Pain and Value Adam Swenson Pain and Value Adam Swenson Rutgers, The State University of New Jersey Ph.D. Dissertation ©2006 ALL RIGHTS RESERVED Pagination in this edition may differ from the original. TO CHRISTINE WITHOUT WHOM, NOT From: Swenson, Pain and Value 1 © 2006 by Adam Swenson Chapter 1 Introduction If anything is intrinsically bad, pain is. Even the staid skeptic should accept this conditional. For anyone who cares about the nature of value, consequentialist, Kantian, virtue ethicist, and even those who deny the intelligibility of mind--‐‐independent value, an account of the putative intrinsic badness of pain is compulsory. If one believes that moral evaluations attach only to agents, she must explain why pains, which seem to be mental states, are bad. If she holds that nothing is intrinsically bad, she must account for the seeming wrongness of my stomping on your gouty foot. And if she agrees that pains are, in fact, intrinsically bad, she must at least say what she means, if not why this is the case. I believe all existing accounts of pain's intrinsic badness are false. Their mistake has two sources. First, these views assume a virtually universal but false conception of what pains are. Second, accounts of pain's intrinsic badness are usually developed in tandem with accounts of the intrinsic goodness of pleasure. But there are some important disconnects between the source of pain's intrinsic badness and the source of pleasure's intrinsic goodness. At the least, assuming that we can seamlessly transpose claims about pain's intrinsic badness to pleasure's intrinsic goodness, and vice--‐‐versa, obscures what is distinctive about pain and its intrinsic badness. Thus in this dissertation I shall focus solely on understanding pain and its intrinsic badness. This will yield new insights that extend to other areas of value theory. In particular, I shall argue that when we correctly understand the nature of pain and its intrinsic badness we must revise the existing theories of the nature of intrinsic value. In this chapter, I'll sketch the main claims and arguments of this dissertation. I'll start with a quick overview and then sketch the content of each chapter. Before I begin, one note about terminology. I shall use 'intrinsic value' and 'value' to include the positive, neutral, and negative valences -thus pain's intrinsic badness will be an intrinsic value. Many prefer to reserve 'value' for the positive valence, and use 'disvalue' for the negative. But the difference in terminology does not reflect a substantive difference. §1.1 Synopsis Let me begin with a quick synopsis of the arc of this dissertation and its main claims. I'll then discuss each chapter in a bit more detail. Nearly everyone believes that pain is just a sensation. More specifically, they believe that everything normatively significant about a pain is contained in the way it hurts. The nature of a stubbed toe's pain is exhausted by the way it stings and throbs. This is the kernel view of what pains are. From: Swenson, Pain and Value 2 © 2006 by Adam Swenson Pains certainly involve a particular kind of sensation. But I believe that the sensation is not all that is normatively significant in pain. Pains are reliably accompanied by affective states such as fear, conative states such as the urge to flee, cognitive states such as the pain's perceived meaning (for example, the way a cancer patient's headache throbs memento mori), and many others. I believe these can affect a pain's intrinsic value. I also believe that they are themselves intrinsic properties of the pain. If I'm right, we must reject the kernel view. Once we reject the kernel view and take on a view which allows these affective, conative, desiderative, and cognitive states to be part of the pain, I think we are led to reject all of the traditional accounts of pain's intrinsic badness. The traditional accounts of pain's intrinsic badness fall into four families. On dislike theories, pains are bad because they are disliked; on mental state theories, pains are bad because they are unpleasant; on motivation theories, pains are bad because they involve the urge to flee; and, on representation theories, pains are bad because they represent bodily damage. Each of these theories select a very narrow set of the elements which compose a pain and anoint it as the source of pain's intrinsic badness. The dislike theory seizes on the desiderative components, while the motivation theory seizes on the conative components. But since all the components of a pain affect its intrinsic value, each of these theories has only captured part of the truth. Thus we should reject them in favor of an aversion theory on which all the components of a pain together form the source of its intrinsic value. I believe that many pains have two distinct intrinsic values with different sources. Pain's second intrinsic value lies in the way its presence makes the intrinsically good impossible. This is because pain threatens a particular kind of self--‐‐control which is a necessary condition of intrinsic goods like autonomy, deep personal relationships, well--‐‐ being, and having one's desires satisfied. For example, autonomy requires some measure of control over the train of one's thoughts and the movements of her body. Thus with many pains a person in pain is ipso facto not fully autonomous. That makes pain intrinsically bad. The conclusion that pain is intrinsically bad in these two ways has important implications throughout value theory. In this dissertation I explore just one: its implications for our understanding of the nature of intrinsic value. On my account, pain's intrinsic value depends on its relational properties and derives its value from other things of intrinsic value. But insofar as it undermines intrinsic goods, it also has its value essentially. This is incompatible with all of the existing accounts of the nature of intrinsic value. From: Swenson, Pain and Value 3 © 2006 by Adam Swenson §1.2 Overview of chapters These are the main claims of this dissertation. Let me now sketch each of the chapters and their arguments in a bit more detail. I'll take each chapter in order. 1.2.1 Intrinsic value, pain, and method Chapter two is in some ways more of an introduction than the present chapter. It sets the background and conceptual terrain for this dissertation. I begin with some claims about my methodology and the general aims of my project. The distinctive feature of my approach is that, unlike other projects, I focus solely on issues in value theory as they pertain to pain. This project revolves around one question: Why is pain intrinsically bad? I shall address this question without also discussing any other exemplar of intrinsic value. I shall ignore, for example, the intrinsic goodness of pleasure. This attempt to address pain's intrinsic value in isolation faces a conceptual impediment from the outset. Suppose we believe that the intrinsic value of x is the value which depends solely on x's non--‐‐relational properties. Being disliked is a relational property. Therefore pain cannot be intrinsically bad because it is disliked - the dislike theory is false. We have thus ruled an intuitively attractive account of pain's intrinsic value out of court by our definition of intrinsic value. This is problematic in several ways. To mention just one, my project aims to gain insight into the nature of intrinsic value from an account of why pain is intrinsically bad. But this seems to show that we must understand the nature of intrinsic value before we can address pain's intrinsic badness. To avoid this and other problems, my approach has two twists. Both require a bit of philosophical apparatus, but we can set that aside for now. Instead, I'll just sketch their central features. First, the scope of my project and its conclusions is narrower than I have so far suggested. Instead of reaching conclusions about the nature of intrinsic value in general, my conclusions will only apply to the nature of pain's intrinsic value. For example, instead of asking whether intrinsic value can depend on non--‐‐relational properties, I shall only ask whether pain's intrinsic value depends on non--‐‐relational properties. I shall not assume that the answer for pain will entail answers for more general debates about the nature of intrinsic value. That is, I shall not assume that my conclusions herein can be extrapolated to, say, the intrinsic goodness of pleasure. This may seem to greatly diminish the significance of my project. But the fruits of this dissertation will show otherwise. Second, with the scope of my project thusly restricted, the discussion of why pain is intrinsically bad can be made into a proxy for the more general debates about the nature of pain's intrinsic value. That will avoid the problem above of needing to decide on the nature of intrinsic value before starting out on pain's intrinsic badness. I shall take the From: Swenson, Pain and Value 4 © 2006 by Adam Swenson existing theories which purport to explain pain's intrinsic badness at face value as theories of intrinsic value. Thus we need not worry ahead of time about whether, for example, intrinsic value can depend on relational properties. Instead, we can wait to see whether the best theory of pain's intrinsic badness invokes relational properties. If it does, then intrinsic value, in the case of pain, can depend on relational properties. The remainder of chapter two prepares the ground for the rest of the dissertation. I first set out the kernel view of pain and discuss how it fits with existing views. I then introduce the existing theories of pain's intrinsic badness and place them in a somewhat novel taxonomy to aid my discussion in chapter three. 1.2.2 Contexts vs. kernels In chapter three I argue that the kernel view is false and that it should be replaced with a composite view on which a pain is a composite of a painful sensation kernel and a reaction to the kernel. I then argue that adopting a composite view implies that the existing theories of pain's intrinsic badness are false. I conclude by setting out my aversion theory of pain's intrinsic badness. I attack the kernel view by arguing that two qualitatively identical pains can have different intrinsic values in different contexts. While any change in value between the cases would do, I set out some examples in which a pain is intrinsically good in one case and intrinsically bad in another. Supposing that there can be no difference in intrinsic value without a difference in intrinsic properties, this shows that the two pains have different normatively significant intrinsic properties. Since the kernel view claims that the sensation kernel contains all of a pain's normatively significant properties, this is incompatible with the kernel view. We should therefore reject the kernel view. We should replace the kernel view with a composite view of the nature of pain. As indicated, on this view a pain is a composite of a painful sensation kernel and a reaction to that kernel. This reaction can be influenced by the context in which the pain occurs. For example, the fact that I know my stomachache is the product of cancer makes the reaction much more negative than it would be if I merely had indigestion. I then turn to what constitutes the pain's reaction component. I argue that the phenomena which affect a pain's intrinsic value, such as fear, meaning, desires, beliefs, attention, depression, anxiety, and many others, are themselves intrinsic properties of the reaction component. For example, suppose you must undergo a lengthy unanesthetized surgery. The first incision causes a sensation kernel that is qualitatively identical with the sensation kernel I experience when I slice through a tomato into my hand. But our pains are very different. For one, the reaction component of your pain contains a great deal of fear which the reaction component of my pain lacks. Your pain is thus intrinsically much worse than mine by virtue of the fear it contains. On first blush, the composite view seems to fit nicely with a dislike theory of pain's intrinsic badness. Combining the two yields the plausible claim that pain is bad because From: Swenson, Pain and Value 5 © 2006 by Adam Swenson the sensation kernel is disliked and that the dislike is itself an intrinsic property of the pain. But the dislike of the sensation kernel is just one of the reaction component's many elements. In fact, we find all of the traditional candidates for pain's intrinsic badness among the reaction component's affective, conative, desiderative, and cognitive, elements. This leads me to conclude that all of the existing theories of pain's intrinsic badness are false. Each account held part of the truth. We capture the whole truth with the aversion theory on which a pain is intrinsically bad in virtue of the conjunction of all the elements of its reaction component. 1.2.3 Pains as usurpers In chapter four I set out the second intrinsic value of pain. Many pains undermine intrinsic goods by undermining a certain kind of control we have over ourselves. This user control is involved in nearly every aspect of our lives as agents. I am presently exercising user control over my fingers in typing this sentence. I am simultaneously exerting user control over my train of thought as I write. Everything that is intrinsically good for a person depends on her having certain forms of user control. For example, autonomy requires a certain measure of user control over one's train of thought. A person cannot be autonomous if her thoughts are nothing but unconstrained babble. Pain is thus intrinsically bad because its presence makes autonomy and other intrinsic goods impossible by undermining the user control they require. It seems clear that the source of pain's intrinsic badness must lie in the way it feels. I believe the undermining of user control is present in the experience of pain. Once we reject the kernel view and allow the reaction component to be complex, the phenomenology of pain -the way a pain hurts- is much more nuanced. Thus I believe the experience of pain involves the experience of user control being undermined. We find this in the particular way a pain seems to invade its sufferer and seize control over parts of her mind and body. To see how this is part of the pain's phenomenology, imagine trying to hold your hand in a pot of water as it is slowly brought to a boil. Part of the pain is the feeling that your hand is in rebellion, that it is pulling itself from the water. The pain also wrests away your attention. The worse it becomes, the harder it is to ignore. As it worsens, the pain's control begins to penetrate into the contents of your thoughts. Suppose I threaten to kill your child if you remove your hand before the water boils. At some point, you will find yourself -against your will- rationalizing removing it and letting your child die. This is the experience of pain wresting away your user control and undermining the possibility of intrinsic goods like autonomy. The source of pain's intrinsic badness does lie in the way a pain hurts. The friends of the kernel view were right about that. But they were deeply mistaken about what is involved in a pain's hurting, and thus about why pain is intrinsically bad. From: Swenson, Pain and Value 6 © 2006 by Adam Swenson 1.2.4 Pain and intrinsic value In chapter five, I turn to what we have learned about the nature of intrinsic value from discussing the source of pain's intrinsic badness. I argue that neither of the leading accounts of the nature of intrinsic value fit pain's intrinsic badness. The existing accounts of the nature of intrinsic value differ on what combinations of six kinds of value make up intrinsic value. I'll begin with a sketch of these kinds of value. I'll then say what combination fits pain's intrinsic value, and show that this entails a new conception of the nature of intrinsic value. The first variety is non--‐‐derivative value. An x has non--‐‐derivative value when we can want x strictly for its own sake. x is desired as an end; it does not inherit its value from anything else. The goodness of pleasure and happiness are standard examples. Its opposite is derivative value. Instrumental value is one example of derivative value. Non--‐‐relational value is the value an x has solely in virtue of its non--‐‐relational properties. Its opposite is relational value which something has (at least partially) in virtue of its relational properties. Instrumental value is also a relational value. Finally, essential value is the sort of value a thing has necessarily. That is, an x has its essential value no matter in what circumstances it occurs; x's essential value thus depends solely on x's essential properties. This is what Moore had in mind with his famous isolation test for intrinsic value: In order to arrive at a correct [answer to the question 'what things have intrinsic value?'] it is necessary to consider what things are such that, if they existed by themselves in absolute isolation, we should yet judge their existence to be good1 Many things have non--‐‐essential value. That is, value which depends on some contingent property. Ice cream is good only insofar as people like it. One standard account of intrinsic value stands in Moore's shadow by holding that an x's intrinsic value is its non--‐‐derivative, non--‐‐relational, and essential value. An alternative account takes x's intrinsic value to be its non--‐‐derivative value. These are the two main accounts of the nature of intrinsic value. On my view, at least one of pain's intrinsic values depends on its necessary relationship to that which is intrinsically good. I argue that this makes pain's intrinsic badness a relational, essential, and derivative value. It is thus closest to the second existing view. But, while intrinsic value can be essential on the second view, it need not be. My account of pain entails that intrinsic value must be essential. Therefore, the nature of pain's intrinsic value is not covered by either of the existing accounts of the nature of intrinsic value. 1 Moore (1903), 187. From: Swenson, Pain and Value 7 © 2006 by Adam Swenson 1.2.5 Out of the harbor This dissertation is just part of a much larger project. I believe we can make progress in many areas of value theory by focusing solely on pain. In the concluding chapter six I summarize my conclusions and arguments herein. I then point to some implications which my understanding of pain's nature and intrinsic value may have in other areas of value theory. These include, in no particular order: naturalism about value; the tenability of value hedonism; the moral status of animal and fetal pains; the nature of torture; whether there is just one kind of intrinsic value; the evil of death; the nature of autonomy; the subjective--‐‐objective distinction in value; and the difference between agent--‐‐relative and agent--‐‐neutral value. I then spend the remainder of the chapter discussing some of the implications of my conclusions about pain for our understandings of hedonism, the calculation of hedonic values, and the intrinsic value of pleasure. From: Swenson, Pain and Value 8 © 2006 by Adam Swenson Chapter 2 Intrinsic Value, Pain, and Method We can often gain new insights into old issues by changing our approach. This dissertation is part of a larger project unified by a particular philosophical methodology. I believe that we can make progress on many of value theory's central questions by asking them just about pain. Instead of asking about the nature of intrinsic value, I shall ask about the nature of pain's intrinsic value without assuming that this will translate into a more general account of intrinsic value. For example, I shall not assume that what goes for pain's intrinsic value goes for pleasure's. By narrowing our investigation in this way, we can make a great deal of progress in our understanding of the nature of intrinsic value. To do this, I'll begin with some background by discussing the philosophical methodology most modern writers use and some of its consequences in §2.1. In §2.2 I'll set out two central debates surrounding intrinsic value. Then after sketching my particular approach in §2.3, I'll flesh it out and lay groundwork for the forthcoming chapters by setting out a virtually universal conception of what pain is in §2.4. I'll then do some conceptual cartography by taxonomizing the existing accounts of pain's intrinsic badness in §2.5 and §2.6. §2.1 The coherence method It is difficult to discuss philosophical methodology in the abstract. At a fine--‐‐ enough grain, the number of approaches to philosophy approaches the number of philosophers, and approaches are not readily separable from the topics they approach. But I believe there are (at least) three distinct ways of approaching value theory. I'll adumbrate these three methods in §2.1.1. In §2.1.2 and §2.1.3 I'll give a bit more detail to the most popular approach. 2.1.1 Three methods On the condescension method we begin from the very top. Writers like Kant, Brandt, and Hare, begin with purely formal concepts, or rarified claims about the nature of rationality, or thin axiological and metaethical claims about the structure of value and normative discourse. From those heights these writers then derive and justify answers to more substantive questions about value -for example, why is pain intrinsically bad?'- and the problems of practical ethics.2 Of course, as many have pointed out, if one begins with conceptions of rationality and such which are too rarified and insubstantial, there will not be enough to derive 2 For example, Kant (1785), (1788); Hare (1952), (1972), (1971), (1981); and Brandt (1979). From: Swenson, Pain and Value 9 © 2006 by Adam Swenson answers to substantive questions. At the same time, if one builds too many substantive assumptions about human nature and motivation into the starting point, the results will be tainted and will fall short of the universality at which such approaches aim. On the swamp--‐‐draining method we proceed by casting a jaundiced eye on normative topics as they've been traditionally raised. On this view, normative theory and discourse is a fever--‐‐swamp which we must drain before we can understand and apply normative concepts. In the shadow of Hume, the this method's proponents discard traditional questions like 'what is the nature of intrinsic value?' or 'why is pain intrinsically bad?' in favor of the careful study of human normative talk and behavior. These writers thus draw heavily upon the resources of behavioral economics, psychology, evolutionary biology, ethnography, and other sciences. The new aim of moral philosophy becomes cataloging and finding common structures in the norms and customs of the world's peoples. We might find, for example, that there is a widely held aversion to certain kinds of sensations that most cultures regard as in of themselves undesirable. And with enough evolutionary background as to why an aversion to such sensations is biologically optimal, we've said what there is to be said about the intrinsic badness of pain. The coherence method is by far the most common modern approach to value theory. On this method, we proceed in value theory by seeking coherence in our answers to a host of metaethical, normative, axiological, and practical questions on the one hand; and our judgments about example cases on the other. Griffin summarizes the approach: The best procedure for ethics...[is one of] going back and forth between intuitions about fairly specific situations on the one side and the fairly general principles that we use to try to make sense of our moral practice on the other, adjusting both, until eventually we bring them all into coherence.3 Like both of the other methodologies, the coherence method is implemented in many different forms by different writers. My own approach will be a version of the coherence method. I shall have no more to say about the condescension and swamp--‐‐draining methods. Both can be fruitful. Though I suspect that their fruits will be most significant as data for the coherence method. That is a question far beyond the purview of this dissertation. This chapter will set out my particular version of this method. In this section I'll discuss this method as it is generally applied before setting out my own version of it in §2.2. 2.1.2 The coherence method in outline Let me begin with an extremely rough and idealized picture of how work in value theory proceeds on the coherence method. It will help to imagine that we are just starting out on the broadest questions of value theory. We begin with a large set of normative and metaethical theses, and a set of prima facie judgments about substantive 3 Griffin (1996), 9. My thoughts about method have been very much influenced by Griffin's work. From: Swenson, Pain and Value 10 © 2006 by Adam Swenson cases. Each thesis and judgment has its own weight -we find them to various degrees more and less plausible, and more and less difficult to give up. I shall not address the details of this notion of weight or its relationship to the justification of our moral beliefs. For my purposes it will be enough to take 'weight' as something like 'degree of conviction.'4 Taken individually, some theses and judgments seem to have a particularly heavy weight. This is true of the thesis that equals are to be treated equally; and the judgment that something very wrong occurs when one wantonly kills. Others have lesser but still significant weight. We might be attracted to, yet somewhat ambivalent about, the doctrine of double effect; or about the judgment that we ought to save the ten trapped miners instead of diverting the resources to preventing future catastrophes. And so on, all the way down to theses which we believe are simply false and judgments in cases with no normative significance. Taken together, the prima facie weightings conflict. Some theses which fit with intuitively plausible judgments in one case endorse seemingly implausible judgments in other cases. We then must decide how to rearrange the prima facie weights. For example, many find certain claims about the impartial promotion of utility plausible but balk when they imply that those in richer countries ought to transfer much of their wealth to those in poorer countries. That strikes many as making morality too demanding. We must then lower the weight of the alleged moral requirement or convince ourselves that the negative reaction is misleading. In this case, the change in weights need not be all--‐‐or--‐‐nothing (though it might be). In practical terms, we may change our judgments about the amount we owe while retaining the belief that we do owe. How we resolve these conflicts depends both on the apparent weights of the thesis and judgment, and on their relationships to other theses and other judgments. Some conflicts require that we revise just one thesis or judgment. With others we must revise large sets of interrelated theses and judgments. The ultimate goal is a normative theory -a maximally coherent set of weighted theses and substantive judgments.5 Like coherence theories of justification or truth, the coherence method in ethics faces several well--‐‐known objections. Famously, for whatever set of weightings of theses and judgments we come to, there will be other equally coherent sets of weightings and no principled way of choosing between them. I must leave this and other objections to others. In any event, the ultimate defense of a taxonomy or methodology is its fruits. 4 For some important discussions of the relationship between coherence and justification in ethics, see Rawls (1971), Ch.1--‐‐3; Griffin (1996), Ch.1; Scanlon (1998), Ch.4--‐‐5. 5 We need not think that 'maximally coherent' means 'completely coherent'. The coherence method is compatible with the possibility that the best normative theory will contain intractable disputes between some theses and/or substantive judgments. Larry Temkin makes something like this point in Temkin (1993), Ch.10. From: Swenson, Pain and Value 11 © 2006 by Adam Swenson And, like many others, I believe that some version of this approach will give us much to harvest. Different writers apply the coherence method in importantly different ways. But the general approach is the same. Most writers also share a common conception of the scope of their projects. They focus on general questions like 'what is intrinsic value?' and use particular phenomena like the intrinsic value of pain as test cases. That is, the intrinsic values of pain, pleasure, autonomy, and other putative exemplars, function as proving grounds for answers to these general questions. 2.1.3 Ship--‐‐building on the open seas As the coherence method is normally applied, there can be no a priori guarantees that any of our normative beliefs will be included in the final maximally coherent normative theory. That in turn suggests that there are no unshakable foundations in value theory. This is because the concepts and therefore the questions we ask in value theory are deeply theory--‐‐laden. In building a theory we are, in a sense, at the same time building the very concepts that are at issue. For example, in inquiring about what has intrinsic value, we are at the same time crystallizing what we mean by 'intrinsic value'. Similarly, our concept of rights acquires a great deal of content from our broader theoretical concerns. If we are Kantians, we may see rights as (nearly) inviolable restrictions on conduct which have a central and, in a sense, underived moral status. Whereas, if we are rule utilitarians, rights may be relatively strict constraints on conduct that have their normative status in virtue of our inability to know what actions will maximize utility in every particular case we face. All of these views share some common core which fixes the concept in a rough position in logical space. But while there is a core to the concept, the content of our concept of a right is in large part a nexus of interrelated normative theses and judgments about cases. Thus, in a sense, we are never talking just about rights. If the concepts involved are theory--‐‐laden in this way, the questions we address will be similarly laden. We can only take on one neighborhood of issues at a time. Thus when we take up a topic, we must hold seemingly remotely related theses and judgments in abeyance. The fact that different writers will bring different concepts to the table will often mean that they are holding different issues in abeyance. If this is correct, when we do value theory there are no theory--‐‐neutral concepts and the questions we ask are somewhat artificial subsets of interconnected issues. These two observations show that there can be no a priori guarantee that any of our normative beliefs -no matter how deeply held- will not be overturned in the final analysis. Thus there cannot be any theory--‐‐neutral foundation on which to stand that is not itself subject to crumbling as we proceed. There are no Archimedean points in value theory. This isn't a new observation. Nor is it a problem for the coherence method as it is usually applied. There are better and worse places to stand. On better ground the From: Swenson, Pain and Value 12 © 2006 by Adam Swenson concepts and questions have wide theoretical stability and widespread intuitive backing and thus seem less likely to be overturned. I believe that the claim that pain is intrinsically bad is as close as we can possibly come to an Archimedean point. If we narrow our scope to just pain and do not consider any other examples of intrinsic value, we can get the concepts involved thin enough that they will be neutral between the competing theories. To help flesh this out, I'll now turn to some issues about intrinsic value.6 §2.2 Conceptions of intrinsic value Let me now turn to the nature of intrinsic value. In adumbrating two important and interrelated debates about intrinsic value, I'll be both introducing one of this dissertation's main topics and giving an example of the sorts of interconnections that I discussed above. I'll begin with the competing conceptions of intrinsic value. 