial expression is a mechanism of empathy and second-person consciousness.

Estimating the financial value of pain informs issues as diverse as the market price of analgesics, the cost-effectiveness of clinical treatments, compensation for injury, and the response to public hazards. Such costs are assumed to reflect a stable trade-off between relief of discomfort and money. Here, using an auction-based health market experiment, we show the price people pay for relief of pain is strongly determined by the local context of the market, determined either by recent intensities of pain, (...) or their immediately disposable income, but not overall wealth. The absence of a stable valuation metric suggests that the dynamic behaviour of health markets is not predictable from the static behaviour of individuals. We conclude that the results follow the dynamics of habit formation models of economic theory, and as such, the study provides the first scientific basis for this type of preference modelling. (shrink)

The condition, known as mirror-touch synesthesia, is related to the activity of mirror neurons, cells recently discovered to fire not only when some animals perform some behavior, such as climbing a tree, but also when they watch another animal do the behavior. For "synesthetes," it's as if their mirror neurons are on overdrive.

When you suffer a pain are you suffering a sensation? An emotion? An aversion? Pain typically has all three components, and others too. There is indeed a distinct sensory system devoted to pain, with its own nociceptors and pathways. As a species of somesthesis, pain has a distinctive sensory organization and its own special sensory qualities. I think it is fair to call it a distinct sensory modality, devoted to nociceptive somesthetic discrimination. But the typical pain kicks off other processes (...) too. For one it can grab your attention in a distinctive way, alerting you to its presence and sometimes obliging you to focus attention on the damaged member. Intense pain can eliminate your ability to think about anything else. Pain typically has direct and immediate motivational consequences: one wants it to stop, has an incentive to do whatever one can to reduce it, and is gratified by its termination. As these desires and motives collide with neural reality, emotional components of mental anguish, anxiety, and dread arise. The suffering involved in suffering from pain has multiple strands: it is not just the painfulness of the sensation, or the frustration of the desire that it end, but also the anguish over the possibility that it will never end, and the impossibility, if the pain is sufficiently intense, of focusing one’s attention on anything else. (shrink)

In early 2010, the Nebraska state legislature passed a new abortion restricting law asserting a new, compelling state interest in preventing fetal pain. In this article, we review existing constitutional abortion doctrine and note difficulties presented by persistent legal attention to a socially derived viability construct. We then offer a substantive biological, ethical, and legal critique of the new fetal pain rationale.

Human pain experience and expression evolved to serve a range of social functions, including warning others, eliciting care, and influencing interpersonal relationships, as well as to protect from physical danger. Study of the relatively specific, involuntary, and salient facial display of pain permits examination of these roles, extending our appreciation of pain beyond the prevalent narrow focus on somatosensory mechanisms.

How can a pain wake you up? You were not dreaming, nor did any bodily stimuli filter into your consciousness. You did not just wake up and realize you were in pain, as you might wake up and realize it is Saturday. You were deeply, dreamlessly asleep, and suddenly you were awake, and in pain. How is this possible? If pain exists only inasmuch as it is experienced, it seems that the pain did not exist when you were asleep, and (...) so could not have woken you up. I shall argue that you were woken by a pain sensation that you did not know you had, so that the distinction between what is and what is known holds even for the contents of consciousness. This illuminates the relationship between consciousness and attention, and casts light on the Classical Empiricist tradition that identifies the foundations of knowledge with direct experience. (shrink)

What differentiates expressions of pain from other facial expressions? Which facial features convey the most information in an expression of pain? To answer such questions we can explore the expertise of human observers using psychophysical experiments. Techniques such as change detection and visual search can advance our understanding of facial expressions of pain and of evolved mechanisms for detecting these expressions.

We attempt to bring the concepts of pain, suffering, and anxiety into sufficient focus to make them serviceable for empirical investigation. The common-sense view that many animals experience these phenomena is supported by empirical and philosophical arguments. We conclude, first, that pain, suffering, and anxiety are different conceptually and as phenomena, and should not be conflated. Second, suffering can be the result — or perhaps take the form — of a variety of states including pain, anxiety, fear, and boredom. Third, (...) pain and nociception are not equivalent and should be carefully distinguished. Fourth, nociception can explain the behavior of insects and perhaps other invertebrates (except possibly the cephalopods). Fifth, a behavioral inhibition system associated with anxiety in humans seems to be present in mammals and most or all other vertebrates. Based on neurochemical and behavioral evidence, it seems parsimonious to claim that these animals are capable of experiencing anxious states. (shrink)

The purpose of this paper is to elaborate on the notion of clinical medicine as a hermeneutical enterprise and to bridge the gap between the general perspectives of hermeneutics and the particularities of medical practice. The case of a patient with low back pain is analyzed. The discussion centers around the metaphor of the patient as a text and a model of five social discourses about low back pain. The problems addressed are: (1) the nature of a moral experience, (2) (...) the variety of available texts, (3) the difference between the doctor's and patient's narratives, and (4) the patient's and doctor's responsibility regarding the existential, biographical meaning of an illness. Although many problems are left unsolved, it is argued that from a philosophical point of view the notion of medicine as a hermeneutical enterprise opens up the possibility of gaining insight in the foundations of the clinical encounter. (shrink)

Painful stimuli evoke functional activations in the cortex, but electrical stimulation of these areas does not evoke pain sensation, nor does widespread epileptic discharge. Likewise, cortical lesions do not eliminate pain sensation. Although the cortex may contribute to pain modulation, the planning of escape responses, and learning, the network activity that constitutes the actual experience of pain probably occurs subcortically. (Published Online May 1 2007).

In the last two decades there have been many critics of western biomedicine's poor integration of social and psychological factors in questions of human health. Such critiques frequently begin with a rejection of Descartes' mind-body dualism, viewing this as the decisive philosophical moment, radically separating the two realms in both theory and practice. It is argued here, however, that many such readings of Descartes have been selective and misleading. Contrary to the assumptions of many recent authors, Descartes' dualism does attempt (...) to explain the union of psyche and soma - with more depth than is often appreciated. Pain plays a key role in Cartesian as well as contemporary thinking about the problem of dualism. Theories of the psychological origins of pain symptoms persisted throughout the history of modern medicine and were not necessarily discouraged by Cartesian mental philosophy. Moreover, the recently developed biopsychosocial model of pain may have more in common with Cartesian dualism than it purports to have. This article presents a rereading of Descartes' mental philosophy and his views on pain. The intention is not to defend his theories, but to re-evaluate them and to ask in what respect contemporary theories represent any significant advance in philosophical terms. (shrink)

The expression pain refers to a phenomenon intrinsic to individuals. The object of the language of pain is restricted to an individual experience which excludes any form of direct access by others. Speaking about pain is thus one of the most difficult forms of linguistic activities, as has been repeatedly pointed out by Wittgenstein. The difficulties involved in this type of communication are not only dependent upon individual linguistic ability but are also clearly reflected in the state (...) and structure of the linguistic means which are at the disposal of the speakers of a language. Linguistic means vary in status and complexity with respect to the ends which they can be used for.In this paper, I discuss two aspects of communicating pain: types of expression which are involved in speaking about pain, and linguistic activities which are carried out when speaking about pain. The two aspects are interrelated. My analysis makes use of categories belonging to the theory of linguistic activity and to the extended field theory of language (an expansion of Bühler's concept of symbolic and deictic field analysis of language). (shrink)