Online research in philosophy

That pain and suffering are unwanted is no truism. Like the sadist, the masochist wants pain. Like sadism, masochism entails an irrational, abnormal attitude toward pain. I explain this abnormality.

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.

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.

Do animals other than humans feel pain? How do we know? Well, how do we know if anyone, human or nonhuman, feels pain? We know that we ourselves can feel pain. We know this from the direct experience of pain that we have when, for instance, somebody presses a lighted cigarette against the back of our hand. But how do we know that anyone else feels pain? We cannot directly experience anyone else's pain, whether that "anyone" is our best friend or a stray dog. Pain is a state of consciousness, a "mental event", and as such it can never be observed. Behavior like writhing, screaming, or drawing one's hand away from the lighted cigarette is not pain itself; nor are the recordings a neurologist might make of activity within the brain observations of pain itself. Pain is something that we feel, and we can only infer that others are feeling it from various external indications.

In Stephanie Beardman's discussion of the empirical results of Kahneman and Tversky and Kahneman, et al. on pain preference and rational utility decision she argues that an interpretation of these results does not require that false memory for pain episodes yields irrational preferences for future pain events. I concur with her conclusion and suggest that there are reasons from within the pain sciences for agreeing with Beardman's reinterpretation of the Kahneman, et al. data. I cite some of these theoretical and empirical reasons. I engage in some speculation as to why preferences for pain experiences, which harbor the Peak and Ending profile, make biological sense. Given the results from the pain sciences and the clinical practices based in them, I conclude that the medical ethical issue Kahneman raises and Beardman tries to solve is not a pressing moral demand on medical practitioners.

This paper investigates the status of the purported explanatory gap between pain phenomena and natural science, when the “gap” is thought to exist due to the special properties of experience designated by “qualia” or “the pain quale” in the case of pain experiences. The paper questions the existence of such a property in the case of pain by: (1) looking at the history of the conception of pain; (2) raising questions from empirical research and theory in the psychology of pain; (3) considering evidence from the neurophysiological systems of pain; (4) investigating the possible biological role or roles of pain; and (5) considering methodological questions of the comparable status of the results of the sciences of pain in contrast to certain intuitions underpinning “the explanatory gap” in the case of pain. Skepticism concerning the crucial underlying intuitions seems justified by these considerations.

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.

This paper develops an instrumentalistic argumentagainst an eliminativist approach to using the folkconcept of pain in clinical medicine and draws someimplications for biomedical theories of pain. Thepaper argues that the folk concept of pain plays afundamental role in several aspects of clinicalmedicine, including the diagnosis and treatment ofdiseases and symptoms, relieving human suffering, andthe doctor-patient relationship. Since clinicians mustbe able to apply biomedical theories of pain inmedical practice, these theories should not stray toofar from pain's clinical realities. Biomedicaltheories of pain should at least incorporate an analogof the folk concept of pain, even if this concept isrevised in light of scientific advances.