2.2.1 Six varieties of value Different writers may mean very different things by 'intrinsic value'. But there is a common core. Our putative concept of intrinsic value is of a value that is most tightly tied to its bearer and which plays a particular and important role in our normative thought. Moore captures a large part of this role: That which is meant by '[intrinsically] good' is...the only simple object of thought which is peculiar to Ethics. Its definition is therefore, the most essential point in the definition of Ethics and moreover a mistake with regard to it entails a far larger number of erroneous ethical judgments than any other. Unless...its true answer [is] clearly recognized, the rest of Ethics is as good as useless from the point of view of systematic knowledge.7 His acolyte Zimmerman adds At the heart of ethics lie the concepts of good and bad; they are at work when we assess whether a person is virtuous or vicious, an act right or wrong, a decision defensible or indefensible, a goal desirable or undesirable.....It is in virtue of intrinsic goodness and badness that other types of goodness and badness may be understood8 6 In Ernie Sosa's metaphor, coherence methods attempt to assemble theories in the same way that one might struggle to build a raft while floating in the middle of the ocean. Extending the metaphor may help clarify my point about guarantees. Imagine yourself floating in the debris field of a shipwreck. The reasonable thing to do is to clamber onto the biggest and sturdiest bit of driftwood you can find. You would then paddle around looking for other suitable pieces to lash to the first piece, gradually building a boat as you go. Sometimes you will find new, better, pieces and discard older more ill--‐‐fitting components. Indeed, at some point you may find that you ought to abandon the large piece that you began with in favor of something else which better fits the whole. Even though it is a big and sturdy piece, there's no telling what else you'll find. 7 Moore (1903), 5. 8 Zimmerman (2001), 4. From: Swenson, Pain and Value 13 © 2006 by Adam Swenson With 'intrinsic value' we are referring to one of several possible combinations of six kinds of value which fits this role. Many of these normally overlap. For perspicuity I shall separate them here. My goal here is to frame some of the debates and what's at stake. Thus I'll gloss over several details. I shall discuss them in §5.1. The first variety is non--‐‐derivative value. An x has non--‐‐derivative value when we can want x strictly for its own sake. x is desired as an end; it does not inherit its value from anything else. The goodness of pleasure and happiness are standard examples. Its opposite is derivative value. Instrumental value is a paradigm example of derivative value. The instrumentally valuable is only valuable insofar as it conduces to the achievement of some non--‐‐derivative value. Money is valuable because it allows one to buy new records, the listening to which gives one pleasure. Contributive value -the value an x has in virtue of being part of a valuable whole- is another form of derivative value.9 Non--‐‐relational value is the value an x has solely in virtue of its non--‐‐relational properties. Its opposite is relational value which something has (at least partially) in virtue of its relational properties. While instrumental values are again paradigm relational values, there can be others. As Korsgaard points out Certain kinds of things, such as luxurious instruments...are valued for their own sakes under the condition of their usefulness. Mink coats and handsome china and gorgeously enameled frying pans are all things that human being might choose partly for their own sakes under the condition of their instrumentality: that is given the role such things play in our lives.10 Thus the value of a mink coat depends on the role it plays in our lives as an object of aspiration. In a similar vein, Kagan suggests that the pen Lincoln used to sign the Emancipation Proclamation is valuable in virtue of its causal and historical properties (these are also allegedly cases of things with non--‐‐derivative value).11 Finally, essential value is the sort of value a thing has necessarily. That is, an x has its essential value no matter in what circumstances it occurs; x's essential value thus depends solely on x's essential properties. This is what Moore had in mind with his famous isolation test for intrinsic value. In order to arrive at a correct [answer to the question 'what things have intrinsic value?'] it is necessary to consider what things are such that, if they existed by themselves in absolute isolation, we should yet judge their existence to be good12 Many things have non--‐‐essential value. That is, value which depends on some contingent property. Ice cream is good only insofar as people like it. Though they tend to be closely related, non--‐‐relational value and essential value need not always 9 There is another conception of non--‐‐derivative value on which an x has non--‐‐derivative value if there is no helpful explanation of why x is good. I shall ignore this alternative in this chapter. I discuss it in §5.1.3. 10 Korsgaard (1983), 185. 11 Kagan (1998). 12 Moore (1903), 187. From: Swenson, Pain and Value 14 © 2006 by Adam Swenson correspond. A thing's non--‐‐relational and essential properties are often different. The box's being square is a non--‐‐relational property, but not an essential property -it remains the same box even after being squished.13 2.2.2 Two answers When we ask what intrinsic value is, we want to know which mélange of these six values properly fills the conceptual role carved out by the putative conception. The existing accounts of intrinsic value divide into two broad camps. In the prime example of the first sort of view, Moore writes that When I say, with regard to any particular kind of value, that the question whether and in what degree anything possesses it depends solely on the intrinsic nature of the thing in question, I mean to say two different things at the same time. I mean to say (1) that it is impossible for what is strictly one and the same thing to possess that kind of value at one time, or in one set of circumstances, and not to possess it at another; and equally impossible for it to possess it in one degree at one time, or in one set of circumstances, and to possess it in a different degree at another, or in a different set. This, I think, is obviously part of what is naturally conveyed by saying that the question whether and in what degree a thing possesses the kind of value in question always depends solely on the intrinsic nature of the thing. For if x and y have different intrinsic natures, it follows that x cannot be quite strictly one and the same thing as y; and hence if x and y can have a different intrinsic value, only where their intrinsic natures are different, it follows that one and the same thing must always have the same intrinsic value....(2) The second part of what is meant is that if a given thing possesses any kind of intrinsic value in a certain degree, then...anything exactly like it...must...possess it in exactly the same degree.14 Thus the first competitor for the concept of intrinsic value is the Moorean view: The intrinsic value of x is x's non--‐‐relational, non--‐‐derivative, and essential value. The alternative, is the Final value view: The intrinsic value of x is x's non--‐‐derivative value. These are, I think, the two basic positions on what intrinsic value is. 2.2.3 The bearers of intrinsic value On the coherence method, we cannot simply compare the theses involved in each view and the substantive judgments they yield, for these are all bound up with other claims and judgments. They are, for example, deeply entangled with questions about the bearers of intrinsic value. There are many different candidates for what exactly has intrinsic value. Some writers, hold that concrete objects can bear intrinsic value.15 On these views, people, books, works of art, and other concrete objects, are what is intrinsically good. Others locate 13 We can distinguish still other sorts of value. For example, C.I. Lewis introduced the notion of inherent value to cover the objects of an intrinsically good experience. See, Lewis (1946), Nonetheless, I think these six values are at the heart of the debates about intrinsic value. 14 Moore (1951), 260--‐‐61. Italics original. 15 For example, Kagan (1998); Korsgaard (1983); Rabinowicz and Ronnow--‐‐Rasmussen (2004). From: Swenson, Pain and Value 15 © 2006 by Adam Swenson intrinsic value in more abstract entities. On some views it is the state of affairs consisting in someone feeling pleasure or an artwork existing that is intrinsically good.16 Still others hold that facts17 or properties18 or tropes19 are intrinsic value's bearers. For simplicity, in discussing this bearers debate I will talk only about objects and facts as the candidate bearers. These two views can reasonably stand in for other potential bearers. They are also, I think, the two most plausible competitors.20 The metaphysical issues of the bearers debate are important in the dispute between the Moorean and final value views. Suppose the proponent of final value introduces a case wherein an x seems to have intrinsic value in virtue of its relational properties. As Kagan notes, if a view on which facts or states of affairs are the bearers of intrinsic value is correct, there will of course be a fairly easy translation from the common, informal object--‐‐based idiom to the strictly correct fact--‐‐based idiom. Instead of saying that Lincoln's pen has intrinsic value, for example, by virtue of its having been used to sign the Emancipation Proclamation, we will say that what has value is the fact that there exists a pen which was used to sign the Emancipation Proclamation.21 Thus the proponent of the Moorean view can accept the suggestion that the pen has intrinsic value. We can recognize that [the fact that such a pen exists] has intrinsic value by virtue of its being about a pen being used in a particular way -but since we are assuming that this is an intrinsic property of the fact in question, it will still be true that only intrinsic properties of the fact are relevant to its intrinsic value.22 That is, by making facts the bearers of intrinsic value, the Moorean can suck up any relevant relational properties of the object and make them non--‐‐relational properties of the fact. 2.2.4 Why is pain intrinsically bad? Our most ground--‐‐level axiological questions are laden with these and other disputes. The Moorean/final value and bearers disputes infect the question 'why are pains intrinsically bad?' Depending on which views we adopt, some independently plausible substantive accounts of pain's intrinsic badness may be non--‐‐starters. Consider two simple substantive accounts. On the mental state theory, pains are bad because they are unpleasant. On the dislike theory, pains are bad because we 16 For example, Chisholm (1986); Zimmerman (2001); and Lemos (1994). 17 For example, Ross (1930), 137. 18 For example, Butchvarov (1989). 19 Zimmerman seems to suggest this view in. Zimmerman (2001), Rabinowicz and Ronnow--‐‐Rasmussen attack it in. Rabinowicz and Ronnow--‐‐Rasmussen (2003), 20 Facts, on this understanding, are instantiated states of affairs. 21 Kagan (1998), 293. Italics original. 22 Kagan (1998), 294. From: Swenson, Pain and Value 16 © 2006 by Adam Swenson dislike them. On the final value view, both are candidate accounts of pain's intrinsic value. Pain's unpleasantness could be non--‐‐derivatively bad. The same is true of being disliked. But on the Moorean view, the dislike theory cannot be an account of pain's intrinsic badness. Being disliked is a relational property. Thus if pain is bad in virtue of its relationship to the sufferer, that value cannot be intrinsic value. The bearers debate is also enmeshed with our understanding of pain's intrinsic badness. The Moorean cannot say that pain is intrinsically bad because it's disliked. But she can say that the fact that there is a disliked pain is intrinsically bad. Thus by coupling the Moorean view with the claim that facts bear intrinsic value, one does not rule out dislike theories as accounts of intrinsic value. Of course, on the coherence method, we are not deciding these issues first and then turning to pain's evil. Indeed, since pain is a key exemplar of intrinsic value, our substantive judgments about it carry heavy weight in the more general debates. For example, if we found the dislike theory overwhelmingly plausible for pain, that would be a substantial consideration in favor of the final value view or the Moorean view coupled with the claim that facts bear value. But pain is just one of many exemplars of intrinsic value. Thus the support the dislike view gives to these views might be outweighed by theoretical or metaphysical concerns, or by what we find most plausible with other exemplars of intrinsic value like pleasure, well--‐‐being, and knowledge. Therefore we cannot approach the intrinsic badness of pain without simultaneously addressing (at least) the Moorean/final value and bearers debates. What we say about pain's intrinsic badness depends on much more than what we think about pain. §2.3 Privileging pain Let me turn now the particular way I shall apply the coherence method. In this dissertation, instead of asking 'what is intrinsic value?' I shall ask only Q1: Why is pain intrinsically bad? Given that our beliefs about pain's intrinsic value have a particular firmness and centrality in our thought throughout value theory, I think we can make progress on many issues by focusing solely on how these debates play out with respect to pain. The remainder of this chapter will discuss this approach and lay the groundwork for the rest of this dissertation. I'll begin by clarifying the scope of this project and the strategy I shall use. 2.3.1 The univocality assumption This proposal to attempt to make progress in our understanding of the nature of intrinsic value by focusing solely on pain's intrinsic value, may seem to give short shrift From: Swenson, Pain and Value 17 © 2006 by Adam Swenson to our intuitions about other exemplars of intrinsic value. Why not, one might wonder, try to draw conclusions about intrinsic value by talking only about pleasure or knowledge or Korsgaard's cookware? My answer may be surprising. I do not propose to draw conclusions about everything that has intrinsic value. I shall only be seeking coherence in our beliefs about intrinsic value as they fit with pain. I shall not assume that what goes for pain goes for anything else. In pursuing the coherence method, we usually proceed by weighing competing views of the nature of intrinsic value by examining a wide range of cases. This depends on the assumption that a concept like intrinsic value is univocal. The univocality assumption entails that the weight we give our intuitions about the intrinsic value of one exemplar of intrinsic value can be compared to the weights we give intuitions about the intrinsic value of other exemplars. Suppose that α is a claim about the nature of intrinsic value. α entails plausible results when applied to the intrinsic value of pleasure, but implausible results when applied to the intrinsic value of close personal relationships. The univocality assumption entails that the positive results in one case and the negative results in the other represent a genuine conflict and test for α. I propose to proceed by suspending the univocality assumption. I'll now flesh out the strategy this suspension allows me to pursue. 2.3.2 Strategy Once we've restricted ourselves to the intrinsic value of pain, we can set aside the bearers debate until we've answered a more basic question: Q2: What are pains insofar as they are normatively significant? As I'll explain in §2.4.1 this is a narrower question than 'What are pains?' but for now the details won't matter. It would be a mistake to ask whether pain or the fact that someone is in pain is what is intrinsically bad without first being sure we know what pains are. And, as I'll show in chapter three, the view that virtually everyone accepts is wrong. As I argued above, there is an intimate tie between the Moorean/final value debate, the bearers debate, and Q1. What position we take on any of the three can affect our views about the other two. If we can legitimately set aside the bearers debate until we understand what pains are, then we can also set aside the question of whether intrinsic value can depend on relational properties. If we don't know what pains are, we can hardly get started on asking whether their relational properties figure into their intrinsic value. Once we have a picture of what pains are, we can address the Moorean/final value debate via a proxy. I shall ask: Q3: In virtue of what are pains intrinsically bad? From: Swenson, Pain and Value 18 © 2006 by Adam Swenson If we are not considering any other exemplars of intrinsic value, we'll be limited to investigating how a pain's relational and non--‐‐relational properties figure into our judgments about its intrinsic value. That is, we will be examining substantive views of the value most tightly tied to pain which plays a particular and central role in our normative thought. Thus when we limit the debate to pains, we can make progress on the Moorean/final value debate by discussing the mental state and dislike theories (and their competitors). In the following sections I'll lay the necessary background for Q2 and Q3. I'll begin by discussing a common conception of what pains are that nearly everyone holds. I'll then describe the most prominent theories of pain's intrinsic badness -that is, answers to Q3. Once we come to a view of the best substantive account of pain's intrinsic value and what that leads us to say about other issues with respect to pain, we can then reinstate the univocality assumption and see what this shows us about intrinsic value in general. I shall not do so in this dissertation. My project will be limited to answering Q2 and Q3, and drawing conclusions about some issues in value theory as they stand to pains. §2.4 The kernel view In this section I'll lay the groundwork for my answer to Q2 in the next chapter. This requires distinguishing two conceptions of pain's nature. In this dissertation, I shall be only interested in the question: Q2: What are pains insofar as they are normatively significant? I shall not discuss the broader question: Q4: What are pains? In §2.4.1 I'll describe the difference between these two questions, and why it is significant for my project. I'll then turn to the virtually universal answer to Q2 in §2.4.2 and §2.4.3. 2.4.1 Two conceptions of pain Q4 is the most general metaphysical question about pain. It demands a complete account of the nature of pain. Q4's answer will likely include an answer to Q2. Any answer to Q4 will likely be the product and synthesis of several disciplines: philosophy of mind, cognitive science, psychology, medicine, and neurophysiology, on the one hand; literature, art, and personal experience, on the other. Q2 is much narrower. It is confined to the nature of pains insofar as they figure into our normative judgments and theories. When we inquire about the nature of pain from the normative standpoint of Q2, the firing of Aδ nociceptors and activation levels in the reticular formation are hardly likely to be relevant. Thus when Korsgaard claims that From: Swenson, Pain and Value 19 © 2006 by Adam Swenson Pain is the perception of a reason23 or Ryle writes that we only call pains those [sensations] which we dislike. And if there are sensations which we ordinarily dislike but on some occasions like having, then we do not call them pains on those occasions on which we like having them.24 they are making claims about the essential nature of pain qua normative phenomenon. If these claims were supposed to imply full accounts of pain -answers to Q4- we should dismiss them. If Korsgaard or Ryle were correct, pain scientists studying the sensory qualities of pain would be fundamentally mistaken about their subject. Studying pain tolerances to different patterns of noxious stimuli would be a questionable project if pains were only reasons or whatever we dislike. Limiting discussion to Q2 may seem to beg the question on many important issues in the philosophy of mind. Some writers have vigorously argued that there are no such things as pains.25 I shall assume that pains exist and have normative significance. I shall also distinguish pains from other mental states and each other via their normatively significant properties. That simply bypasses some of the most controversial questions about mental content and the metaphysics of mind. But philosophers of mind should see my project as more helpful than threatening. I shall be fleshing out a commonsense conception of pain as it figures in our normative thought. Indeed, in our day--‐‐to--‐‐day lives our foremost concern with pain is as something bad. Thus the answer to Q2 is the conception of pain that should be at issue when philosophers discuss the entities referred to in our folk--‐‐theories of the mind. Once we have a well--‐‐described account of what we believe pains qua normative phenomena to be, we can then ask the philosopher of mind whether there are any such things. Thus I shall henceforth use 'pain' only to refer to a normatively significant phenomenon. Let me now turn to what nearly everyone believes this phenomenon is. 2.4.2 The kernel view On the kernel view of the nature of pain, a pain is just a painful sensation. Insofar as it is normatively significant, its nature and intrinsic badness lie solely in the way it hurts. When I stub my toe, the pain is wholly before my mind in the way it stings and throbs. Insofar as it affects our lives, there is nothing else to pain. The kernel view holds that pains are the atoms of experience which hurt. As an experiential atom, a pain is necessarily distinct from the other elements of one's experiential milieu. The arthritic pain in my hand as I type this sentence is distinct from my experience of the cat draped drooling across my forearms, though I am 23 Korsgaard (1996), 149. 24 Ryle (1949), 273. 25 Most notably, Hardcastle (1997) and Hardcastle (1999). From: Swenson, Pain and Value 20 © 2006 by Adam Swenson simultaneously conscious of both. Thus my reaction to a painful sensation is not part of the pain; it is a reaction to the kernel. On this view, the character of the painful sensation exhausts the properties in virtue of which a pain is intrinsically bad. Stubbed toes throb; cuts sting and burn; migraines pound and crush. Hence if pains are bad because they are unpleasant, these properties constitute a pain's unpleasantness. If pains are bad because we dislike them, the kernel composed of these properties is what we dislike. Terms like 'sensation', 'feeling', and 'hurting' are vague. There is a good deal of room for disagreement about what exactly they refer to. Nonetheless, we have a sufficient grasp on the way a pain hurts to distinguish it from other elements of our experiential milieu. A person in pain may also be, for example, anxious, depressed, and have negative beliefs about her predicament. But these are not part of the pain on the kernel view. Her pain kernel could have occurred in another situation where she did not have these beliefs. For example, Hare imagines jumping repeatedly into cold water to generate an analogy to how one could feel a pain without disliking it. Suppose...that I do this diving act many times in the hope of getting not to mind this degree of cold; and that in the end I succeed. It is not necessary to suppose that there is any change in the degree of cold that I feel (even subjectively); there might be, but that would spoil the example. It may be merely that through habituation I stop minding my skin feeling like that. We do not even need to suppose any course of habituation. Whether I found the cold unpleasant or invigorating might depend on my general state of mind -on whether I was feeling depressed or elated. [80 ital added] The sensation itself (the cold kernel) could persist between the two cases while other factors change around it and its value thereby changes. The depression or elation which matter in Hare's example do not seem to be part of the pain. Hopefully, this makes the kernel view as I've described it plausible. But it is a further question whether the kernel view is as widely held as I've claimed. The answer will come in the next chapter. I shall argue that nearly every existing account of pain's intrinsic badness relies on the truth of the kernel view. I'll now briefly sketch the existing accounts of pain's intrinsic badness. §2.5 Containment views Let me now turn from what pains are to why they are intrinsically bad. Substantive accounts of pain's intrinsic badness are answers to the question: Q3: In virtue of what is pain intrinsically bad? I believe the existing answers to Q3 divide into two camps. On containment views, the presence of a pain kernel by itself is both necessary and sufficient for the pain being intrinsically bad; the source of the badness is contained entirely within the pain. One simple account holds that a pain is bad insofar as it is From: Swenson, Pain and Value 21 © 2006 by Adam Swenson unpleasant. The more unpleasant a pain, the more intrinsically bad. On another, pain's badness lies in the power with which it motivates the sufferer to escape it. Stance views hold that the presence of a pain kernel by itself is a necessary but not sufficient condition of its being intrinsically bad. The sufficient condition lies in some relationship between the sufferer and her pain. On some stance views, pain is intrinsically bad only insofar as its sufferer wants not to have it. Suppose you and I both stub our toes and experience qualitatively identical sensations (pain kernels). If I don't really mind my pain but you intensely dislike yours. Your pain is intrinsically worse than mine, even though they involve qualitatively identical pain kernels.26 The crucial difference between the two is that, on containment views, the sufferer contributes little to the intrinsic value of her pain; she is, in a sense, merely the location where something bad occurs. Stance views hold that the intrinsic badness of a pain depends on some contribution made by the sufferer to the intrinsic value of her pain. It's not enough that the pain kernel simply occur in her, she must be involved with it. She must, for example, take some attitude toward the pain kernel. I shall discuss the containment views and their three genera in this section. I'll discuss the stance views in §2.6. 2.5.1 Mental state theories Mental state theories are the putative exemplars of containment views. On these views, pain is bad in virtue of its being unpleasant (or some other intrinsic phenomenological property). As Mill writes, pleasure, and freedom from pain, are the only things desirable as ends; and that all desirable things...are desirable either for the pleasure inherent in themselves as a means to the promotion of pleasure and the prevention of pain.27 Rachels emphasizes that on mental state theories: It is an intrinsic, nonrelational fact about certain experiences that they are unpleasant [and therefore intrinsically bad]. Unpleasantness, on this view, supervenes on qualia: there cannot be a change in unpleasure intensity without a change in qualia. Also, unpleasantness does not reduce to motivation or disliking bodily damage relating in the right way to experience.28 At least in this general form, these theories should be familiar. On a mental state theory, pains are always unpleasant. But it is also true that we usually dislike pains when they occur. Thus it is worth emphasizing that on a mental 26 There is a third kind of account. On privation views the intrinsic badness of pain consists in its being the absence of the intrinsically good. These views have, for good reason, fallen into ill--‐‐repute. I shall not discuss them in this chapter. I will discuss them in chapter four when I set out my own privation view in answer to Q3. 27 Mill (1863), 7. 28 Rachels (2000), 195. The added phrase clarifies that on his view unpleasantness implies intrinsic badness. From: Swenson, Pain and Value 22 © 2006 by Adam Swenson state theory pains are disliked because they are bad, not vice--‐‐versa. To clarify this relationship, consider a slightly cryptic passage from Mill: desiring a thing and finding it pleasant, aversion to it and thinking of it as painful, are phenomena entirely inseparable or, rather, two parts of the same phenomenon -in strictness of language, two different modes of naming the same psychological fact; that to think of an object as desirable (unless for the sake of its consequences) and to think of it as pleasant are one and the same thing; that that to desire anything except in proportion as the idea of it is pleasant is a physical and metaphysical impossibility.29 In this passage he is ostensibly claiming that being undesired and unpleasant are the same thing. That may seem to deny that the badness of unpleasantness is prior to the pain being disliked. But the appearances are misleading. Mill is being loose with 'desiring x' and 'x being desirable' -shifting back and forth between them as though they are equivalent. Mill believes that unpleasantness is an intrinsic property of a pain kernel. If unpleasantness and being undesired are equivalent, he must be claiming that being undesired is an intrinsic property of the pain kernel. But desires are attitudes that we take toward pain kernels. Therefore, he cannot mean that 'x is undesired' and 'x is unpleasant' are equivalent. Rather, 'undesired' here means 'undesirable'. As with all mental state theories, on Mill's view pains are undesired because they are undesirable. They are undesirable because they are unpleasant (things can be undesirable without being unpleasant). 