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).

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)

David Bain Abstract: It can seem natural to say that, when in pain, we undergo experiences representing 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, (...) rationalising, 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)

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)

Williams argues that humans have evolved special purpose adaptations for eliciting medical attention from others, such as a specific facial expression of pain. She also recognises that such adaptations would almost certainly have coevolved with adaptations for providing and responding to medical care. The placebo response may be one such adaptation, and any evolutionary account of pain must also address this important phenomenon.

Most readers of ancient Greek psychology will agree that the Philebus is where we find Plato’s best attempt to theorize about bodily pain.1 But they will probably also agree that the account he develops there has no real chance of being true, and so should not have much appeal to us today — at least insofar as we are philosophers rather than historians. It’s this second conviction that I want to challenge in what follows. More specifically, I want to argue (...) for two connected claims about the merits of Plato’s account: first, that despite its flaws — which are significant — it is stronger and more subtle than most commentators have yet realized; and second, that it anticipates in interesting ways a view that has become both increasingly popular and increasingly controversial in the last couple of decades: the view that pains — like beliefs, desires, hopes, and fears — are mental states with representational content. I will call this view representationalism. (shrink)

A functional interpretation of facial expressions of pain is welcome. Facial expressions of pain may be useful not only for communication, such as inviting help. They may also be of direct use, as parts of writhing pain behavior patterns, serving to get rid of pain stimuli and/or to suppress pain sensations by something akin to hyperstimulation analgesia.

In this paper I demonstrate that the "pain problem" Dartnall claims to have discovered is in fact no problem at all. Dartnall's construction of the apparent problem, I argue, relies on an erroneous assumption of the unity of consciousness, an erroneous assumption of the simplicity of pain as a phenomenon ignoring crucial neurophysiological and neuroanatomical information, a mistaken account of introspective knowledge according to which introspection gives us inner episodes veridically and in their totality and a model of consciousness that (...) depicts the mind as an attic of inner objects towards which attention might or might not be directed. Once these errors are dispelled, no problem remains. None the less, given the seductiveness of these errors, and the havoc they wreak in cognitive science, dispelling them is a worthwhile exercise. (shrink)

As the above quote clearly highlights, it is the responsibility of researchers and research supervisors to be certain that their research staff and students assistants are very familiar with all of the ethical principles and current standards relevant to the research they are conducting. Indeed, they must take an active role in being certain that their research staff and students complete appropriate training in these ethical principles and standards, and how they apply them to the research context in which they (...) are working. This is especially important in areas in which there may be physical harm such as chronic pain research. (shrink)

Neuroscience, together with a broadened concept of “mind” has instigated pragmatic and ethical concerns about the experience and treatment of pain. If pain medicine is to be authentic, it requires knowledge of the brain-mind, pain, and the relative and appropriate “goodness” of potential interventions that can and/or should be provided. This speaks to the need for an ethics that reflects and is relevant to the contemporary neuroscience of pain, acknowledgment and appreciation of the sentient being in pain, effects of environment (...) and value(s), and the nature of healing. It may be that neuroethics provides this viable meta-ethic for pain care. This essay describes how an integrative neuroethics of pain care allows, if not obligates, alignment of facts, values, and moral attitudes as a continuing process of re-investigation, analysis, and revision of what we know (and don’t know) about brains, minds, selves, and how we regard and treat the painient. (shrink)

Orthodox neural materialists think mental states are neural events or orthodox material properties of neutral events. Orthodox material properties are defining properties of the “physical”. A “defining property” of the physical is a type of property that provides a necessary condition for something’s being correctly termed “physical”. In this paper I give an argument against orthodox neural materialism. If successful, the argument would show at least some properties of some mental states are not orthodox material properties of neural events. I (...) argue against the existence of a posteriori identities. (shrink)

By what types of properties do we specify twinges, toothaches, and other kinds of mental states? Wittgenstein considers two methods. Procedure one, direct, private acquaintance: A person connects a word to the sensation it specifies through noticing what that sensation is like in his own experience. Procedure two, outward signs: A person pins his use of a word to outward, pre-verbal signs of the sensation. I identify and explain a third procedure and show we in fact specify many kinds of (...) mental states in this way. (shrink)