2.5.2 Motivation theories Motivation theories are an often overlooked form of containment view. On these theories a pain is intrinsically bad in virtue of its intrinsic power to motivate its sufferer to escape the pain. Motivation theories thus tie degree of intrinsic badness to the strength of the motivation. Mild pains nudge; intense pains shove. On Nagel's view: Physical pleasure and pain do not usually depend on activities or desires which themselves raise questions of justification and value. They are just sensory experiences in relation to which we feel involuntary desire or aversion. Almost everyone takes the avoidance of his own pain...as subjective reasons for action in a fairly simple way; they are not backed up by any further reason.30 Thus we dislike and desire to escape pain kernels in virtue of their intrinsically and necessarily spurring these feelings. Nagel explicitly rejects the claim that this motivational power could lie outside of the pain. On such a view, aversion to pain is a useful phobia -having nothing to do with the intrinsic undesirability of pain itself-which helps us avoid or escape the injuries that are signaled by pain....There would then be nothing wrong with pain in itself, and someone who was never motivated deliberately to do 29 Mill (1863), 38. 30 Nagel (1986), 156. From: Swenson, Pain and Value 23 © 2006 by Adam Swenson anything just because he knew it would reduce or avoid pain would have nothing the matter with him.31 Since he believes that this view is insane, Nagel holds a motivation theory of pain's intrinsic badness. But others do hold the view Nagel rejects. I'll argue in §2.6.2 that Korsgaard holds a stance view version of the motivation theory. On the stance view competitor, the motivational power lies in a person's disposition to be motivated in reaction to the occurrence of a pain kernel, not in the pain kernel itself. Interestingly, there seems to be another possible containment version of the motivation theory which skirts very close to the stance view version by holding that a pain's disposition to move one to act may not necessarily be manifested whenever the pain occurs. But this is a containment view because the potentially unmanifested disposition is located within the pain instead of in the sufferer. Sidgwick quotes Mr. Bain as holding that "pleasure and pain, in the actual or real experience, are to be held as identical with motive power." By this Mr. Bain does not, of course, mean that all pleasures when actually felt actually stimulate exertion of some kind; since this is obviously not true of the pleasures of repose, a warm bath, &c. The stimulus must in such cases be understood to be latent and potential; only becoming actual when action is required to prevent the cessation or diminution of that pleasure.32 If I read this correctly, the stimulus is allegedly latent in the pleasure itself. That would make this a containment view. 2.5.3 Representation theories The third genus of containment views are representation theories which hold that pain is bad in virtue of its representing bodily damage. Pitcher writes that To be aware of a pain is to perceive -in particular to feel, by means of the stimulation of one's pain receptors and nerves- a part of one's body that is in a damaged, bruised, irritated, or pathological state, or that is in a state that is dangerously close to being in one or more of these kinds of states.33 Similarly, Tye holds that Pains are sensory representations of bodily damage or disorder.34 Representation theories of pain's intrinsic badness hold the representation Pitcher and Tye describe is the source of pain's intrinsic badness. In Hall's nice image: [Pains are bad because] they accompany nociceptual reports of bodily damage, and bodily damage is something we don't like to hear about. It is like the ruler who slew the messenger who brought the bad news35 31 Nagel (1986), 157. 32 Sidgwick (1884), 122. Italics original. 33 Pitcher (1970), 371. 34 Tye (1995), 113. 35 Hall (1989), 647. From: Swenson, Pain and Value 24 © 2006 by Adam Swenson If we take Hall's claim that damage is 'something we don't like to hear about' seriously, his representation theory may be a stance view; indeed it may just be a dislike theory. The fact that a pain represents damage would explain why we tend to dislike pain kernels, but the pain would be bad in virtue of the stance we take toward it. Notwithstanding, Hall's claim, taken as he intends it, captures what a genuine representation theorist holds. Any genuine representation theory must be a containment view. These theories are untenable if 'representing bodily damage' isn't an intrinsic property of the sensation. On a stance view version of the representation theory, the badness of pain depends on the presence of the pain kernel and the belief that the pain represents damage. This view is false. A person with causalgia may experience a constant and intense burning sensation in her hand. After a few years, it is unlikely that she will believe the sensation to be representing bodily damage. Yet her pain is still intrinsically bad. If that's right, representation theories of pain's intrinsic badness must be containment views.36 §2.6 Stance views On containment views, the sufferer contributes little to the intrinsic value of her pain; she is, in a sense, merely the location where something bad occurs. Stance views hold that the intrinsic badness of a pain depends on some contribution made by the sufferer to the intrinsic value of her pain. The presence of a pain kernel is necessary but not sufficient for the pain being intrinsically bad. Taking the relevant stance to the pain kernel is both necessary and sufficient for the pain being intrinsically bad. On all these views, if a person has a pain kernel but lacks the appropriate attitude, then the pain will not be intrinsically bad. That distinguishes them from containment views. 2.6.1 Desire and dislike theories Desire and dislike theories of pain's intrinsic badness are the paradigm stance views. These views may be the most widely held accounts of pain's intrinsic badness. On a desire theory a pain is intrinsically bad in virtue of its sufferer desiring that it stop (or not occur). Desires are propositional attitudes. Thus on these views the pain kernel is indirectly the object of the desire via its figuring into the proposition. An alternative is a dislike theory on which pain is intrinsically bad in virtue of its being disliked. On these views the pain kernel itself is the object of the attitude. For the argument herein the desire and dislike theories stand and fall together and their differences will not matter. For simplicity I shall only discuss dislike views. Within this family the many views differ along other dimensions as well. One difference concerns whether we necessarily dislike pain kernels. Views which hold this 36 Rachels makes this point with an unfortunately infelicitous example at Rachels (2000), 188. From: Swenson, Pain and Value 25 © 2006 by Adam Swenson remain stance views because the pain is bad in virtue of the stance we take toward it. Sidgwick holds a dislike theory and seems to endorse this view when he writes that Let then [pain] be defined as feeling which the sentient individual at the time of feeling it implicitly or explicitly apprehends to be [undesirable]; -[undesirable], that is, when considered merely as feeling, and not in respect of its objective conditions or consequences, or of any facts that come directly within the cognisance and judgment of others besides the sentient individual.37 Similarly, Baier, as described by Hare, thinks that the fact that we dislike pains is not a contingent fact; 'whatever sorts of sensations we like and dislike, we only call pains those which we dislike. And if there are sensations which we ordinarily dislike but on some occasions like having, then we do not call them pains on those occasions on which we like having them.'38 Thus on these stance views, it is impossible to like a pain kernel. Pains are therefore intrinsically bad because they are necessarily disliked. On another sort of dislike theory, it is perfectly possible to fail to dislike the pain kernel. Ryle seems to hold this with his claim that Pain is a sensation of a special sort, which we ordinarily dislike having39 where 'ordinarily' implies contingency. More strikingly, in Pain and Evil Hare holds that If I were flogged with a cat of nine tails, I should certainly dislike it, constituted as I am. But all this is not enough to establish...[a] logical, and not merely a psychological connexion, however inescapable, between experiencing the sensation φ and disliking it....If I have the sensation called 'φ', all that I can be compelled logically to admit is that I have the sensation called 'φ'. Logic cannot make me suffer.40 While this distinction raises a host of interesting issues, we can set it aside and treat all dislike views together. 2.6.2 Stance view motivation theories Finally, as I mentioned above, there are stance view versions of the motivation theory. Korsgaard initially seems to hold a containment view when she writes that The painfulness of pain consists in the fact that these are sensations which we are inclined to fight.41 But the motivation and thus the intrinsic value of the pain do not lie in the pain kernel. Instead it is in the sufferer's disposition to be moved when a pain occurs. She writes that Pain is not the condition that is a reason to change your condition, the condition in which the natural and the normative are one. It is your perception that you have a reason to change your condition.42 and, that 37 Sidgwick (1884), 131. I have replaced 'pleasure' with 'pain' and 'desirable' with 'undesirable'. 38 Hare (1972), 77. 39 Ryle (1949), 109. 40 Hare (1972), 90. 41 Korsgaard (1996), 147. 42 Korsgaard (1996), 148. Italics original. From: Swenson, Pain and Value 26 © 2006 by Adam Swenson pain is nearly always bad -because the creatures who suffer from it object to it. But it is important to see that this does not show that pain is an intrinsically bad sensation. For one thing, we don't always object to pain43 Given that the intrinsic value of pain depends on an essential contribution by the sufferer, Korsgaard's motivation theory is a stance view. §2.7 Conclusion In chapter five, we will see that focusing narrowly on Q1 yields some important conclusions about the nature of pain's intrinsic value. In the next two chapters I shall argue for some very surprising answers to Q2 and Q3. These answers will be surprising and fresh in part because they tend to be off the radar screen when we follow the standard coherence method. 43 Korsgaard (1996), 154. From: Swenson, Pain and Value 27 © 2006 by Adam Swenson Chapter 3 Contexts versus Kernels In this chapter I shall argue that the kernel view of pain is false. That is, insofar as they are normatively significant, pains are not merely sensation kernels which hurt. Instead, they are complex mental states with sensory, affective, conative, desiderative, and cognitive components. As such, the character, identity, and significance of a pain is deeply influenced by the context in which it occurs. In the next chapter I shall argue that abandoning the kernel view and properly understanding what pains are, opens the way to the correct understanding of why they are bad. That and several results along the way will be a payoff of the narrowly focused strategy I set out in the last chapter. I'll begin this chapter by arguing that the context in which a pain occurs influences its intrinsic value. If intrinsic value depends just on intrinsic properties, this will show that the intrinsic properties of a pain extend beyond the particular way it hurts to, inter alia, one's mood, level of attention, desires, and the meaning a pain bears. In §3.2, I'll then explore these further intrinsic properties of the pain and their interactions. I shall conclude in §3.3 by arguing that rejecting the kernel view entails rejecting existing accounts of pain's intrinsic value in favor of a new account that had previously been obscured by the kernel view. §3.1 Against kernels I shall now begin by arguing that we must reject the kernel view. That is, I shall argue that, insofar as they are normatively significant, pains are not merely sensations. My argument is straightforward. I shall present pairs of cases which contain phenomenologically identical painful sensations. However, in virtue of the contexts in which they occur, the two pains have different intrinsic values. Thus, if intrinsic value depends solely on intrinsic properties, then the two pains which involve the same painful sensations must differ in intrinsic properties. That is, the pains' intrinsic values must depend on more than just the sensation. Therefore, the kernel view is false. I'll then broach the alternative to the kernel view in §3.1.5. 3.1.1 The kernel view On the kernel view of the nature of pain, a pain is just a painful sensation kernel. Insofar as it is normatively significant, its nature and intrinsic badness lie solely in the way it hurts. When I stub my toe, the pain is wholly before my mind in the way it stings and throbs. Insofar as it affects our lives, there is nothing else to pain. The kernel view holds that pains are the atoms of experience which hurt. As an experiential atom, a pain is necessarily distinct from the other elements of one's experiential milieu. The arthritic pain in my hand as I type this sentence is distinct from From: Swenson, Pain and Value 28 © 2006 by Adam Swenson my experience of the cat draped drooling across my forearms, though I am simultaneously conscious of both. This is the sense in which pains are they are sensation kernels. Thus my reaction to a painful sensation is not part of the pain; it is a reaction to the kernel. On this view, the character of the painful sensation kernel exhausts the properties in virtue of which a pain is intrinsically bad. Stubbed toes throb; cuts sting and burn; migraines pound and crush. Hence if pains are bad because they are unpleasant, these properties constitute a pain's unpleasantness. If pains are bad because we dislike them, the kernel composed of these properties is what we dislike. In making this argument, I shall assume that if x is intrinsically bad, x's badness must depend solely upon its intrinsic properties. I'll return to this assumption and how different accounts of intrinsic value sit with my argument in §3.1.4. 3.1.2 Intrinsically good pains The kernel view is false. I shall now argue that pain's intrinsic value cannot depend solely on the kernel's intrinsic properties. When embedded in the right context, some pains are intrinsically good. If the same pain can have different intrinsic values in different contexts, there is no hope for the kernel view. To be a genuine intrinsically good pain, a pain must not satisfy any of the following. (i) The pain is good solely in virtue of some instrumental purpose it serves.44 (ii) The pain is good solely in virtue of its being an ineliminable part of a positively valued activity. (iii) The sufferer has the false belief that her pain is intrinsically good. She is deluded by some sort of sickness or psychosis. All cases of allegedly good pain can be described so that they satisfy some of (i)--‐‐(iii). For example, an ascetic may whip herself to atone for her and humanity's sins through the pain: (i). A weightlifter may endure 'the burn' only because of her commitment to building muscle: (ii). And, in many sad cases, past abuse and psychological trauma are manifested in self--‐‐destructive desires and practices: (iii). But the fact that we could recast hypothetical cases doesn't show how we must describe them. The brute assertion that a case is impossible does not answer an argument from possibility. The following involves an intrinsically good pain that need not be ruled out by (i)--‐‐(iii). Weightlifter: Kylie is a weightlifter. She enjoys going to the gym and looks forward to her workouts. One reason she looks forward to her workouts is that she enjoys the burning sensation caused by the buildup of lactic acid and the microtearing of muscle the exercise involves. She readily admits that this sensation, the burn, hurts. 44 Pain is of course instrumentally good in its contribution to self--‐‐preservation. The horrific fates of those congenitally insensitive to pain leaves no doubt. See, Nagasako, Oaklander et al. (2003). From: Swenson, Pain and Value 29 © 2006 by Adam Swenson However, Kylie looks forward to experiencing the burn. For her, the burn is not just an unavoidable byproduct of the exercise; nor does her liking it consist in the fact that its onset signals that she is nearing the end of a successful set. She enjoys the burn not just despite the fact that it hurts, but because of the way it feels. For Kylie, the pain is intrinsically good. Imagine that Kylie and her workout partner Kyle are both given a drug which suppresses the burn without affecting their performance. Taking it does not allow them to lift more, and they remain perfectly aware of their level of exertion. Kyle regards the burn as an unpleasant side--‐‐effect. He may occasionally say that he likes the burn but he really only means it in the extrinsic senses of (i) and (ii); or, if deluded by machismo, in a way explained by (iii). Kyle is enthusiastic about the drug. It affords him all the enjoyment without the pain. Kylie claims she enjoyed her workout less, and that she would not use the drug again. Weightlifter need not be an isolated case. Let me sketch a few others; each can be sharpened as necessary. Coffee Drinker: Natalie looks forward to her cup of morning coffee. She enjoys its aroma, its deep flavor, the gentle buzz it imparts, the warmth of the mug in her hands, and the way the first sip burns her lips. Like the rest of us, she attests that burning her lips hurts. Nonetheless, she enjoys that particular pain. When one morning she is given a cup of slightly cooler coffee which does not burn her lips, but which has all the same characteristics, she claims that she enjoys it less than one which burns her lips. Given the choice, she prefers to have her lips slightly scalded by the coffee.45 Ascetic: Francis belongs to a religious order of ascetics. She acknowledges that being whipped hurts. However, she always volunteers to be scourged during ceremonies and whips herself during solitary prayer. The pain caused by whipping holds an important place in her religious asceticism. Her beliefs about the mortification of the flesh underlie its goodness for her but it is the pain per se which is good. She does not value it as a means for atoning for the sins of mankind. It is good because the pain in the context of religious ceremony is a religious experience.46 Masochist: Melissa the masochist enjoys certain pains in certain contexts. She does not deny that they hurt or claim that they are pleasurable. She has not been abused in childhood nor does she have any 'dark reasons'. She balks at any such suggestion, claiming instead that some pains can be good if they are suffered in the right contexts. 45 Alternatively, we can imagine that she is given a heat--‐‐resistant lip balm. This removes the chance that the flavor, aroma, and warmth, have been altered. 46 See, for example, Avila (1976--‐‐1985); and Siena (1980). From: Swenson, Pain and Value 30 © 2006 by Adam Swenson Spicy Food: Meena likes spicy food. When she goes to Korean restaurants she orders the spiciest dishes and requests them 'aju mepke' (extra hot). The heat of the food makes her mouth hurt, she readily admits, and she sips water and tea frequently. Nonetheless, it is precisely that burning sensation which she enjoys. These cases likely strike you as variously more and less plausible. I hope some strike you as possible.47 These pains are intrinsically good in virtue of the contexts in which they occur. Consider two new cases. Weightlifter*: Walking to the gym, Kylie slips and suffers a minor tear of the biceps in her left arm as she grabs a railing to arrest her fall. The sensation is phenomenologically indistinguishable from the burn that a set of curls produces. Nonetheless, her cursing and complaining about the pain are evidence that it is intrinsically bad. Ascetic*: Francis is kidnapped by the state police who whip her to extract information. The sensation is phenomenologically indistinguishable from that which she experiences during her religious ceremonies. Nonetheless, her pleas for mercy are evidence that the pain is intrinsically bad. If Weightlifter and Ascetic are possible, these extensions should be as well. If both Weightlifter and Weightlifter* involve the same sensation, and the sensation is intrinsically good in Weightlifter and intrinsically bad in Weightlifter*, then the same pain has different intrinsic values in different contexts. That difference can only be explained by the change in context. But the properties of a context are not intrinsic properties of a pain on the kernel view. Therefore, the kernel view is committed to the intrinsic value of pain depending on non--‐‐intrinsic properties. The kernel view is false. 1.3 Phenomenologically indistinguishable sensations I shall assume that the phenomenology suggests that the pain's intrinsic value really can be what is changing in these cases. Hopefully you will agree that this is possible -if only provisionally until you've seen the complete account of pain which it leads to. I do, however, want to briefly argue for another assumption: that these contrasting cases involve phenomenologically indistinguishable sensations. It is empirically true that the character of a painful sensation can vary independently of the emotions and attitudes which accompany it.48 Moreover, I am not alone among 47 Margaret Temkin pointed out that several of these cases involve a kind a ritualistic activity; that they may involve a kind of addiction. Since the association between the enjoyment of the activity and the pain is very tight, we might worry that Kylie and company fail to discriminate between the two in their evaluations. We can imagine parallel cases with one--‐‐off or first--‐‐time evaluations to circumvent this concern about the soundness of their judgments. But we should not shrink from the tight association. I argue in chapter four that it is quite revealing about the source of pain's intrinsic badness. From: Swenson, Pain and Value 31 © 2006 by Adam Swenson philosophers in believing that a painful sensation can remain the same between contexts in which the pain seems to have different intrinsic values. For example, Korsgaard writes: Pain really is less horrible if you can curb your inclination to fight it. This is why it helps, in dealing with pain, to take a tranquilizer or to lie down. Ask yourself how, if the painfulness of pain rested just in the character of the sensations, it could help to lie down? The sensations do not change.49 Similarly, Hare imagines jumping repeatedly into cold water to generate an analogy to feeling pain without disliking it. Suppose...that I do this diving act many times in the hope of getting not to mind this degree of cold; and that in the end I succeed. It is not necessary to suppose that there is any change in the degree of cold that I feel (even subjectively); there might be, but that would spoil the example. It may be merely that through habituation I stop minding my skin feeling like that. We do not even need to suppose any course of habituation. Whether I found the cold unpleasant or invigorating might depend on my general state of mind -on whether I was feeling depressed or elated.50 This suggestion that the sensation itself (the cold kernel) can remain invariant between cases where its value differs is an analogue of my assumption about pain. But perhaps the assumption that the phenomenology does not change is implausible where the pains allegedly differ in valence. Hopefully a more streamlined case will bolster the intuition supporting my assumption. Consider: Weightlifter**: Kylie is carrying her friend's couch up five flights of stairs. She really dislikes the attendant burning sensation of the exertion. At the third flight it dawns on her that this is just another form of weightlifting. With that realization she comes to like the sensation. Indeed, we can imagine that, after banging into a wall, Kylie stops thinking of the job as a form of weightlifting and the burn becomes bad again (we can iterate so that the burn flips back and forth between bad and good). If this is possible, we should accept the possibility that the sensations in my cases are phenomenologically indistinguishable. That is enough to undermine the kernel view. 3.1.4 How other accounts of intrinsic value fit with this To complete this argument, let me return to the assumption that intrinsic value depends solely on intrinsic properties. As we saw in chapter two, this view is widespread among both proponents of containment views and proponents of stance views. But not everyone accepts it. Shelly Kagan, for example, argues that relational 48 See §3.2.2.1. 49 Korsgaard (1996), 147. My italics. 50 R.M. Hare (1970), 80. My italics. From: Swenson, Pain and Value 32 © 2006 by Adam Swenson properties such as an object's causal history can contribute to its intrinsic value. Thus, on his view, the pen used to sign the Emancipation Proclamation can have an intrinsic value which another qualitatively identical pen lacks.51 I thus need to say how my argument sits vis--‐‐à--‐‐vis this conception of intrinsic value. The conceptual apparatus I set out in chapter two answers this problem. Nonetheless, it will be helpful to briefly recapitulate the rough answer here. My examples purport to show that the intrinsic value of a pain rests on something more than the sensation kernel. On a containment view, this is the claim that the character of the kernel by itself is a sufficient condition of the pain's intrinsic value. On a stance view, this is the claim that the relevant evaluative attitude has more than just the kernel as its object. For example, what we dislike isn't just the kernel, it's the kernel in the particular context. So far so good. I then claim that this entails that the pain must have some intrinsic property in addition to the kernel which responds to the context. But this need not follow on Kagan's view. If intrinsic value can depend on relational properties, then it could be that the pain is just the kernel but that the kernel's intrinsic value depends partially on its relation to certain features of the context. Thus nothing about the intrinsic properties of pain would follow from the claim that pain's intrinsic value is partially context dependent. The topic of this chapter is Q2: What are pains insofar as they are normatively significant? I therefore use the term 'pain' to denote whatever bears the intrinsic value we find in our putative conception of the experience of pain. I have argued that the bearer of pain's intrinsic value includes both the kernel and its relationship to the context. Hence, I have argued that the kernel's relationship to the context is in fact an intrinsic property of pain. Thus the claim that pain's intrinsic value depends on relational properties of the kernel is consistent with the claim that these relational properties are intrinsic properties of the pain. Therefore, given how I propose to use the term 'pain', Kagan's account of intrinsic value has no bearing on my conclusion that pain, as it is normatively significant, is not merely a painful sensation. 3.1.5 The alternative to the kernel view If my argument up to this point is correct, pain, as it is normatively significant, is much more complex than simply a sensation. Its intrinsic value and therefore intrinsic properties are sensitive to the context in which it occurs. I believe that this leads us to the view that pain is a complex phenomenon with sensory, affective, conative, desiderative, and cognitive, components. That is, certain of the affective states, emotions, desires, and beliefs, which accompany the painful sensation kernel are themselves intrinsic properties of the pain. 51 Kagan (1998). From: Swenson, Pain and Value 33 © 2006 by Adam Swenson I shall spend the next section fleshing out and defending this conception of what pains are. Once we have the proper conception of pain in view, we will then be in position to examine the existing theories of pain's intrinsic badness. In §3.3 I shall argue that, having approached pain and its value directly and not as a mere example in a larger theoretical discussion, we can see that all of the existing views are mistaken. That will be a payoff of the methodological strategy set out in chapter one. §3.2 The composite view If the kernel view is false, pain cannot be merely a sensation kernel. To avoid the problems besetting the kernel view, a pain must have some intrinsic property which can be affected by context while the quality of the painful sensation kernel remains unchanged. The composite view holds that a pain is a composite of a painful sensation kernel and a reaction. In Weightlifter, Kylie likes the burn; in Weightlifter* she hates it. Since the two burn tokens each include different reactions, they are tokens of different pain types. The fact that they involve qualitatively identical sensation kernels but have different intrinsic values is thus unproblematic. This section sets out the composite view. §3.2.1 is an overview. In §3.2.2 I'll sample some of the extensive scientific literature discussing the factors which potentially influence the reaction component. Then in §3.2.3 I'll set out the nature of the reaction component of pain. In the next section -§3.3- I'll explain how the existing accounts of pain's evil fit with the composite view, and then argue that we should reject these views. I'll close this chapter by setting out an alternative account on which pain's intrinsic badness lies in a disjunction of all the traditional candidate accounts of pain's evil -dislike, unpleasantness, et cetera- as well as some of the affective, desiderative, conative, and cognitive states identified in the present section. Then in the next chapter, I'll argue that this is not pain's only intrinsic evil. 3.2.1 Overview of the composite view The composite view's answer to Q2 -what are pains insofar as they are normatively significant?- is straightforward. Considering two cases will help bring out the formal relationship between the painful sensation kernel, the reaction component, and the context. Normal Day: My day so far isn't either especially good or bad. While putting some papers away, I accidentally slam my finger in a drawer. On an arbitrary scale of 0--‐‐ 100, the resulting pain is bad to degree 12 (bad12). and Bad Day: I'm having a bad day. I'm feeling downtrodden, anxious, irritable, and generally on edge. I accidentally slam my finger in a drawer. The sensation coupled From: Swenson, Pain and Value 34 © 2006 by Adam Swenson with my preexisting affect, and the explosion of negative emotions makes the pain bad20. In the second case, the reaction component of my pain is influenced by my dispositions to think negatively and to react explosively. Hence my pain in Bad Day is intrinsically worse than my pain in Normal Day, even though they involve the same sensation. Similarly the fact that a cancer patient's headache throbs memento mori causes her to have a very strong negative reaction to the otherwise innocuous sensation. More outré contextual elements can also affect the reaction component. For example, the gender of those present can cause one's reaction to be more positive or negative than it would be otherwise. These influences are no more mysterious than the way the presence of sour cream causes me to decline the avocado served alone but partake of the proffered guacamole.52 I now turn to a sampling of what these influences can be. 2.2 Contextual factors The factors which can influence the reaction component are myriad, and some are surprising. It is therefore important to have a sense of the breadth of what these factors can be. I shall approach this with a very brief survey of some of the relevant scientific literature on pain. All of the factors I shall survey can have significant effects on a pain's reaction component. Though their actual influence differs case by case. I shall not assume that any of these features are actually part of the pain as it is normatively significant. Instead, we should think of them as dimensions of the painful experience or parts of the context in which the pain occurs. For some dimensions - especially states like fear and anxiety- the claim that they are dimensions of the experience of pain but not parts of the pain itself may seem rather awkward. And for good reason. In §3.2.3 I shall argue that many of these dimensions of the experience of pain are actually part of the reaction component; that they are part of the pain itself. But that is an important substantive thesis that must be established, not assumed. The McGill Pain Questionnaire, the gold--‐‐standard for evaluating clinical pain, contains seventy--‐‐eight adjectives for pain along twenty different dimensions.53 These further divide into roughly three categories the sensory--‐‐discriminative, affective--‐‐ motivational, and cognitive--‐‐evaluative dimensions of the experience of pain. I shall first give some examples of what composes each of these. I'll then briefly discuss some 52 There are two possible relationships between the context and the reaction. The causation version holds that the elements of the context -including my dispositions- cause the particular reaction. On the reasons version, the elements of the context are (or provide) reasons for reacting in a particular way to the sensation kernel. This distinction, and the issues it raises, bear on important metaethical questions about the nature of reasons and rationality. I shall not discuss these herein, and will assume the causation version in what follows. 53 See Melzack (1975); Tursky (1976); and, Melzack and Torgerson (1971). From: Swenson, Pain and Value 35 © 2006 by Adam Swenson features of the contexts in which a pain occurs that can influence the reaction component of the pain. The literature and topics I'm now going to skim is vast and I have no room in this chapter to discuss more than a few features in each category. I have selected these features for two reasons. First, the features I shall discuss are hopefully diverse enough to give a sense of how complex the experience of pain and the associated contexts can be. Second, many of them will be central to my discussion of pain and its evil in the rest of this dissertation. 3.2.2.1 The sensory--‐‐discriminative dimension Let's begin with the sensory--‐‐discriminative dimension of the experience of pain. This includes the way a pain burns, itches, tears, and throbs. That is, it contains the complex phenomenology which §§1--‐‐10 of the McGill Pain Questionnaire attempt to capture. The sensory--‐‐discriminative dimension is thus what exhausted the nature of pain on the kernel view -it is, I think, the pain kernel. On the composite view, the sensory--‐‐ discriminative dimension is what the reaction component is a reaction to. The attractiveness of the kernel view shows that this is the most intuitively straightforward dimension of pain. I thus shall say little about it here. I'll limit my remarks to pointing out that sensory--‐‐discriminative dimension can have its character determined independently of the presence or influence of the other dimensions of the experience of pain. This is easy to show. For one, the sensory and affective dimensions can be experimentally manipulated separately. A dose of the tranquilizer diazepam diminishes a pain's affective dimension but leaves the intensity of the sensation kernel unchanged. Whereas, fentanyl diminishes the intensity of the sensation kernel but tends to exacerbate the affective dimension -it makes it more unpleasant.54 Indeed, painful sensations can occur without any significant affective concomitant Price writes that we can experience nociceptive sensation [kernels]...without any experience of unpleasantness whatsoever. This possibility has been verified several times in my own experience as well as that of my colleagues in pain research. We have all administered well--‐‐controlled nociceptive heat stimuli to our own skin to check the reliability of our thermal stimulators. Although the resulting sensation [kernels] are intense and even have burning, throbbing, or stinging qualities, they serve merely to remind us that our thermal stimulators are working properly. The sensation [kernels]...are not unpleasant.55 54 See Gracely, McGath et al. (1978); Gracely, Dubner et al. (1979); Gracely, Dubner et al. (1982). 55 Price (1999), 6. Italics original. I have added 'kernel' to fit his claim into my terminology. From: Swenson, Pain and Value 36 © 2006 by Adam Swenson With some forms of hypnotic analgesia, subjects give similar reports.56 And, in cases well--‐‐loved by philosophers -especially those favoring dislike--‐‐theories- certain patients who have undergone prefrontal leucotomies report feeling painful sensations but being completely untroubled by them.57 Therefore, while, as we shall see, the character of the sensory--‐‐discriminative dimension of the experience of pain can be influenced by other dimensions, it can also exist and have its character independently of these influences. That is, the sensation kernel can be separate from the reaction component. 3.2.2.2 The affective--‐‐motivational dimension The affective--‐‐motivational dimension of the experience of pain covers a wide range of broadly emotional and conative states. It is very roughly what we mean when we talk about pains being 'unpleasant'. Though since it can include some of the character of disliking the sensation we should not understand 'unpleasantness' here in the sense invoked by mental--‐‐state theories of pain's evil. Like all dimensions of the experience of pain, it can be both affected by and affect many of the other dimensions. Price writes that, even the immediate affective dimension of pain may be synthesized from [many different] sensory processes. Pain sensation may be a salient but not the sole determinant of the affective state during pain.58 Thus, we can get a sense of this category and its significance without worrying about these relationships to the sensory--‐‐discriminative dimension. The role of negative emotions and affective states such as depression, anxiety, and anger, are most perspicuous in cases of chronic pains.59 60 61 Indeed, it is clear that the more chronic a pain becomes, the more psychosocial factors -including these affective states- exert their influence.62 But these negative states can have important roles in the acute pains that are our main focus herein. For example, depressed patients are more likely to interpret sensations as painful and are more likely to report aches and pains.63 56 See, for example, Price (1999), Ch. 8; Price and Barber (1987); Price (1996); Hilgard and Hilgard (1983); Hilgard, Morgan et al. (1975); and, Hilgard, Morgan et al. (1974). 57 See, for example, Trigg (1970); and, Hardcastle (1997). 58 Price (1999), 49. Sic. Italics original . See also Chapman (1995). 59 For depression, see Banks, S.M. and Kerns (1996); Max (1995); Turk, Okifuji et al. (1995); and, Romano and Turner (1985). 60 For anxiety, see, McCracken, Gross et al. (1996); McCracken, Gross et al. (1993); Brown, Robinson et al. (1996); Asmundson, Norton et al. (1997); and, Atkinson, Slater et al. (1991). 61 For anger, see Fernandez and Turk (1995); Kerns, Rosenberg et al. (1994); Schwartz, Slater et al. (1991); Kinder and Curtiss (1988); Gaskin, Greene et al. (1992); and, Taylor, Lorentzen et al. (1990). Though anger is the least studied of the three. 62 Gatchel (1996). 63 Pennebaker (1982); and, Salovey and Birnbaum (1989), respectively. From: Swenson, Pain and Value 37 © 2006 by Adam Swenson These patients also seem to have a decreased tolerance for experimental pain.64 That suggests an important role for these affective states in influencing the reaction component of the pain. This is especially the case where these states are yoked with more cognitive dimensions, particularly one's beliefs about a pain's meaning and her preexisting expectations about the pain.65 3.2.2.3 The cognitive--‐‐evaluative dimension The cognitive--‐‐evaluative dimension of the experience of pain contains various beliefs about the pain's meaning, as well as states that may more properly be thought of as desires, for example, the judgment that a pain is terrible. It also contains less clearly cognitive states such as perceiving oneself as threatened and invaded by the pain. Price writes that Pain--‐‐related sensations may not only be intense and persistent, but can be perceived as spreading, penetrating, and sometimes summating [getting worse the longer they persist]. They are experienced as an invasion of both the body and consciousness because their intensity and qualities are perceived as intense and penetrating. Therefore, a frequent meaning given to painful sensations is that of intrusion, a meaning that requires little reflection and occurs somewhat (although not entirely) automatically.66 In the next chapter I shall argue that this feature of pain lies at the heart of its intrinsic badness. Pains can, and often do, have meanings. When one has cancer, the symptomatic pains can present themselves as signifying her condition. A pain which throbs memento mori is much worse than a pain that consists in the same sensation kernel but with no such meaning. Price gives this example Suppose two patients have mild abdominal pain sensations, which both rate as 3 along a 10--‐‐point scale of pain sensation intensity. One patient has a history of indigestion and attributes her present abdominal sensation to just having eaten. She rates this experience as 2 along a 10--‐‐point scale of pain unpleasantness. The other patient has just been diagnosed as having cancer. He cannot help but consider the possible implications of this mildly intense abdominal sensation. Thoughts of these implications dominate his experience, and the sensation itself serves as a persistent 64 Zelman, Howland et al. (1991). 65 The interrelationships between these various constituents of the affective--‐‐motivational dimension, and their relationship to the sensory--‐‐discriminative dimension present several important empirical questions. For a good overview of the relevant issues, views, and literature, see Robinson and Riley III (1999). 66 Price (1999), 50. See also, Buytendijk (1961); and, Bakan (1968). From: Swenson, Pain and Value 38 © 2006 by Adam Swenson reminder of them. He rates this experience as 8 along a 10--‐‐point scale of pain unpleasantness.67 There appear to be two instances of the same pain type where one is much worse than the other because of the meaning it carries. Thus it seems that the meaning of the pain influences the reaction component and makes the cancer patient's pain much worse, even though both patients experience the same sensation kernel. There are myriad cases where pain tokens of the same type have large differences in intrinsic badness due to differences in meaning. Think, for example, of qualitatively identical chronic and acute pains. A mild pain in my otherwise healthy back may be a small annoyance. But someone with chronic back problems may experience the same sensation as signifying the onset of another painful bout and as intrinsically much worse. Similarly, some women report less pain in childbirth because the pain is experienced as the coming of a new child whereas those who experience their pain as just a pain report it to be excruciating.68 In his famous study comparing the pains of a soldier injured in war and that of a civilian with a comparable injury, Beecher writes that Strong emotion can block pain. That is common experience. In this connection it is important to consider that position of the soldier: his wound suddenly releases him from an exceedingly dangerous environment, one filled with fatigue, discomfort, anxiety, fear, and real danger of death, and gives him a ticket to the safety of the hospital. His troubles are about over, or so he thinks they are. He overcompensates and becomes euphoric....On the other hand, the civilian's accident marks the beginning of disaster for him.69 Thus we can imagine that when a professional athlete and I both break an ankle, her pain is much worse than mine. Her pain suggests the end of her career. I can still do philosophy on crutches. More generally, beliefs can heavily influence the reaction component, both through their effects on the sensory and affective dimensions, and on their own. In particular, this is true of the beliefs a person has about the cause, likely outcome, control of, and responsibility for, her pain.70 It is well--‐‐established that patients suffer the least when they believe that they have a measure of control over their pain, that the medical care 67 Price (1999), 7. 68 The literature of pain in childbirth is extensive and fraught with complications. For example, many expectant mothers (regardless of their previous experience with labor) underestimate the painfulness of labor. See Norvell, Gaston--‐‐Johansson et al. (1987); and, Fridh and Gaston--‐‐Johansson (1990). But underestimating the severity of an expected pain often leads to the pain being more severe than it otherwise would be. See Arntz, Hout et al. (1991). 69 Beecher (1946), 445. See also Beecher (1956); and, Wall (1979). 70 DeGood and Shutty (1992); Skevington (1995), Ch.5; and, Jensen, Turner et al. (1991). From: Swenson, Pain and Value 39 © 2006 by Adam Swenson they are receiving is effective, that their family and friends care for and support them, and that they are not seriously disabled by their condition.71 Moreover, beliefs and expectations are also heavily implicated in the placebo effect which does have a significant analgesic effect on many types of pain.72 As with the other dimensions, these psychosocial factors exercise progressively more influence as the pain becomes increasingly chronic. But it is clear that they also affect the intensity and character of acute pains.73 Indeed, a patient's expectations can influence whether a particular sensation kernel is perceived as painful or pleasurable. In one famous experiment, volunteers were told to place their finger in a machine containing only a vibrating emery board. Those who had been told to expect a pleasurable sensation reported a mild and pleasurable tickle; those who had been told to expect a painful sensation reported feeling a painful electric shock.74 In another, one hundred paid volunteers were told that the shock they would receive from an electrical stimulator might produce a headache. Unbeknownst to them, the machine produced no shock, only a low humming sound. Yet fifty--‐‐percent of the subjects reported feeling pain.75 Beliefs about self--‐‐efficacy -about one's ability to control her pain- are probably the most central and most crucial cognitive dimensions of the experience of pain.76 These beliefs can be central to the experience of a pain, and have some of the heaviest influence upon the reaction component. For example, one study of over a hundred post--‐‐ surgical patients found that a patient's pre--‐‐surgical expectations about her ability to control and cope with her pain was the variable most strongly associated with total pain 71 Jensen and Karoly (1991); Jensen, Turner et al. (1991); Jensen and Karoly (1992); Jensen, Turner et al. (1994). 72 Though placebo effects are extraordinarily complex. For an overview of the topic, see Price (1999), Ch.7. 73 Williams, Robinson et al. (1994) and Williams (1996) show that certain beliefs affect acute postoperative pain. Williams and Keefe (1991) and Shutty, DeGood et al. (1990), respectively, show that a patient's beliefs can predict both the intensity of her pains and the outcome of her treatment for pain. 74 Anderson and Pennebaker (1980); and Pennebaker (1982). 75 Bayer, Baer et al. (1991). In another case, patients suffering from irritable bowel syndrome undergoing a procedure involving the inflation of a rectal balloon were told that the balloon was being inflated for a second time, when in fact it was not. Still many reported again feeling pain. Silverman, Munakata et al. (1997). Similar results have been found with patients undergoing arteriotomies Austan, Polise et al. (1997) and various minor surgeries Wallace (1985). Some philosophers have made something like this point with the example of a (perhaps apocryphal) fraternity prank wherein pledges are told that they will be branded on their backs with a hot iron. When they are touched with a piece of ice instead, they believe that they have been burnt, until the melting ice and laughter tells them otherwise. Stuart Rachels gives this example in Rachels (2000), 11. 76 For just a few examples, see Kanfer and Goldfoot (1966); Kanfer and Seidner (1973); DeGood and Shutty (1992); Jensen and Karoly (1992); Skevington (1995), 223--‐‐226; Turk, Okifuji et al. (1995); Arnstein, Wells--‐‐ Federman et al. (2001); Asghari and Nicholas (2001); Porter, Keefe et al. (2002); Strong, Westbury et al. (2002); Barry, Guo et al. (2003); Cremeans--‐‐Smith, Stephens et al. (2003); and, Keefe, Ahles et al. (2003). From: Swenson, Pain and Value 40 © 2006 by Adam Swenson experience.77 In the next chapter, I shall argue that the heavy weight of the (perceived) ability to control one's pain is extremely important to understanding the nature of pain's evil.78 3.2.2.4 Attention and context In addition to cognitive elements, the attention one pays to her pain has some of the greatest significance in determining the reaction component. This is well--‐‐established by the empirical research.79 But it should also be clear from personal experience. If you are in pain and become engrossed in a conversation, while the pain may be there in the back of your mind, it is much less bad than it was before. This is true even for relatively severe pains. Of course, the worse your pain is, the more difficult it is to distract yourself from it. Many forms of palliative care exploit this connection between the reaction component and the degree of attention paid to the pain. The power of distraction is part of what makes hypnosis effective in pain relief for many types of pain.80 And, in recent years, doctors have found that virtual reality devices are effective in attenuating many severe pains -most notably the agony burn patients suffer during debridement.81 There are many features of the context in which a person experiences a pain which can influence the reaction component. Social cues, for example, affect the experience of pain. If a person is given an electric shock after watching a model tolerate the pain well, her pain thresholds are significantly higher than if the model had been absent (or, worse, handled the pain poorly).82 These social and situational cues can extend to some surprising factors. For example, as I've mentioned before the gender of those present in 77 Bachiocco, Scesi et al. (1993). 78 Eccleston, Chris, Williams et al. (1997) draw a connection between pain and the way it assaults one's personal identity that resonates with the account I shall give of pain's evil. 79 For example, Kahneman (1973); Eccleston, C. and Crombez (1999); Rode, Salkovskis et al. (2001); Kuhajda, Thorn et al. (2002); Legrain, Guerit et al. (2002); Lenz and Treede (2002); Van Damme, Crombez et al. (2002); Villemure and Bushnell (2002); Wade and Hart (2002); Legrain, Bruyer et al. (2003); Roelofs, Peters et al. (2003); Villemure, Slotnick et al. (2003); Tsao, Dobalian et al. (2004); Van Damme, Crombez et al. (2004). 80 See Barber, T.X. (1959); Hilgard, Morgan et al. (1974); Hilgard, Morgan et al. (1975); Barber J, and Mayer (1977); Hilgard and Hilgard (1983); Banks, W. (1985); Price and Barber (1987); Baram (1995); Gracely (1995); Price (1996); Kochs and Schneider (2002). 81 Hoffman (2004); Hendrix and Barfield (1995); Hoffman (1998); Hoffman, Doctor et al. (2000); Hoffman, Patterson et al. (2000); Hoffman, Garcia--‐‐Palacios et al. (2001); Hoffman, Patterson et al. (2001); Hoffman, Carlin et al. (2003); Hoffman, Garcia--‐‐Palacios et al. (2003); Hoffman, Richards et al. (2003); Hoffman, Patterson et al. (2004); Hoffman, Richards et al. (2004); Hoffman, Coda et al. 82 See Craig and Weiss (1971), . Also interesting are studies which show that that children shown films of kids like them receiving their treatment and being calm, are themselves less anxious and experience less complications with their own treatments. See Craig (1978); Melamed and Siegel (1975); and, Melamed, Yurcheson et al. (1978). From: Swenson, Pain and Value 41 © 2006 by Adam Swenson the room, and even the gender of the person inflicting the pain, can influence the reaction component.83 Also, one study has found that the décor of the room in which an experimental pain is inflicted can also have an effect.84 Many features of the individual's background and personality also influence the reaction components of her pains. The relationship between gender and the many features of pain is extremely complex. I do not have space to delve into the extensive literature herein.85 Similarly, a patient's social, cultural, and historical, background, for example, can be rather significant. The researcher David Williams writes that, for example, [a person's] culture's tendency to be emotionally expressive or stoic, beliefs about the meaning of pain and its controllability, and learned models for illness behaviors [all] influence how a patient responds to pain.86 Other significant features include the patient's own memories of past pains and how she dealt with them, as well as her exposure to her friends and family's reacting to other people's pains, impacts her own experiences of pain.87 The attitudes -especially their solicitousness- that a patient's caregivers, friends, and family, express toward her can also have a large impact.88 All of these features of the experience of pain and its context together determine the nature and strength of the pain's reaction component (and, in some cases, the character of the sensation kernel as well). The list I have given is a small subset of the factors unearthed in the literature. At this point, the list may seem to lack order; to lack a unifying theme. We shall see in the next chapter that many of these factors in fact coalesce around a specific kind of helplessness which I believe lies at the heart of pain's evil. Now that we have a sense of what can influence the reaction component, let me turn to what it is. 83 Levine (1991); Kallai (2004); Haley (1985). 84 Williams (unpublished) 85 To get a sense of how gender permeates every component of pain and its treatment, here's a sample list: Rollman, Hapidou et al. (1990); Feine, Bushnell et al. (1991); Kepler, Standifer et al. (1991); Strong, Ashton et al. (1992); Ruda (1993); Vallerand (1995); Unruh (1996); Paulson, Minoshima et al. (1998); Keogh, Hatton et al. (2000); Keogh and Herdenfeldt (2002); Sarlani and Greenspan (2002); Wise, Price et al. (2002); Chesterton, Barlas et al. (2003); Sarlani, Farooq et al. (2003); Kim, Neubert et al. (2004); Sarlani, Grace et al. (2004); Keogh, McCracken et al. (2005). 86 Williams (1999), 158. See also Bonica (1990); Morris (1991), (1999); Friedman, Gaughan et al. (2000); Ansary, Steigerwald et al. (2003); Raj, Steigerwald et al. (2003); Zborowski (1952); Zborowski (1960); Lipton and Marbach (1984); Bates, Edwards et al. (1993); Greenwald (1991); Sternbach and Tursky (1965); and, Faucett, Gordon et al. (1994). 87 Edwards, Zeichner et al. (1985); Haley, Turner et al. (1985); Bachiocco, Scesi et al. (1993); Koutantji, Pearce et al. (1998); Spertus, Burns et al. (1999); Fillingim, Edwards et al. (2000); Kovacs, Gestoso et al. (2003); Fillingim (2000). 88 See Skevington (1995). From: Swenson, Pain and Value 42 © 2006 by Adam Swenson 3.2.3 The reaction component I have argued that, given that the kernel view is false, the intrinsic properties of a pain must contain some additional component which, by being affected by the context, can be responsible for a difference in intrinsic value between two pains with identical painful sensation kernels. We then saw that the elements of the context are extremely diverse and tightly bound up with the reaction component. That completes this answer to Q2. Given the composite view of pain, Q3 -why is pain intrinsically bad?- now becomes: What properties does the reaction component contain? Different substantive theories of intrinsic value explain the nature of the reaction differently. Coupled with the composite view, the dislike theory entails that the reaction component of pain is the dislike of the sensation. The mental--‐‐state theory entails that the reaction component is the sensation's appearing unpleasant. I shall now argue that, while formally compatible with these substantive theories, the composite view strongly suggests an alternative substantive account of pain's intrinsic badness which was logically unavailable on the kernel view. I'll begin by arguing that the reaction component can contain a substantially more diverse array of affective, desiderative, conative, and cognitive states than the traditional accounts have supposed. In §3.3 I'll argue that we should reject the traditional answers to Q3 in favor of a more catholic account -the aversion theory- which is truer to the diversity of the reaction component. I believe that the logical relationship between affective, desiderative, cognitive, and conative attitudes, and a painful sensation is identical to the relationship between the putative reaction component (e.g., dislike) and the sensation. That will show that these attitudes are also part of the reaction component. The argument is most perspicuous assuming a stance view like the dislike theory. I'll return to containment views in a moment. Consider: Operation: You must undergo a painful operation without anesthetic. The intense pain you feel at the first incision elicits a heavy dose of fear. You've been told that the pain will only get worse. The fear thus makes the present pain much worse than it would be otherwise. On the composite view coupled with the dislike theory, the fear is not part of the pain. Its contribution to the pain's intrinsic badness is mediated by the reaction component. In Operation, the sensation and context cause the fear which, in turn, causes a greater dislike of the painful sensation. Because this is a change in the pain's intrinsic properties, the pain has become intrinsically worse -it doesn't matter that the change was caused by a non--‐‐intrinsic property. I think this is a mistake. I shall now argue that fear's contribution to the pain's intrinsic badness need not be mediated by a separate attitude such as dislike. Instead, fear stands From: Swenson, Pain and Value 43 © 2006 by Adam Swenson in the same relationship to the painful sensation as the putative reaction component. We should, I think, take the fear to be part of the reaction. In Operation, the fear's badness need not depend on the reaction which it influences. This can even be true on the dislike theory. The victim of a serious accident could have two separate, but causally interacting, attitudes: a dislike of her fear of dying (which the pain arouses), and a dislike of the painful sensation. Morphine would alleviate one but not the other. This is compatible with the fear influencing her dislike of the sensation (and it does not entail the problematic conclusion that she dislikes the sensation in virtue of the fear's badness). Thus the fear itself can be bad in Operation. The sensation may cause the accompanying fear. But the painful sensation does not on its own determine the level of fear. If, for example, you knew that the forthcoming pains will be no worse, you may fear them much less. Thus the context's effect on the degree of the fear's evil is at least partially determined independently of the painful sensation. Your fear in Operation need not be restricted to future pains. When I am running from the axe--‐‐wielding psychopath and hit a dead--‐‐end, I certainly fear my impending death. But I can also fear her as she slowly approaches. Similarly, it is possible to fear the present painful sensation in Operation.89 Therefore, in Operation, your fear is a response to the painful sensation; it is itself bad; its badness is influenced by context; and it (partially) determines the badness of the pain. That should sound familiar. Fear and the putative reaction component can stand in the same relationship to the painful sensation. That is, both attitudes: (1) Arise because of the painful sensation. (2) Have the painful sensation as their object. (3) Can be bad per se when accompanying the painful sensation.90 (4) (Partially) determine the pain's intrinsic badness. I think (1)--‐‐(4) are jointly sufficient conditions for an attitude being a constituent of a pain's reaction component. There are myriad and interrelated, affective, motivational, and cognitive attitudes which satisfy these conditions. Anger, despair, the impulse to escape, and feelings of helplessness, among many others, are parts of the reaction component. They are therefore intrinsic properties of the pain. 89 It may seem conceptually awkward to claim that one can fear something that is present -fear may be a diachronic attitude like regret. But I need not legislate on this. Being terrified is an essentially affective state. However, it can still be an attitude toward something. Thus, if necessary, we can substitute 'is terrified of x' when I say 'fears x' herein. 90 There is a complication here. It may seem that the state of disliking x is not bad per se, instead it's only x that's bad. That seems disanalogous to fear which is itself bad. This raises some larger issues about the bearers of intrinsic value which I shall address in §5.2. From: Swenson, Pain and Value 44 © 2006 by Adam Swenson §3.3 Against the traditional accounts I shall now argue that understanding the reaction component in this capacious way undermines existing views of pain's evil. 3.3.1 The alleged gap As we saw above, the proponents of the traditional answers to Q2 hold that states like fear influence the intrinsic badness of pain by influencing the dislike which wholly composes the reaction component. Thus (4) -the claim that fear (partially) determines the pain's intrinsic badness- seems to beg the question against this view. By adding 'partially' to (4) I claim that dislike and fear affect the value in the same unmediated way. But that is precisely what is at issue. However, I think we have shifted the burden onto my opponent. We know that when the fear of the sensation kernel is greater, the pain is intrinsically worse. Coupled with the claim that fear is an intrinsic property of the pain, this seems to be a complete explanation of fear's contribution to pain's intrinsic badness. Thus, given the metaphysical capaciousness of the composite view, the dislike theorist owes us an account of the alleged gap between fear and the pain's value which, she holds, dislike must bridge. More importantly, to claim that we need dislike to fill this alleged gap, she owes us a substantive account of the normatively significant form of 'dislike'. It cannot simply be a negative attitude toward the painful sensation kernel. Fear satisfies that requirement; and we've seen that the relationship between fear and the sensation is very tight as it stands. There must be something more to the substantive conception of dislike. But this will be hard to come by. One of the perennial strengths -and most frustrating aspects- of dislike--‐‐based views is that the attitude is so non--‐‐specific and thin. I shall return to this in a moment.91 The same conclusion follows for containment views. On a containment view like the mental--‐‐state theory, the reaction component and kernel together compose the way the pain feels. The pain takes on a certain distinctive felt character -its unpleasantness- when it involves certain meanings or is accompanied by certain emotions. That is the source of its intrinsic badness. But it's not clear why we would appeal to the particular change in the pain's phenomenology caused by being fearful to explain why the pain in Operation is worse than it would be otherwise. It seems that the fact that one is fearful does all the work. Indeed, even if the presence of fear affected the qualitative character of the sensation kernel, the fact that the fear is present would still do all the explanatory work. 91 C.f., Scanlon's treatment of desire which imbues normatively significant desires with rationally assessable features. That makes dislike more plausibly akin to fear, and less something special and basic in our conceptions of value. See, Scanlon (1998), 37--‐‐41. From: Swenson, Pain and Value 45 © 2006 by Adam Swenson Moreover, emotions like fear (and even cognitive states like perceiving a meaning) have their own phenomenological content. This makes the alleged phenomenological boundary between the fear and pain (the composite of the kernel and the reaction component) hazy at best. The borders are further smudged if the presence of fear affects both the reaction component and the character of the painful sensation kernel. These vague boundaries suggest that things like fear are part of the pain after all. But as with the dislike theory, this conclusion may have been obscured by the looseness of the term 'unpleasantness'. And again, this looseness may have contributed to the specious attractiveness of these traditional theories.92 3.3.2 The aversion theory Thus once we accept that the reaction component of a pain can contain fear and other attitudes which satisfy (1)--‐‐(4), we must abandon the traditional accounts of pain's evil. Fortunately, the composite view's metaphysics suggest (but do not entail) an alternative answer to Q3 -in virtue of what is pain intrinsically bad? On the composite view, a pain is a complex of a painful sensation kernel and a reaction to it. I have argued that this reaction can include a diverse array of mental states. On this account of the reaction component, the reaction is an aversion, that is, a complex of interrelated affective, motivational, desiderative, and cognitive responses to a painful sensation kernel. Thus, accepting the composite view pushes us to an aversion theory of pain's intrinsic badness. That is, pain is intrinsically bad in virtue of the kernel and the constituents of the reaction component. This theory, I think, comports with the attractiveness and power of a thin conception of dislike. I suspect that part of the attraction to dislike theories lay in the relevant aspect of the experience of pain being much more complex than we can plausibly capture with, for example, my having a desire that the pain cease. More importantly, we can find all the traditional candidate sources of pain's intrinsic value in the aversion. The reaction component contains unpleasantness, dislike, motive power, and the representation of damage. If I'm right, when we accept the composite view as the answer to Q2, we are led to an irenic answer to Q3 on which a pain's intrinsic badness lies in all of the traditional candidates. 3.3.3 The composite view and my methodology In the last chapter I promised that, by suspending the univocality assumption and focusing just on pain to the exclusion of broader theoretical concerns, we would make new progress on old issues. We have now harvested my strategy's first fruit. We have found that all of the traditional accounts of pain's badness are false. We have also found 92 The same conclusion follows mutatis mutandis for other containment views such as the motivation and representation theories. From: Swenson, Pain and Value 46 © 2006 by Adam Swenson that the intuitive distinction between stance views and containment views obscures the correct account. Let me explain. As I characterized them in chapter one, stance views hold that pain is bad because we take a certain attitude toward it. This certainly seems true of the aversion theory. An aversion is a complex negative reaction to a painful sensation kernel. For example, our fear of the pain seems to be a stance in the relevant sense. Indeed, I argued that fear is part of the reaction component by pointing out just how analogous it is to dislike -the paradigmatic evaluative stance. But the aversion theory is also a containment view. On a containment view the presence of the pain is both necessary and sufficient for its badness. Everything that goes into a pain's badness is part of the pain. On the aversion theory, the reaction component is an intrinsic property of the pain. That is, pain is bad because of our reaction to the painful sensation kernel, but the reaction itself is an intrinsic property of the pain. Thus once we expand our understanding of what pains are we find that all of the existing views were onto part of the truth. I suspect that they failed to see it because they were looking for the source of pain's evil to lie in either the pain kernel or in the reaction to it. Certainly, when the battle--‐‐lines have been drawn by the dislike and mental--‐‐state theories, it is hard to even make sense of the possibility that pain's evil lies in both. It is only when we resolve to approach pain directly and not through the lens of broad theories that this answer becomes available. In the old Indian parable, three blind men encounter an elephant for the first time. The first, seizing hold of the trunk, declares that elephants are a kind of snake. The second, upon touching the massive leg, demurs. Elephants, he avers, are a kind of tree. The third touches the ear and declares that elephants are a kind of fan. Each held part of the truth. Part of the elephant is like a snake. But they were all wrong. The proponents of the traditional accounts of pain's intrinsic badness are like these blind men. The dislike theory claimed that pain is intrinsically bad because we dislike the painful sensation kernel; on the mental--‐‐state theory it was because the sensation kernel is unpleasant. I have argued that each held part of the truth, but that they've all been blinded by a mistaken assumption about what pain is. Elephants are not snakes, and pains are not kernels. From: Swenson, Pain and Value 47 © 2006 by Adam Swenson Chapter 4 Pains as Usurpers In the last chapter I argued that, once we discard the kernel view and adopt the composite view as our account of what pains are, we should reject the traditional accounts of why pains are intrinsically bad. I shall now argue that on the composite view the aversion theory is not the only correct account of pain's intrinsic badness. That is, for some pains, one pain can have two distinct intrinsic evils that are independently normatively significant. The aversion theory accounts for one. In this chapter I shall explore the other.93 On the composite view, many pains have a distinctive invasive character. These pains are usurpers. Being a usurper gives a pain a second intrinsic evil. Intense pain necessarily undermines autonomy and other intrinsic goods. I suspect that all pains have this character and this additional value to some degree. But I shall only press herein for the more moderate thesis that many intense pains have it. I shall accordingly abbreviate 'intense pain' with 'pain' in this chapter. The view I shall articulate has a disreputable history. Aquinas, Plotinus, Augustine, and a few other brave or foolhardy souls have held privation views. Pain, these writers claim, is bad because it is the absence or loss of the good. These views are patently false. Pain hurts. Any account of pain's evil which doesn't place its phenomenology at center stage is simply mistaken. Pain's evil must lie with the way it feels. However, when we reflect on what is normatively significant in the experience of pain, we see that the experience of a pain -the way it feels- is much broader than the painful sensation. Thus once we adopt the composite view, I think we do find that pain is necessarily bad as a privation. Pain is, and is experienced as, in part, the loss of a kind of self--‐‐control. This form of self--‐‐control is a necessary condition of intrinsic goods like autonomy. A person cannot, for example, be autonomous if her train of thought is unconstrained babble. Pain is, I'll argue, intrinsically bad insofar as its presence makes autonomy and other intrinsic goods impossible. If my argument in this chapter is correct, a person in pain is ipso facto not fully autonomous. I will be arguing that pain's evil as a privation is found in the way it feels. I'll begin in §4.1 by setting out the distinctive features of pain's phenomenology in which we will find this evil. Then in §4.2 and §4.3 I shall set out the kind of self--‐‐control pain necessarily undermines, and show how the undermining is intrinsically bad. In §4.4 I shall argue that this intrinsic bad is at least as significant as the intrinsic badness 93 The view I shall now set out is independent of the aversion theory. It depends only on the composite view's inclusion of the reaction component amongst the intrinsic properties of pain. From: Swenson, Pain and Value 48 © 2006 by Adam Swenson described by the aversion theory. I shall close in §4.5 by answering the objection that my account of pain's evil is overinclusive. §4.1 The experience of pain The experience of pain is, in part, the experience of being destroyed from the inside by an alien and invasive enemy. This experience has two necessary conditions. INVASION: Pains are aliens which invade one's inner life and dominate parts of it and PASSIVITY: Pains usurp one's control over parts of oneself. One is made passive, in a distinctive way, with respect to these parts. Together the invasiveness of pain and the passivity it imposes constitute the usurpation of a kind of self--‐‐control which I'll call user control. This is a very general kind of control we normally have over the movements of our minds and bodies. It is, I think, deeply connected with our conceptions of agency and value. For now, think of user control along the lines of willpower or self--‐‐discipline. Though we'll see that it runs much deeper than those forms of self--‐‐control. I'll say much more about it and the normative significance of its loss in §4.2 and §4.3. I'll now discuss the usurpation at the heart of the experience of pain by addressing INVASION and PASSIVITY. I'll then conclude by drawing them together. 4.1.1 INVASION Being in pain involves being invaded by an alien. Pains are not merely unwelcome - as are embarrassment and shame. They are experienced as entities that are not part of the sufferer. The depth and scope of this invasion increases with its severity. In the playwright Antonin Artaud's words, pain as it intensifies and deepens, multiplies its resources and means of access at every level of the sensibility.94 There are two parts to the invasive dimension of pain which pull in different directions: ALIEN NATURE: The constituent elements of a pain are experienced as alien presences. That is, a sufferer doesn't identify with the sensations, feelings, urges, thoughts, and desires, that pains involve. DISASSOCIATION: A sufferer is disassociated from a pain's constituent elements; though she retains the dim awareness that they are part of her. Let me say a bit about each. 94 Artaud (1958), 23. From: Swenson, Pain and Value 49 © 2006 by Adam Swenson The key feature of pain's alien nature is the lack of identification with its parts. The sensations and desires pain involves are alien in this way, as are the sufferer's screams and contortions.95 We normally identify with parts of ourselves to different degrees. Spasms and interloping thoughts are to some degree alien; so are the unfamiliar movements involved in learning a musical instrument or new sport. The parts of a pain can similarly be more and less alien. The less a sufferer identifies with the emotions, desires, thoughts, and other aspects of the reaction component, the worse the pain will tend to be. The pain is worse (partially) in virtue of this lack of identification. Being disassociated from a part of one's mind or body involves it being alien. Hence, the disassociative character of pain is tightly tied to its alien nature. The term 'disassociation' can refer to all sorts of phenomena, but pains involve a particular kind of disassociation which, in combination with its alien nature, constitutes pain's invasiveness. A person is disassociated from an x in this sense only if she retains a dim awareness that x is part of her. Thus while she doesn't identify with the desires a pain imposes, she is aware that they belong to her. This dim awareness tempers the lack of identification that the alien nature of pain involves. Though a person doesn't identify with her pain, she still feels it as part of her. This is not simply because the pain happens to be occurring in her. It is because pain destroys its sufferer by turning her own body and mind against her. The writer Elaine Scarry brings this out nicely Regardless of the setting in which he suffers...and regardless of the cause of his suffering...the person in great pain experiences his own body as the agent of his agony. The ceaseless, self--‐‐announcing signal of the body in pain...contains not only the feeling 'my body hurts' but the feeling 'my body hurts me.' This part of the pain...sometimes becomes visible [to an observer] when a young child or an animal in the first moments of acute distress takes maddening flight, fleeing from its own body as though it were a part of the environment that could be left behind. If self--‐‐ hatred, self--‐‐alienation, and self--‐‐betrayal...were translated out of the psychological realm where [they have] content and [are] accessible to language[,] and into the unspeakable and contentless realm of physical sensation it would be intense pain.96 Being in pain involves, inter alia, the sufferer feeling that parts of herself have been turned against her. That involves thinking of her body as something independent of herself, but at the same time, remaining aware that it is hers. I believe that this is also 95 Certain injuries and pains are reliably accompanied by characteristic contortions. Once, an emergency room doctor took one look as I hobbled in the door -right elbow tightly tucked against ribs, arm across chest, and body leaning 45 degrees- and asked how I broke my collarbone. 96 Scarry (1985), 47. The body 'being in rebellion' or having 'turned against her' is part of PASSIVITY. From: Swenson, Pain and Value 50 © 2006 by Adam Swenson true of the beliefs, desires, emotions, and other mental components of a pain. What I'm calling DISASSOCIATION attempts to capture this quasi--‐‐schizophrenic aspect of pain.97 4.1.2 PASSIVITY Now for the second part of the experience of pain: PASSIVITY. Being passive in this sense is not mere inertness. The passivity bound up in the experience of pain involves feeling and being helpless and controlled. This comes out when we attempt to resist or ignore our pains. Consider: Trial By Ordeal: Your hand is placed in a pot of water which is gradually brought to a boil. If you remove your hand before it reaches a boil, your child will be killed. Your pain involves the urge to withdraw your hand. The urge takes several forms: You want to remove your hand, and it feels as though your hand is being involuntarily pulled toward the water's surface. You find yourself rationalizing removing your hand, and trying to make excuses for giving in and allowing your child to die. At the same time, you try to keep user control over your hand and your thoughts. You strain to keep your hand in the water. You remind yourself of the stakes and your love for your child; and you actively resist the lure of the rationalizations. Insofar as you are successful, you retain user control over your hand, desires, and thoughts. Insofar as you fail, you lose user control over these aspects. When you fail, you feel helpless. You may, for example, feel like a spectator watching in horror as your hand pulls from of the water. These feelings of helplessness are part of the passivity pain imposes. In Scarry's wonderful turn of phrase, In physical pain...suicide and murder converge, for one feels acted upon, annihilated, by inside and outside alike.98 This connects with the dim awareness that the disassociation involves. In being disassociated, the sufferer is aware that the usurped aspect is part of her. The passivity adds a sense of helplessness that's tied to the (usually dim) awareness that the aspect is something that should be hers to control. Your desire to remove your hand seems alien and imposed upon you; yet it is sickenly yours. 4.1.3 The phenomenological essence of pain The combination of INVASION and PASSIVITY, along with a certain kind of sensation are parts of (intense) pain's phenomenological essence. They are necessary conditions of a 97 DISASSOCIATION is also bound up with PASSIVITY. Again, I suspect they are logically distinct, but little turns on the issue. To reflect the passivity implicit in DISASSOCIATION, I shall say 'A is disassociated from x' rather than 'A disassociates from x'. Elsewhere I use 'detachment' to refer to the way one may actively dis--‐‐identify herself with a pain. Detachment is an effective means in combating pain; DISASSOCIATION is part of the pain. 98 Scarry (1985), 53. From: Swenson, Pain and Value 51 © 2006 by Adam Swenson state being a pain. The experience of pain is necessarily the experience of being destroyed from within. It is the experience of the usurpation of user control. User control, I'll now argue, runs deeply into and throughout our conception of agency, and it underpins many things of intrinsic value. As such, pain is intrinsically bad in virtue of its being the usurpation of user control. §4.2 User control There are many senses in which agents control themselves. Some are tinged with free will -as a person is the author of her acts- while others seem just to describe physiological states and abilities -as alcohol impairs one's motor control. And we praise still others as virtues -for example, willpower and self--‐‐discipline. User control is a catholic conception which underlies control in all of these senses. Whenever we say that someone can do x, we are implicitly ascribing certain forms of user control to her. Thus user control is, I think, pervasive and deeply important. 4.2.1 First pass at user control I'll now say a bit more about what user control is; I'll then turn to its normative significance. Any creature capable of purposive action has and exercises forms of user control over its thoughts, actions, and body. Its objects include, inter alia, intentions, emotions, beliefs, and bodily movements. User control is not limited to rational agents. Most creatures with minds -my cat Sanuk but probably not Harry Frankfurt's benighted spider- exercise user control in their lives. I'll only discuss humans herein. Very roughly, An agent A exercises user control over x, where x is some mental or bodily state or process of A, only if A consciously and effectively, manipulates or changes x. All physical and mental acts involve exercises of user control. User control comes in degrees. I presently have complete user control over the motion of my left index finger -my willing makes its typing 't' so. But purposive choice is not sufficient for the effective exercise of user control. Despite her heavy concentration and effort in fretting difficult chords, the beginning guitar player still hits sour notes. 4.2.2 Two categories of user control's objects The objects of user control come in two categories. A person can have user control of x or she can have user control over x's effects upon her. I cannot control the feeling of mild hunger, but I can control how much it affects me by ignoring it and focusing on the task at hand. Both are equally forms of user control and having one does not entail having or lacking the other. With many of our mental states, we may have strong user control over their content and persistence, but have extremely weak or no user control over their onset. Many From: Swenson, Pain and Value 52 © 2006 by Adam Swenson beliefs and desires pop into our consciousness despite our best efforts to concentrate. While writing the last sentence, I was struck with the thought 'isn't she cute' and the desire to pet the cat sitting next to me. The occurrence of such states may be beyond our control.99 Interloping beliefs and desires seem to be a fact of mental life. It is thus important to underscore that nothing of normative significance follows just from our lack of user control over their onset. The normative significance of a form of user control is given by its connection to what is valuable for us. That will be the topic of §4.3. First, I need to say more about the forms of user control. 4.2.3 Exercising user control User control underlies agency and action. Agency normally requires consciousness - sleepwalkers are not agents. Thus all exercises of user control emanate from a conscious decision or some other conscious initiation of mental or physical movement. The objects and means of user control, however, reach beyond the domain of consciousness. There are roughly three modes by which we exercise user control over our minds and bodies: we can do it directly, or via symbolic or external means. I'll say a bit about each in that order. First and most obviously, we can exercise user control through direct access to the object of control. When I exercise user control over my left index finger in making it type 't', I simply direct my will to my finger. While there is plenty of metaphysical mystery here, direct exercise of user control is commonplace and needs no special discussion. Second, in certain cases, we seem to be able to exercise user control through symbolic means. Techniques such as biofeedback, meditation, and hypnosis, turn out to be effective means of influencing some mental and bodily processes and states that are normally beyond our conscious direction. For example, some hypertensives apparently can learn to exercise a measure of control over their blood pressure through biofeedback; similarly for sufferers of chronic pain. Meditation carries many benefits for the lay--‐‐practitioner's psychological dispositions, and highly--‐‐trained practitioners like some Buddhist monks can achieve surprising degrees of control over things like their core body temperature. With symbolic means, the intentional object of control is rather different from the extensional object. A biofeedback session might involve attempts to modulate a line on a screen rather than introspection upon one's blood pressure, and meditative practice often involves a carefully structured set of visualizations and imagery. These phenomena may seem a bit strange. But I think that the monk who modulates his body 99 C.f., Scanlon's discussion of judgment sensitive attitudes and irrationality. Scanlon (1998), 37--‐‐41, especially 40. From: Swenson, Pain and Value 53 © 2006 by Adam Swenson temperature by imagining a fire built in his lower abdomen is doing something unusual but nothing especially mysterious. Third, we can exercise user control through external (i.e., non--‐‐mental) means. The diabetic who controls her blood sugar by injecting insulin uses an external means, but it is no less an exercise of user control than my calming myself with a few deep breaths. It is important to remember, however, that a person's user control originates from and centers upon herself. While you can exercise user control by using other people as external means (for example, doctors or motivational speakers), they don't exercise user control over your states.100 4.2.4 Diachronic and synchronic user control Finally, both the possession and exercise of user control can be synchronic or diachronic. While I shall focus mainly on synchronic user control, let me sketch two forms of diachronic user control. One form of diachronic user control provides the sense in which it is true that the irascible person has weak user control over her irritability even when she is calm. Such dispositional diachronic user control accounts for one way it can be true that the equanimous person presently filled with blind rage has strong user control over her emotions. In most cases, the normative significance of losing synchronic user control is not diminished by retaining dispositional diachronic user control. Though, as is often the case with chronic pain, the loss of dispositional diachronic user control often exacerbates the badness of the synchronic loss. The more important form of diachronic user control involves extended and non--‐‐ continuous effort. The diachronic user control involved in behavioral and psychological habituation is a prominent example. A person addicted to heroin has some degree of diachronic user control over her cravings and their power to move her. If she makes no effort to quit or feels helpless to control the cravings, that degree is very low. The puzzle comes when she begins to actively resist the cravings and tries to quit. Sometimes during the long process of quitting, she has very weak control -she caves in when a friend shoots up in front of her- but at other times she has strong control -she watches Requiem for a Dream and strengthens her resolve. In these cases, she has variously weaker and stronger degrees of synchronic user control over her cravings and their motivating force. Diachronic user control in cases of extended effort thus tends to be relatively inelastic. It slowly increases over the course of her recovery, and it does not drastically change with each success and failure. But the magnitude of the increase (or decrease) need not 100 I believe that torture attempts to do just this. That is, torture is an attempt to gain user control over another person's thoughts and actions. The fact that pain is necessarily the usurpation of user control thus makes it an efficient means. David Sussman articulates a similar view in Sussman (2005), and roughly this picture appears throughout Scarry (1985). From: Swenson, Pain and Value 54 © 2006 by Adam Swenson be so slow or constrained in every case. For example, with some addictions one's diachronic user control may typically increase slowly for a long period of time before rapidly rising at some tipping--‐‐point; similarly for the downward spiral into addiction. This form of diachronic user control may prove important in understanding certain features of chronic pain. The many degrees and forms of user control are widespread. They're virtually universal in our lives. They run the gamut from the silly -the ability to wiggle one's ears- to the profound -the ability to direct one's thoughts. They are also what pain threatens. §4.3 User control and the intrinsically valuable That brings us to the relationship between user control and pain's evil. I'll argue that some forms and degrees of user control are necessary conditions of intrinsic goods. Since pain is the usurpation of user control, it is therefore the loss of the necessary conditions of various intrinsic goods. That, I'll claim, makes pains intrinsically bad. I'll begin in §4.3.1 with a sketch of the metaphysical relationship between user control and the intrinsically valuable. I'll then turn to the specific examples of autonomy in §4.3.2 and desire--‐‐satisfaction in §4.3.3. 4.3.1 The normatively significant sphere If certain forms and degrees of user control are necessary conditions of intrinsic goods, the nature of the intrinsically good circumscribes what forms and degrees of user control a person must have to be, for example, autonomous. We thus can say that the forms and degrees of user control that are necessary conditions of intrinsic goods constitute the normatively significant sphere of user control. Where a person lacks the constituents of this sphere, certain intrinsic goods are not possible. So if a measure of user control over one's impulses is a necessary condition of autonomy, a person led around by only her urges cannot be fully autonomous. Many forms and degrees of user control don't fall within this sphere. It may seem that if one is lost in the mountains, autonomy requires a Tibetan monk's user control over her core body temperature. After all, life is a necessary condition of autonomy, and avoiding hypothermia certainly serves that end. But being instrumentally useful is not being a necessary condition. The necessary conditions of an intrinsic good like autonomy are given by a substantive theory of what autonomy is; the contents of the normatively significant sphere with respect to autonomy are thus entailed by substantive accounts of the intrinsically good. While I believe that virtually everything that is intrinsically good for someone has various forms and degrees of user control as its necessary conditions, I shall only argue that this is true for two values: autonomy and desire--‐‐satisfaction. From: Swenson, Pain and Value 55 © 2006 by Adam Swenson 4.3.2 Autonomy To lead an autonomous life, an agent must be free and able to pursue certain of her projects. User control over some set of the beliefs, desires, intentions, movements, et cetera, which constitute these pursuits are therefore necessary conditions of autonomy. Some of user control's objects are more central to the intrinsically good than others. Most conceptions of autonomy accept that some components of an autonomous life are more central, and more important, than others. Joseph Raz, for example, writes that An autonomous person's well--‐‐being consists in the successful pursuits of self--‐‐chosen goals and relationships. Like all people's...[these] will...be nested goals, with the more comprehensive ones being, other things being equal, the more important ones.101 Such nested goals plausibly have corresponding capacities. The capacities corresponding to the more comprehensive goals are thus more important. The kinds of user control necessary for these capacities -for reflection, choice, free action, and self--‐‐ discipline, and others- will thus be the most important. Hence, the loss of the user control necessary for basic reflection may undermine the very possibility of autonomy. It may help to return to my case of Trial By Ordeal. When the water passes 42.5°C, your hand starts hurting. And that's barely halfway there. At some point your hand will feel as though it is pulling itself to the surface. But autonomy requires some measure of user control over the movements of your body. Thus, the more your hand rebels the more the pain eats away at your autonomy. As the temperature rises, the pain begins usurping more central forms of user control. Autonomy requires some measure of control over your attention and your thoughts. But part of the increase of pain is the diminution of your ability to ignore it. After a certain point, you will be unable to think of anything else. Worse, the pain begins stripping away your control over your beliefs and desires. You may find yourself not caring about your child's death or rationalizing letting her die. In a sense then, it is not you who eventually jerks your hand out of the pot. You are no longer at the controls of your body and mind. That, I think, makes autonomy utterly impossible. Of course, the forms of user control autonomy demands are not sufficient conditions of autonomy. Coercion undermines autonomy, but the coerced still form intentions, plan, and act -one can plot how best to rob the liquor store to save her mom from the thugs demanding it. Substantive theories of autonomy often agree on what forms of user control are necessary for autonomy, but disagree on how much. Consider the relationship between autonomy and intoxication on different views. I can't think precisely enough to do 101 Raz (1986), 370. From: Swenson, Pain and Value 56 © 2006 by Adam Swenson philosophy if I'm mildly intoxicated. Many believe that my autonomy has not been compromised by that loss of user control; I've lost nothing within my normatively significant sphere. But this is a substantive question. Some religious writers hold that intoxication and sensual pleasures in and of themselves despoil the soul, and are anathema to autonomy. For them, the forms and amounts of user control lost with intoxication are part of the normatively significant sphere of user control. Similarly, while we lose the ability to control our movements while sleeping, few theories of autonomy would hold that sleep is anathema to the autonomous life. That is, the user control lost during sleep is no more a part of the normatively significant sphere than is the user control of one's thoughts that one occasionally loses with a few glasses of wine. The same applies to the user control we lose when consumed with pleasure (though with a slight twist since pleasure is itself intrinsically valuable -I shall say more about that issue in §4.5). Thus there is plenty of disagreement about what lies in the normatively significant sphere of user control. Fortunately, my account only demands that this answer be given by substantive theories of the intrinsic goods in question. What we believe about goods like autonomy thus entails much of what we believe about pain's evil. 4.3.3 Desire--‐‐satisfaction I've now argued that, in virtue of the relationship between user control, pain, and autonomy, pain necessarily involves the privation of autonomy. I think this is also true of the intrinsic value of desire--‐‐satisfaction. That is, I shall argue that, for many kinds of desire, D1: The satisfaction of desire d is good only if A has an appropriate measure of user control over d. There are many different kinds of desire, and thus there are probably some exceptions. Nonetheless, I believe that D1 is generally true, and that it is widely assumed. Indeed, most modern theories which base value on desire--‐‐satisfaction tacitly assume that user control over a desire is a necessary condition of it being a source of value -of the satisfaction of that desire being good.102 Among those who hold desire theories, very few, if any, accept: D2: For any x, if A desires x, obtaining x is good for A We all occasionally have uncharacteristic transient desires, urges, and compulsions, which we would not endorse upon reflection. These interlopers are usually weak and merely distracting. But when they are the products of psychosis, mania, or obsession, they can be overpowering. 102 For stylistic reasons I shall usually omit the caveat that there may be exceptions to D1. It remains in force in what follows. From: Swenson, Pain and Value 57 © 2006 by Adam Swenson The place of interlopers in our lives strongly suggests that we should reject D2. Consider: Dishes: While washing dishes, I am assailed by the overwhelming urge to plunge my hand into the whirring blades of the garbage disposal. At that moment, it is what I most want to do. Since D2 places no constraint on what desires it is good to satisfy, D2 entails that the satisfaction of my desire to mutilate my hand is (very) good. This is implausible. There has to be some filter on what is good for me. Thus most proponents of desire theories hold something like: D3: For any x, if A desires x and would continue to desire x after an appropriate form of reflection, then obtaining x is good for A. Different substantive theories may characterize the appropriate form of reflection differently. For example, some views may require fully informed deliberation in a cool moment; others may require the desire to survive a stricter form of cognitive psychotherapy. And, depending on my preferences and the substantive theory we accept, it could be that mutilating my hand would be good for me (in which case the desire would not have been an interloper). Nonetheless, whatever the specifics, any tenable theory which holds that desire--‐‐satisfaction is intrinsically good should reject the unconstrained D2 for some version of D3. I believe that D3 implies: D4: For any x, if A desires x and would cease to desire x after an appropriate form of reflection so dictated, then A has an appropriate measure of user control over the desire for x (mutatis mutandis for the continuation of desires which pass reflection). That is, some measure of user control over a desire is a necessary condition of the satisfaction of that desire being good for one. Again, the 'appropriate measure' is determined by the various substantive theories (and it may differ depending on the kind of desire at issue). A view which required the desire to persist or extinguish in the face of rigorous self--‐‐examination would require a higher degree of user control than a view which required the desire to survive only a quick weighing against other current desires.103,104 103 Scanlon's conception of desires as judgment sensitive attitudes may be an example of the former. The claim that the existence and persistence of desires are sensitive to judgments may require a great deal of user control on the part of a rational agent. Indeed, this is, I think, an important part of his argument that there can be akrasia of belief. See Scanlon (1998), 35--‐‐36. 104 D4 probably excludes desires that can be posthumously fulfilled or frustrated. Indeed, there may be a broader class of timeless desires which do not depend on our states at any given moment. Thus these kinds of desires may be exceptions to D1. There are a host of interesting issues concerning the relationship between user control and these kinds of desires which I cannot explore herein. Earlier drafts of this dissertation contained a chapter that discussed these and other temporally--‐‐indexed desires and From: Swenson, Pain and Value 58 © 2006 by Adam Swenson It's worth noting that what separates interlopers from desires which pass D4 is not the fact that the interlopers arise unbidden. Many desires simply pop into our consciousness. We have no user control over their appearance. But, as we have seen, not every loss or lack of user control is normatively significant. As with the user control we lose with some pleasures, this lack of user control is likely benign. That is, the substantive theories of the good which determine the normatively significant forms of user control are unlikely to condemn this common feature of our psychological lives. The problem with interlopers is not that they show up, it's that they won't leave when we want them to. D4 reflects, I think, the fact that desire theories are partially motivated by the belief that the individual is, in some sense, the gatekeeper of her good. Things are only good insofar as she desires them; the satisfaction of a desire is only good for her insofar as the desire is hers. Desiring x involves making x, selected from the manifold possible objects, part of one's psychological life. That's what makes the satisfaction of the desire, or the x itself, valuable for her. But gatekeepers must be able to shut the gate. Here, gatekeeping requires some ability to manipulate and terminate the sources of value if she chooses. Some measure of user control over a desire is therefore a necessary condition for its satisfaction being good for one -that is, D1 is true for many desires. As with autonomy, the possession of user control is often a necessary condition of the intrinsic value of desire satisfaction. Think again of the pain in Trial By Ordeal. At some point, the pain will involve the overwhelming urge to remove your hand. Like the interloping desires I mentioned before, this desire isn't yours because you do not have user control over it. Thus, when you remove your hand, that satisfaction of your strongest desire cannot be good for you. Your desire to remove your hand is in many ways as removed from you as my present desire for a cold beer. Neither the slaking of my thirst nor the removing of your hand could be good for you because neither desire is yours. This isn't to say that nothing good occurs when you remove your hand. My claim is only that there is no good in the satisfaction of the desire by itself. Removing your hand is (pro tanto) good in at least two ways. First, removing your hand ends the pain, and ending the pain is good. But the good need not arise from the satisfaction of any desire. Being in pain is being in a bad state, and ending bad states is good. Thus the good can come from the fact that the state is bad, not the fact that you don't want to be in it. Second, satisfying a desire is normally accompanied by a feeling of relief. This can be true even when we don't want the feeling -we may horrified at ourselves for feeling the relief. Even though you have no control over the desire to remove your hand, the values, and the distinction between 'good' and 'good for'. I could not include it because it departed too far from the main argument of this dissertation. From: Swenson, Pain and Value 59 © 2006 by Adam Swenson desire is still in you. Thus the feeling of relief occurs in you. Hence when you remove your hand, the satisfaction of the desire causes you to feel relief. This relief is a kind of pleasure. It is therefore intrinsically good. It is true that this feeling of relief is causally dependent on the desire's satisfaction. But that doesn't show that the relief is good in virtue of the satisfaction of the desire. The relief may be good simply as a pleasure.105 With these out of the way, we should accept that the satisfaction of the desire to remove your hand is not itself good. It has been forced upon you by the pain. You have no user control over it. Thus, in this case, desire--‐‐satisfaction can only be intrinsically good if one has a measure of user control over the desire. I suspect the same will be true for most other desires. 3.4 The evil of usurpation I've now argued that pain undermines both autonomy and the goodness of desire--‐‐ satisfaction. These are two very different kinds of intrinsic value. Thus, while I cannot argue for it here, I suggest that many things that are intrinsically good for a person have some form of user control as a necessary condition. Thus I suspect that pain qua usurper is evil because it is necessarily the privation of the possibility of many intrinsic goods including, but not limited to, autonomy and desire--‐‐satisfaction. Intense pains are usurpers of user control. As such they necessarily undermine the possibility of autonomy and desires as a source of value. If making the intrinsically good impossible is intrinsically bad, then the usurpation of user control is intrinsically bad.106 Certain forms of user control are necessary conditions of autonomy. Hence the usurpation of user control is itself intrinsically bad. However, the possession of user control is not itself intrinsically good. Rather, a usurpation is bad because undermining certain forms of user control is undermining that which is valuable. The usurpation of these kinds of user control does not cause autonomy to be undermined. It is the undermining of autonomy; mutatis--‐‐mutandis for desire--‐‐satisfaction. Therefore, the usurpation of user control is intrinsically bad in virtue of its being the privation of the intrinsically good. If this is correct, and we accept chapter two's aversion theory, then it follows that many intense pains have two distinct intrinsic evils. §4.4 Significance of both evils 105 It is a further question whether the pleasure is good for you. It may be that pleasure cannot be good for one unless she has user control over it. I cannot address this here, so I'll just concede that the pleasure is something good in the desire--‐‐satisfaction. 106 This metaphysical claim requires some qualification and defense which I cannot undertake here. From: Swenson, Pain and Value 60 © 2006 by Adam Swenson The fact that intense pains have two distinct evils is not a mere curiosity. I believe that in some cases each value commends different alternatives. I shall now argue that it can be a mistake to ignore the usurpation's intrinsic badness. This is most clearly true of chronic pains. But I think it is also true of acute pains. Consider an acute pain: Fiona's Fall: Crossing 6th Avenue on a cold New York night, Fiona slips on some ice and lands hard on her left arm breaking the ulna. She lies in the street, clutching her forearm. Traffic is approaching. Passersby urge her to get up, but she moans that she can't. She sees the cars and wants to rise, but finds she can't move. We should take her at her word when she claims that she cannot get up. While it is physiologically possible for her to do so -nothing is wrong with her legs and she has one good arm- the pain has paralyzed her. Every time she moves, the pain pushes her back down. In trying to get up and believing that she should, she fights the pain. In being unable to rise, she loses. She feels taken over by it. The pain is an oppressor which she is helpless to resist. The helplessness and paralysis that she feels are part of the usurpation of user control. Lying in the street, Fiona is subject to the two distinct intrinsic bads of the aversion and the usurpation. Fiona's pain is such that the aversion is bad50 and the usurpation is bad50 (written badaversion/usurpation, it is bada=50/u=50). Now suppose that we offer Fiona a choice: Drug A: Diminishes the aversion's badness to bad45; but leaves the usurpation unchanged. Thus the pain with Drug A is bada=45/u=50. Drug B: Diminishes the usurpation's badness to bad20; but leaves the aversion unchanged. Thus the pain with Drug B is bada=50/u=20. Surely it is rationally permissible for Fiona to choose Drug B's much greater reduction in the pain's overall badness. Whatever the relationship between the two values, it's implausible that the aversion is lexically prior to the usurpation. Indeed, we don't think this about instrumental value. I'd be irrational to accept the ruin of my career to salve a paper cut. I think it is also likely permissible for her to choose B when the effects are equivalent for both drugs; where A yields bada=20/u=50. However, the absence of lexical priority is enough to show that we should not ignore the intrinsic badness of usurpation. But why should we believe that it is possible for the aversion and usurpation's values to vary independently of each other? Drug B operates by diminishing her feeling of helplessness. But, like fear, the feeling of helplessness is part of the aversion. Thus the diminution of the helplessness seems to be ipso facto a diminution of the aversion. The decrease in the usurpation's badness seems to entail a commensurate decrease in the aversion's intrinsic badness. From: Swenson, Pain and Value 61 © 2006 by Adam Swenson We can avoid this problem by stipulating that Drug B's diminution of the helplessness has the side--‐‐effect of increasing the contribution of another component, such as the pain's meaning. Imagine that Drug B must be administered with an instrument shaped like a baseball bat. That makes the fact that she will not be playing second base this season weigh more strongly in the aversion. This increased contribution of the meaning is exactly equal to the helplessness's decreased contribution. Thus the feeling of helplessness present changes, but the degree of aversion does not. Therefore, the usurpation decreases without a commensurate decrease in the aversion. If the two values can vary independently, then it seems that Fiona can rationally choose Drug B. Therefore, considering only the intrinsic properties of her pain, what she ought to do in this case is determined by the usurpation's badness, and not by the badness of the aversion. We should not ignore the badness of the usurpation. §4.5 Overinclusion? In this chapter, I've argued that the usurpation of user control is a necessary condition of pain's evil. Since this is only a necessary condition, there is room for other phenomena to involve the usurpation of user control and be similarly intrinsically bad. This may seem problematic. There are many cases in which we lose user control, but in which we find no evil. Indeed, with the experience of immersion in music, wallowing in the sun, orgasm, and other pleasures, the loss of control seems to be a large part of what makes the experience good. Of course, the concern does not arise for just any loss of user control. Usurpations involve a specific kind of experience -one which satisfies INVASION and PASSIVITY. But we identify with the pleasure of wallowing in the sun, and do not find the sensation invasive in the sense described by INVASION. More importantly, we've already seen that the vast majority of these cases are unproblematic (see §4.3.1). Once we have an account of pleasure's intrinsic value we will know what forms of user control lie within the normatively significant sphere for pleasure. Thus if it turns out that losing user control over some aspect x is part of what makes pleasure good, then the loss of user control over x cannot be bad. But there are some cases in which a pleasure or other innocuous sensation does satisfy PASSIVITY and INVASION, and therefore involves the usurpation of user control. Here are two examples. Sentry: Sarah and her Army squad are deep in enemy territory. They are all exhausted. Sarah remains awake as sentry while the others sleep. If she falls asleep they will all die. Yet as each wave of fatigue washes over her, she finds herself, to her disgust, wanting nothing more than to fall asleep. From: Swenson, Pain and Value 62 © 2006 by Adam Swenson Ascetic**: Francis's tormentors inject her with a combination of heroin and MDMA which causes overwhelming sensations of pleasure and ecstasy. Despite the fact that her deepest convictions demand that she eschew pleasure, she finds herself wanting more. Both cases involve the experience of the usurpation of user control. The sensations are invasive and make each passive with respect to the changes in her beliefs and desires. Since the usurpation of user control is intrinsically bad, it follows that these feelings of sleepiness and pleasure are intrinsically bad. I believe this is the correct result. The sensation of pleasure is invasive and usurping for Francis precisely because of the deeply held beliefs that undergird her autonomous life. She has shaped herself around a life eschewing pleasure. Thus while she, at the moment, wants the pleasures that force themselves on her in Ascetic**, her life is built around wanting not to want them. This is in stark contrast with the rest of us. Many of us would welcome the temporary ecstasy just as we normally welcome the sensation of sinking into the pillow.107 More importantly, Francis's pleasure forcibly draws her to it -it forces her desires away from her deep commitments. By twisting what she wants, the pleasure undermines her autonomy. It not only forces her to act contrary to what she most wants; it also warps what she wants away from what she is deeply committed to. Mutatis mutandis in Sentry. We should therefore agree that Sentry and Ascetic** involve normatively significant usurpations of user control, and thus involve ordinarily innocuous sensations that are intrinsically bad in the same way as pains qua usurpers. §4.6 Conclusion I have described the usurpation of user control in phenomenological terms. It is experienced in the INVASION and PASSIVITY that pain involves. This meets the traditional objection to privation accounts. The critics of the traditional privation views rightly claim that the evil of pain must lie in the way it feels. But once we've rejected the kernel view, we can no longer assume that 'how pain feels' refers solely to the sensation 107 In conversation Larry Temkin has argued that most of us wouldn't welcome this temporary ecstasy if it was forced upon us or if we didn't know its source. For example, if while sitting on the couch watching television you were suddenly and mysteriously overcome with this ecstasy, the feeling would be invasive and unwelcome. I have my doubts. I agree that the initial onset of the sensation might be quite disconcerting or even terrifying. But after a moment or two, the way that intense pleasure tends to obliterate thought and our natural tendency to identify with it will take over. The reason Francis does not give herself over to the pleasure and welcome it is based in her deepest convictions about herself and what's valuable. Thus I suspect that the cases where pleasure is a usurper are rare. Nonetheless, if Temkin is right, these pleasures may be more common than I suspect. From: Swenson, Pain and Value 63 © 2006 by Adam Swenson kernel. On the composite view, 'how pain feels' can be extremely rich and complex. Fear, beliefs about meaning, and the like, can be intrinsic properties of a pain, and they are part of how some pains feel. And these rich experiences which make up the reaction component are all part of the experience of usurpation. Indeed, I believe that seeing pain as a usurper allows us a greater understanding of why factors like the undue solicitousness of one's caregivers can make a pain intrinsically worse. When your loved ones treat you as weak and helpless in the face of your condition, you are more likely to feel weak and helpless to fight the pain for the user control it steals. That feeling of helplessness is part of the pain. Far from removing pain's phenomenology from the center of its intrinsic badness, the complex phenomenology of usurpation gives a much richer and more powerful account of what being in pain feels like than was ever possible with the kernel view. The aversion theory captures the intrinsic badness of pain that lies in our complex reaction to the painful sensation kernel. The intrinsic badness of pain as a usurper lies at a deeper level. The phenomenology of the experience of pain -which unifies the disparate elements of the reaction component and kernel- is the surface manifestation of the privation of the intrinsic good. We experience pain as the exsanguination of that which is intrinsically good in our lives. The evil of pain as a usurper is thus contained in the way that pain feels. That meets the traditional objection to privation views of pain's intrinsic badness. Therefore, if the argument of this chapter is correct, we should accept that some pains have two intrinsic evils. From: Swenson, Pain and Value 64 © 2006 by Adam Swenson Chapter 5 Pain and the Nature of Intrinsic Value We now know what pains are and why they are intrinsically bad. These are significant conclusions in their own right. But at the outset of this project, I promised that by focusing solely on pain's intrinsic value, we could make progress on our understanding of the nature of intrinsic value and its bearers. In this chapter, I shall begin to make good on that promise; in chapter six, I'll point to some further fruits. Here, I'll argue that the existing accounts of the nature of intrinsic value do not explain pain's intrinsic value. In §5.1, the composite view of pain and my privation account of its intrinsic badness will help unearth a new account of the nature of pain's intrinsic value. I'll then resolve the bearers debate for pain's intrinsic value in §5.2. §5.1 Moorean versus final value In chapter two I claimed that almost every conception of intrinsic value's nature falls into one of two families: Moorean view: The intrinsic value of x is x's non--‐‐relational, non--‐‐derivative, and essential value. or the Final value view: The intrinsic value of x is x's non--‐‐derivative value. We are now in a position to adjudicate this debate. I'll proceed by examining which of the six kinds of value compose pain's intrinsic value. I'll then conclude by examining which of these two views is the correct account of intrinsic value as it is had by pain. 5.1.1 Non--‐‐relational value Let me begin with whether pain's intrinsic badness is a non--‐‐relational value. I'll first discuss the relationship between pain and the source of its intrinsic badness. I'll then suggest that this relationship maps onto what we care about in distinguishing between relational and non--‐‐relational value. That will show that pain's intrinsic badness is a relational value. On my account, a pain is a usurpation of user control. The usurpation of user control constitutes a privation -the impossibility of intrinsic goods like autonomy and desire--‐‐ satisfaction. The impossibility of these intrinsic goods is intrinsically bad. Thus privations are intrinsically bad. Therefore, pain is intrinsically bad because it constitutes something intrinsically bad. Pain is therefore intrinsically bad in virtue of its relationship to the privation. But we should wonder whether the mere fact that 'constitution' is a two--‐‐place predicate entails that pain's intrinsic badness is a relational value. After all, 'identity' is nominally From: Swenson, Pain and Value 65 © 2006 by Adam Swenson two--‐‐place. Moreover, constitution is a metaphysically puzzling relationship given its close connection to identity. To decide whether the constitution relation is the sort of dependence relation that makes something a relational value, it will help to begin with a familiar puzzle. Suppose I sculpt a statue of my beloved cat Hobbes out of a lump of clay. The lump of clay constitutes the statue. On first blush, it seems that the two are identical. They seem to share all the same intrinsic and relational properties. For example, the statue weighs exactly as much as the lump, and both are the same distance from the top of the Chrysler Building in New York. A particular pain and the privation it constitutes also seem to be virtually identical. They are both bad in the same degree and are in most respects indiscernible in the experience (see §4.1). Indeed, the constitution relation is very different from the relationships Ross had in mind when he wrote that most theories of value may be divided into those which treat it as a quality and those which treat it as a relation between that which has value and something else - which is usually but not always said to be some state of mind, such as that of being pleased by the object or desiring it or approving of it or finding its desire satisfied by it.108 It may therefore seem that pain's intrinsic badness is a non--‐‐relational value. But the two examples are alike in another respect. Suppose that I become frustrated with my artistic ineptitude and squish the statue into a non--‐‐cat--‐‐shaped ball. I have destroyed the statue but not the lump. Hence the statue and lump were in fact two distinct things even though they seemed to share exactly the same properties prior to the squishing. The statue and lump in fact had different modal properties. The statue had the property 'can be destroyed by squishing' which the lump lacked. The pain and the privation also have different modal properties. Privations can occur in the absence of a pain. Death, Francis's pleasure in Ascetic**, and Sarah's fatigue in Sentry, are privations but not pains (see §4.3.1). Given this difference, to decide whether pain's intrinsic badness is a non--‐‐ relational value, we must look to why we care about the non--‐‐relational/relational value distinction. While the putative tie between intrinsic value and necessity is not strictly at issue in the non--‐‐relational/relational value dispute as I have described it, the connection does seem to play a central role in answering Kagan's question why should we think that [a value identified by all the relevant properties being 'one--‐‐place' properties] picks out a kind of value of particular interest from the perspective of value theory? Why should this type of value be of any more interest to us as value theorists than it would be to pick out the value that an object has on the 108 Ross (1930), 75. From: Swenson, Pain and Value 66 © 2006 by Adam Swenson basis of its relational properties alone? Or the value that an object has on the basis of its 17--‐‐place properties alone?109 I suspect that the answer for many writers has to do with the intuitively short step from one--‐‐place properties to necessary properties (of course, the step is actually quite large). That is, the distinction between relational and non--‐‐relational value may be important in value theory because it is closely tied to questions about what values are necessary. Thus I suspect that the difference in modal properties makes constitution the sort of relational property that is at issue in the distinction between relational and non--‐‐ relational value. Therefore, if my suspicion about the source of this distinction's significance is correct, then pain's intrinsic badness is likely a relational value. 5.1.2 Essential value The connection between necessity and intrinsic value is front and center in the essential/non--‐‐essential value distinction. Essential value is putatively the value which an x has no matter what circumstances x occurs in. This is at the heart of Moore's isolation test. In order to arrive at a correct [answer to the question 'what things have intrinsic value?'] it is necessary to consider what things are such that, if they existed by themselves in absolute isolation, we should yet judge their existence to be good110 This suggests a more general test for essential value: If x has the same value v in every relevant possible world, then v is x's essential value. The question is which worlds are relevant to this essential value test.111 I'm now going to argue that when it is applied to pain, the test for essential value is hardly an isolation test. We'll see that in applying the test to pain's intrinsic badness we cannot easily separate the pain and its value from many features of the context in which it appears. Thus the range of possible worlds we must imagine a pain occurring in to determine whether it has essential value may be narrower than Moore leads us to believe. I'll begin by exploring what the essential value test must look like when applied to pain. I'll conclude by suggesting that pain's intrinsic badness is an essential bad. To apply the essential value test to x, we must know what x is and how to determine the value of an x. I have argued for the composite view of what pains are and I have given a privation account of their intrinsic value. Thus to apply the essential value test to pain -to test whether pain's intrinsic badness is an essential value- we must integrate the test and these two views. I shall argue that the range of relevant 109 Kagan (1998), 290. 110 Moore (1903), 187. 111 For Moore's isolation version of the essential value test the relevant worlds are any in which the pain occurs. From: Swenson, Pain and Value 67 © 2006 by Adam Swenson worlds is circumscribed by the relationship between the pain and its context, and by the role contingent facts about human nature play in pain's intrinsic badness. I'll begin with how the composite view fits with the essential value test. On the composite view, much of a pain's context is, in a sense, built into its intrinsic properties. In Ascetic, Francis has one complex set of attitudes toward the painful sensation kernel because it occurs during a religious ceremony. In Ascetic*, she has a very different set of attitudes toward a qualitatively identical sensation kernel because it is suffered in the police station. I have argued that the painful sensation kernel in Ascetic* is a pain while the qualitatively identical kernel in Ascetic* is not. Thus the essential value test cannot be asking us to imagine the sensation kernel appearing in different worlds. The kernel is not the pain. Instead, we must imagine the whole package of context sensitive states which compose the reaction component being transposed between different worlds. The essential value test is therefore limited to comparing instances of a pain across worlds that do not differ in ways which would entail a change in the pain's intrinsic properties. That is, in applying the essential value test, we may only imagine a pain occurring in situations which make the constituents of the reaction component possible. Consider the pain in Operation -the pain of the first incision in a lengthy unanesthetized surgery. This pain's reaction component involves a degree of fear that does not occur when I slice through the tomato into my finger, even though the sensation kernels are qualitatively identical. Of course, there are plenty of worlds in which I am a hemophiliac or professional violinist or irrationally fearful. These are worlds in which Operation's degree of fear accompanies the sliced finger. Applied to the pain in Operation, the essential value test considers these worlds. It does not consider worlds in which a qualitatively identical sensation kernel occurs when the otherwise normal philosopher slices his finger.112 This first restriction poses no trouble for the claim that pain's intrinsic value is essential value. We have merely clarified which worlds a pain could occur in. It remains the case that a pain is exactly as intrinsically bad in all the worlds in which it occurs. Let me turn to how we should evaluate pain in applying the essential value test. I'll now suggest that my account of pain's intrinsic badness puts a second restriction on what possible worlds are relevant in the essential value test. Given my account of pain's intrinsic badness, we must keep the factors that influence what is good for human beings constant between relevant worlds. This restriction may pose some complications for the conclusion that pain's intrinsic value is an essential value. These complications 112 This restriction may be compatible with Moore's isolation version of the essential value test. It may be possible to have all the affective, cognitive, conative, and desiderative components of the reaction component in a mind which is alone in a world. I have no firm view on this, especially because it raises questions about internalism and externalism about mental content. From: Swenson, Pain and Value 68 © 2006 by Adam Swenson raise issues that lead beyond the purview of this dissertation. Thus I shall merely set out what the complications are, what other issues they depend on, and how they might affect my overall conclusions about the nature of pain's intrinsic value. On my view, pain is intrinsically bad in that it necessarily undermines certain intrinsic goods. But some of these intrinsic goods may be contingent in that they depend on facts about the sort of beings we are. This applies to both what is intrinsically valuable, and to the particular forms of the intrinsic goods that pain undermines (for example, which facets of autonomy it usurps). I'll begin with the more general case. I suspect that the intrinsic value of many intrinsic goods partially depends on contingent facts about, for example, our social psychology. Consider the value of deep personal relationships. Human beings might have had the social structure of sharks. These humans would occasionally come together to hunt and mate, but otherwise live perfectly solitary lives. If human social psychology was this way, deep personal relationships would not be intrinsically good. In that world pain would not be bad in virtue of its undermining the capacity for such relationships. Thus when we are considering whether the chronic pain of brain cancer has essential value, we cannot compare it to the pains suffered by these sharklike humans. Our social psychology deeply penetrates the reaction component of pain and the attendant usurpation of user control. Thus I cannot imagine that creatures this different from us could instantiate tokens of our pains. The shark--‐‐people world is thus not among the relevant worlds for the essential value test. The same may be true for more particular intrinsic goods. What counts as an intrinsically valuable exercise of autonomy and what kinds of desires it is good to satisfy likely depends on contingent facts about human nature and socio--‐‐cultural context. For example, in some social arrangements, autonomy requires a wide range of opportunities for independent decision--‐‐making. In other arrangements, autonomy may require far fewer opportunities to decide and act independently (this may be true of small tribes in which the close--‐‐knit social structure restricts the acceptable and desirable forms of individualism). It thus may be that the essential value test is also constrained by socio--‐‐cultural and historical factors. Therefore, when we change these facts about the human condition we change what is valuable. By changing contingent features of the world, we change the intrinsic value of the pains in it. If this is correct, when we apply the essential value test to pains in our world, the relevant possible worlds are those which share the same intrinsic goods (at least at a suitable level of abstraction). Thus the relevant worlds are those in which the facts about human nature are sufficiently similar the facts in the actual world. I've only argued that the way we evaluate pain imposes a restriction on what worlds are relevant for the essential value test. The content of this restriction is a further question that depends on (at least) two large issues that are beyond the purview of this dissertation. First, it depends on what intrinsic goods there are. Once we have the From: Swenson, Pain and Value 69 © 2006 by Adam Swenson correct list of this world's intrinsic goods we'll have a better sense of whether there could be relevant worlds with different lists. Second, it depends on the extent to which changing facts about human nature can affect the essential value test. That draws us into more general questions about the metaphysical relationship between natural facts and normative facts. Nonetheless, within the confines of these two restrictions on the essential value test, pain's intrinsic value is essential value. 5.1.3 Non--‐‐derivative value There are two conceptions of non--‐‐derivative value which correspond to the two positions in the Moorean/final value debate. Proponents of the final value view often characterize non--‐‐derivative value by contradistinction to instrumental and contributory value. That is, 'because it's a good thing to have' is a full answer to the question 'why do you want it?' In Korsgaard's example, a person may desire a mink coat in this way. This person doesn't want the coat because it will keep her warm or because of the pleasure she will draw from owning and wearing it. The mink coat thus could have non--‐‐derivative value because she wants it for itself.113 But there is a further question: whether the mink coat is a good thing. In some cases, there will be no further explanation to be given. These are things with non--‐‐derivative value in the Moorean sense. As Moore writes, the most fundamental principles [of ethics] must be self--‐‐evident....The expression 'self--‐‐evident' means properly that the proposition so called is evident or true, by itself alone; that it is not an inference from some proposition other than itself.114 Thus, as characterized by Zimmerman, with a non--‐‐derivative value: there is no helpful explanation of why the state is good; it just is good "as such," that is, good in virtue of its own nature....All explanation must come to an end somewhere; the explanation of values stops with the citing of [non--‐‐derivative] values.115 In the Moorean sense, mink coats cannot have non--‐‐derivative value. There is a further explanation of why mink coats are good. For example, they are luxurious items which can tangibly represent one's achievement. Someone who has worked her way out of poverty might desire a mink coat because owning it confirms that 'she has arrived'. 113 For example, Rabinowicz and Ronnow--‐‐Rasmussen write "on our view, the claim that a certain value is final does not imply that it must be non--‐‐derivative. We interpret final value...by contrasting it with value as a means (instrumental value) and value as a part (contributive value). What is non--‐‐derivatively valuable must be valuable for its own sake, but not necessarily vice--‐‐versa." Rabinowicz and Ronnow--‐‐ Rasmussen (2003), 392. 114 Moore (1903), 143. Italics original. 115 Zimmerman (2001), 37. From: Swenson, Pain and Value 70 © 2006 by Adam Swenson That need not imply that the coat's value is instrumental -owning it does not promote her success. Nor does this imply that the mink's value is a contributory value -she would still be successful were she mink--‐‐less. Nonetheless, we can explain why the mink coat is valuable in terms of its relationship to the value of success. It is good to be successful and the tangible representations of success inherit their value from this fact. The availability of any such explanation shows that the coat's value is a derivative value in the Moorean sense. Turn now to pain's intrinsic badness. Pain's intrinsic badness is certainly a non--‐‐ instrumental and non--‐‐contributory bad. We hate pain as such. Pain's intrinsic badness is therefore a non--‐‐derivative value in the final value view's sense. The question is whether it is a non--‐‐derivative value in the Moorean sense. We explain pain's intrinsic badness by appeal to the intrinsic badness of the privation. Does this make it a non--‐‐ derivative value in the Moorean sense? It may help to approach this with a remark by Korsgaard about what sorts of explanation are possible on the Moorean view. Moore's theory drives a wedge between the reason why we care about something and the reason why it is good....if you say that something is good because someone cares about it, that could only mean that the person's interest was an element of an organic whole which had intrinsic value. But according to Moore the question why the whole has intrinsic value must not be raised: it just has the property of intrinsic value; there is no reason why it has that property.116 We certainly care about pain because it is intrinsically bad. Before becoming philosophers, we all avoided bee--‐‐stings and stubbed toes. We knew that pain is intrinsically bad and therefore avoided it. But we did not know why it is intrinsically bad. For the Moorean, there is nothing more for us to have learned. There can be no explanation of why pain is intrinsically bad. But there is an answer to this second question. Pains constitute privations. Privations are intrinsically bad. To explain why privations are bad we must refer to the fact that they are the undermining of that which is intrinsically good. Thus, not only is there an explanation of pain's intrinsic badness, but it is an explanation in terms of intrinsic goods like autonomy and desire--‐‐satisfaction. Therefore pain's intrinsic badness cannot be a non--‐‐derivative value in the Moorean sense. 5.1.4 Which account of intrinsic value? In this dissertation we approached pain's intrinsic value by looking for the best substantive account of the value most tightly tied to pain. My methodology entails that this account will be an account of pain's intrinsic value. I believe we have discovered 116 Korsgaard (1983), 194. From: Swenson, Pain and Value 71 © 2006 by Adam Swenson that neither of the leading accounts of intrinsic value are correct with respect to pain's intrinsic value. Pain's intrinsic value is relational, essential, and derivative (in the Moorean sense). On the final value view, intrinsic value is not supposed to be essential. Lincoln could have used a different pen; a person may see no value in mink coats. On the Moorean view, intrinsic value cannot be relational or derivative. Therefore pain's intrinsic badness is not intrinsic value on either of the Moorean or the final value view's accounts. I believe this is an interesting and significant result. Particularly because we have learned that the Moorean view -which intuitively seemed at its strongest with pain's intrinsic value- cannot be correct. I'll say more about this conclusion's significance later. Let me now turn to what bears intrinsic value. §5.2 Bearers Now that we know what pains are and why they are intrinsically bad, we can sort out whether it is the pain itself or the fact that a pain occurs or something else that is intrinsically bad. In this section, I shall argue that it is the former: pains bear intrinsic value. I'll begin by introducing the three competing accounts of the bearers of intrinsic value. I'll then give my argument for the pain itself bearing intrinsic value. The topics of this section unfortunately require some lengthy and awkward grammatical constructions. For brevity and clarity I shall adopt two conventions. First, I shall sometimes say 'bad' instead of 'intrinsically bad'. But I shall always be talking about intrinsic badness. Second, since we must distinguish between the value of a thing and the value of a fact involving that thing, I shall use brackets to denote the content of a fact. That is, instead of writing 'the fact that the pain exists is intrinsically bad' I shall write 'the fact <the pain exists> is intrinsically bad'. 5.2.1 Competitors As I discussed in chapter two, the candidates for the bearers of intrinsic value include: objects, states of affairs, properties, facts, and tropes. As before, I shall ignore states of affairs and properties. These exist necessarily. As Chisholm writes, States of affairs...are in no way dependent for their being upon the being of concrete, individual things. Even if there were no concrete, individual things, there would be indefinitely many states of affairs. States of affairs, so conceived, resemble what have traditionally been called propositions in the following respect. Even though the author of Waverly was the author of Marmion, "the author of Waverly being knighted" expresses a different state of affairs than "the author of Marmion being knighted (the former...but not the later could obtain in worlds in which there From: Swenson, Pain and Value 72 © 2006 by Adam Swenson is no Marmion, and the latter but not the former could obtain in worlds in which there is no Waverly.117 It is difficult to see how a state of affairs existing, but not obtaining, in a world could make that world better.118 Nor is it easy to find a principled reason for thinking that states of affairs or properties bear value but are only valuable when they obtain. I'll thus focus on the non--‐‐necessary candidates: objects, facts, and tropes. On my understanding, objects are physical and mental things; facts are states of affairs which obtain; and tropes are particular instantiations of a property in an object. To differentiate the three competing views, consider Rabinowicz and Ronnow--‐‐ Rasmussen's example of the intrinsic value of Princess Diana's dress. On the fact view, the fact <Diana's dress exists> is intrinsically good. On the object view, the dress itself is intrinsically good. On the trope view, the instantiation of the property 'x belongs to Diana' is intrinsically good. I'll now say a bit about each of these views, in that order. 5.2.1.1 Facts Facts and states of affairs are proposition--‐‐like entities. That is, they can be referred to with 'that'--‐‐clauses. My cat Sanuk is a thing, she is not a state or a fact. We cannot say, for example, 'It is true that Sanuk.' But we can say 'It is true that <Sanuk is grey>.' As we saw above, states of affairs exist necessarily. The state of affairs that <a cat is on a bed> exists in all worlds; but it only obtains in a small subset. Facts are states of affairs which obtain in a world. Thus the fact that <Sanuk is on my bed> is an obtaining of the state of affairs that <a cat is on a bed>. On a fact view, facts are the bearers of intrinsic value. Ross holds a fact view when he writes, Most of our adjectives, I suppose, refer to qualities that belong to substances; 'good' is the name of a quality which attaches, quite directly, only to 'objectives', and since an objective is an entity more complex than a substance, standing as it does for a substance's having a certain quality or being in a certain relation, 'good' may be called a quality of a different type from those that attach to substances. and If I know 'that A is B', it is implied that 'that A is B' is a real element in the nature of the universe. And if 'that mind A is in state B' is good, then again it is implied that 'that mind A is in state B' is a real element in the nature of the universe. But the proper name for what is expressed in such 'that'--‐‐clauses, which are real elements in 117 Chisholm (1976), 114. 118 An abstract and necessary x exists in every possible world, including worlds in which it has no concrete instances -that is, worlds in which it does not obtain. For example, the abstract property of squareness would exist but not obtain in a world populated only by circles and cylinders. From: Swenson, Pain and Value 73 © 2006 by Adam Swenson the nature of the universe, is not 'objectives'...but 'facts'. It is better therefore to say that the things that have ultimate value are facts. And since these are entities of a higher order of complexity than substances, we get an important distinction between value judgments and the judgments in which we judge about substances.119 Thus instead of Diana's dress being intrinsically valuable, on a fact view, the fact <Diana's dress exists> is intrinsically good. 5.2.1.2 Objects The nature of objects raises deep and vexed questions in metaphysics. Fortunately, the candidate bearers of intrinsic value at issue here are prosaic things like cats, rocks, pains, pleasures, and dresses. Hence, I think we can avoid many difficult issues. For example, we need not ask whether rocks and pains are both objects (or belong to the same metaphysical category of object). For our purposes herein we can understand objects in contradistinction to facts and states of affairs. Objects are non--‐‐propositional entities. That is, not being possibly referred to via 'that'--‐‐clauses is a necessary condition of an x being an object. The claim that objects are the bearers of intrinsic value is intuitively attractive. For example, Elizabeth Anderson writes that our basic evaluative attitudes -love, respect, consideration, affection, honor, and so forth- are non--‐‐propositional. They are attitudes we take up immediately toward persons, animals, and things, not toward facts. Because to be intrinsically valuable is to be the immediate object of such a rational attitude, states of affairs are not intrinsically valuable if they are not immediate objects of such attitudes. Evaluative attitudes take up states of affairs as their mediated objects through the desires, hopes, wishes, and other propositional attitudes that express them.120 Thus on an object view like Anderson's, objects are good and bad, not the fact that an object exists or is in a certain state. Before moving on, let me address whether privations are objects. This will be important in §5.2.2. Pains are clearly objects in our sense. If I am in pain, we cannot say 'it is true that pain.' It may seem odd to say that privations are objects. But it seems clear that some alleged privations are objects. Holes are privations of dirt. We cannot refer to them with 'that'--‐‐clauses. I've argued that the experience of pain is the experience of the usurpation of user control. This usurpation constitutes the impossibility of certain intrinsic goods. Therefore, if pain is an object, the privation it constitutes is also an object. 119 Ross (1930), 112--‐‐113. Italics original. 120 Anderson (1993), 20. See also, Anderson (1997), passim. From: Swenson, Pain and Value 74 © 2006 by Adam Swenson 5.2.1.3 Tropes Tropes are particular instantiations of a property in an object. Imagine a red shirt and a red apple with exactly the same redness. On a traditional account of properties, the redness of the apple and the redness of the shirt are tokens of the same abstract type. On most trope--‐‐based ontologies, there is no such abstract type. Instead, the redness of each particular apple and the redness of each particular shirt are distinct entities sui generis. The apple's redness and the shirt's redness might be qualitatively identical, but these rednesses are themselves different entities; there is no type they are both tokens of. The apple's redness is one trope; the shirt's redness is another. Because qualitatively identical tropes are distinct entities, tropes can unproblematically have different intrinsic values. This fact is useful for writers who take a certain view on cases of 'mixed values'. Consider a familiar example from Kant, the coolness of a villain makes him not only much more dangerous but also immediately more abominable in our eyes than he would have been regarded by us without it121 whereas the coolness of a surgeon is admirable. Many writers, including Kant, find it troubling to claim that coolness is intrinsically good. These writers doubt that the goodness of the villain's coolness is just outweighed by his evil character. They believe that there is nothing at all good about the villain's coolness. On a trope theory, there is no abstract property 'coolness' that has any single value wherever it is instantiated. Instead, the coolness of the villain and the coolness of the surgeon are entirely distinct things which happen to have a great deal of similarity (the same is true of the different coolness tropes two equally cool surgeons have). Thus there is no problem with one being good and the other bad. Hence on a trope view of the bearers of intrinsic value, what is of value is each particular instantiation of [a property] P rather than the mere fact that P is instantiated by some object or other....What is valued is not that this object a has P but rather the instantiation of P, which happens to occur in a. We value, in the same way, each instantiation of P, in whatever object it occurs....The instantiations of P in various objects do not contain these objects as constituents.122 Thus in our example of Diana's dress, it isn't the dress or the fact that the dress exists which is intrinsically valuable. Instead it is the instantiation of the property 'x belongs to Diana' that is good. 121 Kant (1785), 394. I don't mean to suggest that Kant is a trope--‐‐theorist. 122 Rabinowicz and Ronnow--‐‐Rasmussen (2003), 395. Italics original. From: Swenson, Pain and Value 75 © 2006 by Adam Swenson 5.2.1.4 Loyalties There is no general reason Mooreans cannot hold object views.123 Nor is it impossible to fit a final value view with a fact or trope view. But issues surrounding cases like Korsgaard's mink coat, mixed values, and organic unities, tend to wed Moorean views with fact views and final value views with object views (trope views have more ambiguous loyalties). However, all of the existing views tend to be quite slippery. There are many ways each view can be revised to deal with objections. Fortunately, the argument I'll now deploy is broad enough to undermine any version of the fact or trope views. I'll begin with fact views and then extend the objection to trope views. 5.2.2 Carts before horses Suppose that a particular piece of pristine wilderness is intrinsically good in virtue of its having not been touched by human hands.124 On the fact view, the fact <this wilderness exists> is intrinsically good; on the object view, the wilderness itself is intrinsically good. Against the fact view, Rabinowicz and Ronnow--‐‐Rasmussen write But is such a reduction [of object--‐‐born to fact--‐‐born value] reasonable? At first sight, it does not seem to be: it appears to put the cart before the horse. If the existence of the wilderness is valuable, it is because the wilderness itself is valuable. Thus, it is the state that derives its value from the object it involves and not the other way round. Consequently, the value of the object does not seem to be explicable in terms of the value of the state.125 therefore The value of the thing thus seems to be ontologically prior to the value of the state. The former grounds the latter and not vice--‐‐versa.126 If this is right, the fact view is false. The value of the wilderness is both ontologically and explanatorily prior to the value of the fact that it exists. Despite the problems this argument faces with certain alleged exemplars of intrinsic value, I think it is decisive in the case of pain. A pain is intrinsically bad because it constitutes a privation, and privations are intrinsically bad. Thus we explain the badness of the fact <a pain exists> by looking to the value of the privation, but not vice--‐‐versa. Since a pain constitutes a privation, we are thus explaining the badness of the fact <a pain exists> via the pain's intrinsic badness. Therefore the pain is what bears intrinsic value, not the fact <a pain exists>. 123 Indeed, Moore's own view is unclear on this point. In saying that books and works of art can have intrinsic value he sometimes seems to be endorsing an object view. 124 The example is from O'ʹNeill (1992). 125 Rabinowicz and Ronnow--‐‐Rasmussen (1999), 43. Italics original. 126 Rabinowicz and Ronnow--‐‐Rasmussen (2003), 390. From: Swenson, Pain and Value 76 © 2006 by Adam Swenson To keep a fact as fundamental in the explanation, the fact view's friend might suggest that the explanatory work is being done by the evaluative fact <privations are intrinsically bad>. But this fact is not intrinsically bad. Murder is bad; the fact <murder is bad> isn't. We could avoid this by conjoining the evaluative fact <privations are intrinsically bad> with the existential fact <a pain exists>. That compound fact could bear intrinsic value. But again this fact would inherit its value from the privation. But perhaps the fact <a pain exists> is not what the proponent of the fact view has in mind.127 With the wilderness and Diana's dress there are clear alternatives to the facts <the wilderness exists> and <the dress exists> being the bearers of intrinsic value. For example, with the wilderness the value might be born by the fact <the wilderness is untouched>. Similarly, we might say that the fact <the dress belonged to Diana> is intrinsically good, not the dress itself. Indeed, as Zimmerman notes, the apparent intrinsic value of the dress depends on the intrinsic value of the fact <the dress belonged to Diana>. Thus perhaps the fact <the pain exists> is not what bears intrinsic value on the fact view. In the examples of the wilderness and Diana's dress, the value--‐‐bearing fact was the fact that the object has the properties which its value supervenes on. Rabinowicz and Ronnow--‐‐Rasmussen summarize this alternative: Suppose...a is said to be valuable for its own sake. Its putative [intrinsic] value must then supervene on some of its properties. For simplicity, assume that P is the conjunction of all the evaluatively relevant properties of a. Thus, P is possibly a very complex property of a on which a's final value is supposed to supervene....[thus a's intrinsic value] is again located in a certain state of affairs, but the relevant state, rather than being existential in form, simply consists in that a has P.128 But what would the relevant fact be for pain? With pain the metaphysics are quite different from Diana's dress. On the composite view, the evaluatively significant properties of a pain wholly comprise its sensation and reaction components -the pain just is its evaluatively significant properties. Thus the value--‐‐bearing non--‐‐existential fact must be the fact: β = <pain x has all the properties which make it pain x> Given my account of pain's intrinsic badness, the properties that make up a pain are evaluatively significant because they together constitute a privation. Thus 'x is a privation' is one of a pain's evaluatively significant properties. Privations are intrinsically bad because of what they are -because making intrinsic goods impossible 127 My discussion here follows Rabinowicz and Ronnow--‐‐Rasmussen in Rabinowicz and Ronnow--‐‐ Rasmussen (2003). 128 Rabinowicz and Ronnow--‐‐Rasmussen (2003), 393. Italics original. I have substituted 'intrinsic value' where they write 'final value'. From: Swenson, Pain and Value 77 © 2006 by Adam Swenson is intrinsically bad. Therefore, the pain qua object is intrinsically bad because it has the property 'x is a privation'. But this doesn't yet answer the fact view. The properties that make a pain what it is are also the properties which make it intrinsically bad. If it weren't true that a pain has the evaluatively significant properties it does, that pain wouldn't exist. Thus a pain would not be bad if β did not obtain. Therefore, the value--‐‐bearing fact β is a necessary condition of pain x being bad. That seems to make β -and thereby β's badness- ontologically prior to the pain's badness. If so, the cart--‐‐before--‐‐the--‐‐horse objection to the fact view fails for pain. This is a mistake. The fact view's claim that Diana's dress is good in virtue of the goodness of the fact <the dress belonged to Diana> avoided the cart--‐‐before--‐‐the--‐‐horse objection by making the relevant fact the supervenience base of the value. But because of the metaphysics of pain, the attempt to reduce pain's badness to β's badness still commits the equine orientation error. It is true that pain x is bad because the fact <x involves a privation> obtains. Hence, more generally, x is bad because the fact β obtains. But this does not yet establish that x is bad in virtue of β's badness. That requires some sense of why β is bad. In the case of the wilderness we can't explain why intrinsic goodness supervenes on the fact that <the wilderness is untouched>. Thus we have reached a Moorean stopping--‐‐point. We can go no further without committing the naturalistic fallacy. But such an explanation is available in the case of pain. On my view, the badness of the fact β supervenes on the badness of the privation pain constitutes. Privations, I've claimed, are intrinsically bad simply in virtue of what they are. Thus the fact view again places the cart before the horse. The alleged value--‐‐bearing fact inherits its value from the intrinsic value of the object. Any attempt to inject intermediate facts such as <the privation is bad> will not avoid grounding β's value in the privation's value. Thus the ultimate bearer of intrinsic value is the privation. Pains constitute privations. Therefore, facts about pain inherit their value from the intrinsic value of the pain. The trope view falls to the same set of objections. On the trope view, the instantiation of the property 'x is a privation' is intrinsically bad. But again, we must ask why the instantiation of that property is bad. The answer lies in the nature of privations qua objects. Therefore, the intrinsic badness of the trope depends on the intrinsic badness of the object. §5.3 Pain's intrinsic value The intrinsic value of pain is a relational, essential, and derivative value born by the pain itself. As far as I am aware, no conception of intrinsic value has held all of these characteristics together. We saw in §5.1.4 that this conclusion is incompatible with both From: Swenson, Pain and Value 78 © 2006 by Adam Swenson the Moorean and final value views of the nature of pain's intrinsic badness. The Moorean view cannot admit that intrinsic value is relational or derivative. The final value view cannot make intrinsic value essential without giving up on the values of many central and defining cases including Lincoln's pen and Korsgaard's mink coat. §5.2 rounded out this result by showing that this relational, essential, and derivative, form of intrinsic value is born by the pain itself. I shall say more about the significance of these conclusions in the next chapter. For now, let me just note that, given the way most approach the nature of intrinsic value, these results should be surprising. Pain was supposed to be the easy case. It seemed to be a simple and familiar phenomenon which wears its value on its phenomenological sleeve -hence the attractiveness of the kernel view. It was thus supposed to be a convenient proving ground in the debates about the nature of intrinsic value. But when we focused just on pain we found that pain and its value are much more complex than they seemed. That led us into new territory. In this chapter these conclusions unearthed a new account of the nature of intrinsic value and undermined the existing views. Far from being a test case for the competing theories of intrinsic value, thinking only about pain has forced us to, at least for pain, reject all of the theories others come to pain to test. In setting out on this project of focusing solely on pain and its intrinsic value, I promised your indulgence would be repaid with significant dividends. Consider this chapter a first disbursement. From: Swenson, Pain and Value 79 © 2006 by Adam Swenson From: Swenson, Pain and Value 80 © 2006 by Adam Swenson Chapter 6 Out of the Harbor This dissertation is part of a broader project. I believe that by thinking only about pain we can open a new window into many old questions in value theory. This dissertation was focused narrowly on what pain's intrinsic value can show us about the nature of intrinsic value and its bearers. The last chapter completed that project. That was, I think, the first of many of this approach's larger scale payoffs. I now want to close this thesis by mentioning a few directions in which my conclusions herein might be extended to other issues in normative theory. I won't pursue any of these suggestions -I'll simply list most of them. But I hope that they will be suggestive and thus help place this dissertation in the context of a large and fruitful project. I'll begin in §6.1 with a quick list of some important issues the conclusions of this dissertation may impact. Then in §6.2 I'll suggest some similarities and differences between the intrinsic values of pain and pleasure, and discuss some of their potential upshots. I'll conclude this chapter and dissertation in §6.3 §6.1 Bigger issues Throughout this dissertation my arguments have touched on many large issues. Most prominently, I suspect the link I've unearthed between user control and intrinsic value will be useful in many other debates. Thinking about user control may, for example, get to the heart of certain conceptions of autonomy with implications for topics ranging from free will to paternalism in social policy. Also, if I'm right that the intrinsic value of desire satisfaction usually hinges on the possession of certain kinds of user control, then we will have found a thread connecting two very different kinds of value. That may be significant given the close intuitive link between user control and autonomy, and the traditionally deep tension between those who base all value in desires and those who accord autonomy an independent and fundamental moral significance. Closer to home, I think that the relationship between user control, autonomy, and pain, take us to the heart of what is distinctively evil about torture. Torture, I suspect, necessarily involves an attempt to exercise user control over another person's thoughts, preferences, desires, or actions. It may therefore be that pain tends to be an effective means to this end because it essentially breaks down the sufferer's user control.129 129 Sussman recently published a somewhat similar account in Sussman (2005). Also, roughly this idea appears in Griffin's unpublished manuscript on human rights. His discussion inspired my thought on this topic. From: Swenson, Pain and Value 81 © 2006 by Adam Swenson I also suspect that my conclusions may be useful in addressing whether normative facts can be reduced to natural facts. For example, some naturalists suppose that pain and pleasure are phenomena where the natural and normative are one. That leads them to suggest that normative facts like 'It's bad that I'm in pain' can be reduced to natural facts like 'I'm in pain'. But as we have seen, pain, as it is normatively significant, has its identity in virtue of its being a usurper. For example, we understand which mental states are part of the pain by considering whether they play a role in the usurpation of user control that the pain constitutes. But the usurpation of user control is an essentially normative phenomenon. Thus I suspect that there isn't a viable independent and wholly naturalistic notion of pain to be appealed to for a reduction. That is, if we ignore normative facts, there will be no way of telling which sets of mental states are pains. These are just a few examples of the larger debates into which this discussion of pain and its intrinsic value may provide some insights. I cannot say more about any of these here. Instead, I want to conclude by sketching some possible relationships between pain and pleasure. Pain and pleasure are usually assumed to be fellow travelers in normative theory. Most writers assume that whatever theory covers pain and its intrinsic value will be easily transposable onto pleasure, and vice--‐‐versa. But the results of this dissertation may provide reason to doubt this. Thus I want to mention a few ways in which I suspect that they are different and how these differences might have some significant implications for normative theory. §6.2 Pleasure I shall briefly sketch two topics in the relationship between pleasure and pain. First, I believe my account strongly suggests that hedonistic theories of value -that pleasure and pain are the only things intrinsically valuable- are non--‐‐starters. Second, I shall consider some differences between the intrinsic values of pain and pleasure, and their implications. 6.2.1 Hedonism From Epicurus on, hedonistic theories about value have been perennially attractive. For one, these theories provide a clear and unambiguous foundation for moral theory. Bentham famously began An Introduction to the Principles of Morals and Legislation with Nature has placed mankind under the governance of two sovereign masters, pain and pleasure. It is for them alone to point out what we ought to do, as well as determine what we shall do. On the one hand the standard of right and wrong, on the other the chain of causes and effects, are fastened to their throne. They govern us From: Swenson, Pain and Value 82 © 2006 by Adam Swenson in all we do, in all we say, in all we think: every effort we can make to throw off our subjection, will serve but to demonstrate and confirm it.130 Similarly, in Utilitarianism, Mill writes The creed which accepts as the foundation of morals, Utility, or the Greatest Happiness Principle, holds that actions are right in proportion as they tend to promote happiness, wrong as they tend to produce the reverse of happiness. By happiness is intended pleasure; by unhappiness pain, and the privation of pleasure.131 More generally, all hedonistic theories of value seem to hold some version of the following two theses: HT: Pleasure and pain are the only phenomena with non--‐‐derivative value. and J: All evaluative justification ends in a non--‐‐derivative value. My conclusions about the nature of pain and its value show that HT is false and cast serious doubt on the tenability of any hedonistic theory of value. The argument is straightforward. At least one of pain's twin intrinsic values is a derivative value (see §5.1.3). On my view, pain is intrinsically bad in one way because it is the undermining of certain intrinsic goods. Thus there is a list of intrinsic goods threatened by pain. These goods will either be non--‐‐derivatively good themselves or grounded in non--‐‐derivative goods. Let, γ = The set of non--‐‐derivative goods threatened by pain. I have suggested that γ includes more than just pleasure. I have often invoked goods like autonomy, desire--‐‐satisfaction, deep personal relationships, and well--‐‐being. Hence I have claimed that the intrinsic value of pain depends on non--‐‐derivative values other than pleasure. Therefore, if pain is intrinsically bad, pleasure is not the only non--‐‐ derivative value. HT is false. But this argument is incomplete. Throughout this dissertation, I've avoided substantive commitments to what intrinsic goods there are. I've only claimed that some members of the ultimate list of intrinsic goods will appear in γ. The present attack on hedonistic theories of value assumes that pleasure is not the only good in γ. Thus this objection must await an independent argument that something other than pleasure is intrinsically good. Moreover, this suggests that this objection to HT is nothing more than the standard attempt to rebut hedonism by arguing that pleasure is not the only intrinsic good. That would have no interesting connection to the theses of this dissertation. 130 Bentham (1781), 14. 131 Mill (1863), 10. From: Swenson, Pain and Value 83 © 2006 by Adam Swenson But while my argument is incomplete in this way, my claims about pain have already revealed an important conclusion. The hedonist is mistaken about her own view when she claims that pleasure and pain have non--‐‐derivative value. At least one of pain's intrinsic values is a derivative value. Therefore the hedonist cannot hold HT. Instead, she must hold: HT*: Pleasure is the only phenomenon with non--‐‐derivative intrinsic value. Combined with J, this is the claim that all value derives from the goodness of pleasure.132 The purview of this dissertation prevents me from evaluating this claim. Nonetheless, we have seen that hedonism as it is normally conceived -via HT- is too capacious. Therefore, if my claims about pain and its intrinsic value are correct, hedonistic theories of value can only claim that mankind has just one sovereign master: pleasure. 6.2.2 Pleasure and an attraction theory? Let me change gears now to consider what evaluatively significant similarities there are between the claims I've made about pain and their counterparts with pleasure. We've seen that pains have two intrinsic values. Thus in §6.2.2 I'll focus on the metaphysics of pain and the aversion theory, and how they might relate to pleasure's metaphysics and intrinsic goodness. In §6.2.3 I'll make some comments about how pain's intrinsic evil as a privation relates to the intrinsic value of pleasure and some implications that might have. In Sentry and Ascetic** we saw that, in certain contexts, some pleasures can be intrinsically bad as usurpations of user control. This is enough to show that we should reject the kernel view of pleasure and move to a composite view. That is, a pleasure is not merely a pleasurable sensation kernel but rather the composite of a sensation kernel and a reaction to that kernel. In §3.2.3 I argued that adopting a composite view for pain presses us to reject the existing accounts of pain's intrinsic value and adopt the aversion theory. In this section, I want to consider whether adopting the composite view for pleasures presses us to adopt an attraction theory which makes a diverse reaction component the source of pleasure's intrinsic goodness. My argument from the composite view to the aversion theory had several steps. Here I'll just consider whether one of them holds for pleasure. I argued that one way context affects pains is by determining the constituents of their reaction components. Because it is the beginning of a long and painful ordeal, the reaction component of the pain in Operation contains an element of fear that is absent when I slice through the tomato into my hand. I'll now suggest that contexts sometimes affect the identity of the 132 The hedonist will have to somehow keep the disvalue of the absence of pleasure separate from the intrinsic badness of pain. The intrinsic badness of pain would be grounded in its being, to some degree, the privation of the possibility of pleasure. From: Swenson, Pain and Value 84 © 2006 by Adam Swenson elements in a pleasure's reaction component. That will in turn suggest that the composite view of pleasure pushes us toward an attraction theory of pain's intrinsic goodness. With some pleasures, it's clear that their reaction components are affected by context. The joy accompanying the achievement of a lifelong goal or the birth of one's child, or the pleasure of some orgasms, may involve very complex reaction components and be affected in this way. Though it may seem that such cases are few and far between. Let me thus look to a category of pleasures where we would expect to find contexts having an impact on the identity and value of pleasures. The higher pleasures -the pleasures of intellect, refined sensibility, et cetera- and how they differ from the lower pleasures seems a good place to look for contexts impacting the constituents of the reaction components.133 Consider Oenophile: Ruth and I are both served a fine Claret. She is a dedicated oenophile. My sensibilities are relatively unrefined. We both report that it is the best wine we've ever had. As an experienced oenophile, Ruth's palate and vocabulary are much more sophisticated than mine. Where I taste only ripe fruit, she tastes strawberries, raspberries, cassis, dark chocolate, and a hint of fig. Because she can find these in the wine and appreciate how they play off of each other, her pleasure is more refined. Indeed, her pleasure may also be influenced by her knowledge of the varietal, the winemaker's style, the circumstances of the particular vintage, the expected terroir, and the history of the chateau. We should thus say that her pleasure is intrinsically better than mine. It seems likely that our pleasures differ in their sensory and reaction components. The question is whether the reaction component of her higher pleasure has elements which my lower pleasure lacks. I suspect that these higher and lower pleasures do differ in the constituents of their reaction components. We both like the sensation, want it to continue, find it pleasant, et cetera. Of course it may be that these reactions are much stronger in her. It also seems plausible that the sensation component of her pleasure may be richer than mine. That may be partially the product of her training in differentiating the components of the taste and her knowledge of what to look for. Indeed, we can imagine that states like fear affect the reaction components of pleasures. Suppose I know that the flavonoids in a particular kind of wine will give me a particularly intense hangover in the morning. When you and I drink a bottle of this wine, my pleasure may contain some background 133 See for example Mill (1863), 8ff. In what follows I'm going to ignore the deep and central question of the connection between perception via refined tastes and higher pleasures. This may be another impediment to an attraction theory of pleasure following from the composite view. From: Swenson, Pain and Value 85 © 2006 by Adam Swenson dread of the hangover to come. Consequently, my pleasure may be significantly less than it would have been if I didn't know its aftereffects.134 With pain, the argument from the claim that the reaction components differ in their constituents to the aversion theory was somewhat complex. Thus there may be additional obstacles to showing that when we accept the composite view of pleasure, we should adopt an attraction theory of pleasure's intrinsic value and reject the existing accounts. 6.2.3 An analogue to the privation of user control? Whether or not we are led to accept an attraction theory of pleasure, pain also has a second intrinsic value. I think its clear that pleasure has no analogue of the privation of user control. Thus I want to briefly make clear why that is and then suggest one potential upshot of that. Pain is intrinsically bad as a privation of user control. But pleasure has no necessary relationship to user control. Increasing the amount of pleasure one feels does not necessarily lead to more user control. Of course, it is true that getting more pleasure from a task often does lead, for example, to an increased ability to focus on it. But it is also true that feeling a great deal of pleasure often involves a loss of user control. That shows that there is no necessary relationship between increases in pleasure and increases of user control. Moreover, we have seen that while increases in user control are often useful, they are not always normatively significant. Mutitasking is not intrinsically good (see §4.3). Therefore there is no necessary connection between pleasure and user control related values. Hence pain has an additional intrinsic value which has no analogue in pleasure. Let me now consider one possible implication of this result. Acknowledging that pain has two intrinsic values likely requires some revision in any hedonic calculus. I'll now suggest that one revision this result makes possible may help utilitarians account for the alleged moral priority of relieving pain. I'll begin by sketching a central question which will affect any revision of the hedonic calculus to accommodate the dual intrinsic values of pain. I have said nothing about how we are to evaluate the all things considered value of a pain. That is, I have said nothing about how we weigh the badness of the aversion and the badness of the usurpation. Do we simply add them so that a pain with badusurpation=25 and badaversion=30 figures in our normative calculations as bad55? Or is the relationship more complex? Perhaps the usurpation acts as a multiplier on the aversion, or vice--‐‐versa. Or perhaps the aversion's badness is somehow capped in our all things 134 Larry Temkin gave me this example. He also guided me away from several serious errors in this and the next section. From: Swenson, Pain and Value 86 © 2006 by Adam Swenson considered judgment whereas the usurpation has no limit. There are several important and interesting issues here which I cannot take up. But even without answering this question, I think this suggests that the two intrinsic values of pain will make pains of moderate intensity more normatively significant than pleasures of greater intensity. Again this is just a suspicion and its tenability will depend on many further issues -including how we evaluate the all things considered value of pain. But if it is correct, it may have several interesting and important upshots. I'll mention just one here. I am not a utilitarian. Nonetheless, I think this result may provide a way of reforming the utilitarian's hedonic calculus to deal with the common intuition that we ought to prioritize the alleviation of pain over the provision of even greater amounts of pleasure. Let's take a very simpleminded utilitarian view on which (1) The best outcome is the one with the greatest amount of overall utility. (2) The overall utility of an outcome is the amount of pleasure minus the amount of pain present. (3) The overall utility of an outcome where the pleasure is goodn and the pain is bad0--‐‐n is 0. That is, units of pleasure and units of pain count equally in the calculation of overall utility. The problem stems from (3). The supposition that units of pleasure and pain count equally in the calculations of overall utility seems to conflict with the belief that we ought to prioritize the alleviation of pain over the promotion of pleasure. Recognizing that pain is intrinsically bad in two ways while pleasure is only intrinsically good in one way may provide a solution. Let's consider a very simple example with several crucial suppositions. Machine: Scarlet and Violet are hooked up to our machine. On its face are two dials. Each turn of the left dial gives Scarlet one additional unit of pleasure. Each turn of the right dial gives Violet one additional unit of pain. We have calibrated the dials so that each unit represents the smallest noticeable increase from the previous amount of pleasure or pain. Suppose that each turn of the pleasure dial creates an attraction that is one unit greater than before; each turn of the pain dial creates an aversion that is one unit worse than before. Thus each turn of the pleasure dial creates one additional unit of utility; each turn of the pain dial creates one additional unit of disutility. Also, suppose that the usurpation does not become bad until we reach 10 on the pain dial. Finally, suppose that the all things considered badness of a pain is the sum of the badness of the aversion and the badness of the usurpation. All of these assumptions are at least controversial - some surely false because they greatly oversimplify the computations. Nonetheless, this From: Swenson, Pain and Value 87 © 2006 by Adam Swenson is enough to sketch the structure of a plausible response to the intuition that we must prioritize pain. Given these assumptions, the dial settings and the overall utility are: Table 1 Pleasure dial Pain dial Good Bad (aversion) Bad (usurpation) Overall utility 0 0 0 0 0 0 1 1 1 --‐‐1 0 0 2 2 2 --‐‐2 0 0 3 3 3 --‐‐3 0 0 ... ... ... ... ... ... 9 9 9 --‐‐9 0 0 10 10 10 --‐‐10 --‐‐1 --‐‐1 11 11 11 --‐‐11 --‐‐2 --‐‐2 12 12 12 --‐‐12 --‐‐3 --‐‐3 13 13 13 --‐‐13 --‐‐4 --‐‐4 ... ... ... ... ... ... Thus if pleasure and pain count equally in the calculation of overall utility, we should be indifferent between the settings 0/0, 1/1, 2/2...9/9. Each of those has exactly 0 overall utility. But when we turn the dial to 10/10, we've suddenly created negative overall utility. While the values of the aversion and attraction continue to cancel each other out, the additional badness of the usurpation kicks in and makes the pain worse. Thus the pleasure dial setting 17 is equivalent to the pain dial setting 13. That is, we can only be justified in turning the pain dial to 13 if we also turn the pleasure dial to 17 or greater. That shows that we must give Scarlet a significantly larger amount of pleasure to balance out the lesser amount of pain we give to Violet. Now, without a sense of how to evaluate the all things considered badness of pain, it is hard to see whether this result is at all significant. In this example, the disparities between the pleasure and pain's values are minor enough that it may not seem much help in avoiding the problem for (3). But the basic structure is here for a response. Suppose instead that a pain's all things considered value is obtained by multiplying the badness of the aversion and the badness of the usurpation. The relevant values would thus be: Table 2 Pleasure Dial Pain dial Good Bad (aversion) Bad (usurpation) Overall utility 10 10 10 --‐‐10 --‐‐1 0 From: Swenson, Pain and Value 88 © 2006 by Adam Swenson 11 11 11 --‐‐11 --‐‐2 --‐‐11 12 12 12 --‐‐12 --‐‐3 --‐‐24 13 13 13 --‐‐13 --‐‐4 --‐‐39 14 14 14 --‐‐14 --‐‐5 --‐‐56 This begins to make it more plausible that the additional value of pain can help the utilitarian answer the intuition that we ought to prioritize alleviating pain over providing pleasure. She can claim that we have been overlooking the fact that pain has a second intrinsic value. When we turn the pain dial from 13 to 14 we create a pain that involves a slightly greater aversion and is thereby slightly intrinsically worse. But when we add in the second intrinsic value of pain we see that even a pain which is only a little bit worse in terms of the aversion can be much worse all things considered. Thus with a pain and pleasure whose aversion and attraction cancel out, the pain can still be much worse. Thus, for example, it is only justifiable to turn the pain dial to 14 if the pleasure dial is turned to 56 or higher. This is a fairly striking result. In terms of the aversion, the pain produced by setting 14 isn't very bad, but we have to give Scarlet a pleasure that involves an attraction that is almost four times stronger than the aversion in Violet's pain to justify that balance of pain and pleasure. Of course, this argument depends on several controversial assumptions and depends on an account of how we evaluate the all things considered value of pain. Nonetheless, it does suggest a way for a utilitarian to modify the hedonic calculus to answer the intuition that we ought to prioritize pain over pleasure. 6.2.4 Pleasure and pain In this section I've made three claims about pleasure and pain's intrinsic values. Because pain has two intrinsic values while pleasure has only one, we have seen that hedonism, as it is normally put forward, is likely false. And we've seen that the dual values of pain impact our normative thought about how we weigh pleasure and pain. But we've also seen that the relationship between pleasure's intrinsic goodness and its context may mirror the relationship we found with pain. That suggests that we should reject the existing theories and accept a new account of pleasure's intrinsic goodness. All three of these claims are somewhat tentative. They all depend on further issues beyond the purview of this thesis. But, even if they aren't born out in the end, the fact that we must seriously address them is itself important. We have seen that we cannot simply assume that what goes for pleasure will go for pain. However, in the course of my research, I have yet to see anyone question whether we can smoothly transpose claims about pain and its intrinsic value onto pleasure, and vice--‐‐versa. For example, even Sidgwick, one of the greatest writers on hedonic theories of value, writes that In dealing with this point, and in the rest of the hedonistic discussion, it will be convenient for the most part to speak of pleasure only, assuming that pain may be From: Swenson, Pain and Value 89 © 2006 by Adam Swenson regarded as the negative quantity of pleasure, and that accordingly any statements made with respect to pleasure may be at once applied, by obvious changes of phrase, to pain.135 But we have now seen this assumption conceals several live issues. Indeed, to address the three claims of this section, we must give serious thought to the relationship between pleasure and pain -the relationship that was supposed to be transparent. On reflection, I personally find the silence on the assumption that we can seamlessly transpose between pleasure and pain rather surprising. Apart from my arguments in this thesis, it just seems, at least to me, that there is a gap here to be closed. Though they are both in our broad sense sensations and both exemplars of intrinsic value, pain just seems to have a particular evil that has no analogue in pleasure (cases like Ascetic** notwithstanding). I think I have identified that difference in this project. Pains are usurpers. They undermine our autonomy. They alienate us from our desires. They destroy who and what we are. That has no analogue in even the most rapturous joy or most intense orgasm. Pleasure can certainly inundate a person's world, but it doesn't take it away. §6.3 Coda I admit that many of my conclusions in this dissertation are radical and counterintuitive. I have claimed, inter alia, that pains are not what we think, that all existing accounts of their intrinsic badness are wrong, that they have two distinct intrinsic values, that a privation theory of their intrinsic badness is correct, that this privation is found in their phenomenology, and that intrinsic value can have properties no one has thought to combine. Radical and counterintuitive are usually okay in small doses, but in this dissertation the dosage may seem lethal. I suspect that much of what is worrisome here is due to the shadow of the kernel view. All of these conclusions flow from the rejection of the kernel view. If pain kernels are not what we care about from the normative standpoint, then we can take a much more capacious view of what pains are and what we are referring to when we say that a pain 'hurts'. That opens the door to progress and the conclusions of this dissertation. Several years ago, in the middle of a judo match, I broke my collarbone. As is often the case with severe trauma, the immediate pain was surprisingly mild. In many parts of this dissertation I have been painting a picture of what I felt for just a few moments when I later attempted to get out of the car in the hospital parking lot. It's true that my memories may be tainted by theory; and it has been several years since the accident. But it was not me whose body twisted and crumpled or me who shrieked and screamed. 135 Sidgwick (1884), 125. From: Swenson, Pain and Value 90 © 2006 by Adam Swenson As philosophers we must follow our arguments where they take us. But we must also be conscious of when they've taken us over a cliff. I, of course, believe my arguments. But it is my reflections on countless stubbed toes, headaches, and memories of pains past, as well as my research into pain science and the depictions of pain in literature, which convince me that we are still on the right side of the precipice. 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