Focusing on the basic structure as the subject of justice has tended to lead theorists to make a choice: either there is no global basic structure and therefore obligations of justice remain domestic only or there is sufficient institutional basis at the global level to warrant affirming a basic structure global in scope, meaning that duties of justice must also be global. Recent literature, however, has pointed out that this might be a false choice between denying and asserting the existence (...) of a global basic structure. There are two main claims that I make in this paper. First, I claim that on a Rawlsian understanding of the basic structure, justice does not require one before its demands arise, but rather that under certain conditions, justice can require that a basic structure be established as an essential part of fulfilling its demands. This has the benefit of not restricting the scope of justice to the domestic sphere. Thus, the second claim is about determining, from a practice-dependent, non-ideal starting point, what those “certain conditions” are. Specifically, I argue that when currently existing global institutions begin impacting on the freedom of individuals to interact against a fair backdrop and pervasively impact on life chances, then the demands of justice will arise and we will need to establish a global basic structure. This paper, then, also has implications for the ideal/non-ideal theory debate, because I argue that the best way to globalize the basic structure is to begin from a non-ideal starting point.Article first published online: 9 NOV 2015. (shrink)

In her article the author shows the relevance of the concept of compromise for protestant ethics after 1945. Coming from the current discussion about the significance of compromise in the german society today she asks for the role of compromises for community building and as a guarantee for plurality in the civil society nowadays. The author illustrates the relation between compromise, plurality and democracy in protestant ethics after World War II by presenting an article of the German pastor Eberhard Müller, (...) who was the founder of the Protestant Academy of Bad Boll in Wuerttemberg/west-germany in 1945. In his article compromise, published in the Evangelisches Soziallexikon (Protestant Encyclopedia of social ethics, Kreuz-Verlag Stuttgart) 1954 Müller emphasizes his conviction, that after the ideology of Nazi-Germany only a culture of communication and exchance, a culture, that is based on compromises could anchor an understanding of democracy in the young German society. (shrink)

Sabrina Fortin | : La recherche sur les populations permet d’améliorer nos conditions de vie en identifiant les facteurs de risque attribuables aux liens entre l’environnement et certains déterminants socio-sanitaires. Elle nécessite de vastes échantillons qui proviendront souvent de renseignements personnels ou de matériel biologique déjà recueillis. Pour les utiliser, la règle générale veut qu’un consentement individuel soit obtenu. Cependant, dans la pratique, il est souvent impossible d’obtenir un tel consentement sans affecter la qualité et la capacité de généralisation (...) des résultats de recherche. Cette obligation de consentement est fondée sur la primauté de la personne et la dignité humaine, qui ont été intégrées dans le droit des personnes à la fin de la Seconde Guerre mondiale. Ce principe fondamental a également été inséré au coeur de l’encadrement de la recherche scientifique. La philosophie personnaliste en serait à l’origine. Cet article, après avoir établi la provenance philosophique et historique du principe de dignité humaine, tente de rétablir un certain équilibre entre les intérêts individuels et collectifs impliqués dans la recherche populationnelle. | : According to this paper, personalist philosophy could be at the origin of the importance given to consent in an actual research normative framework. The obligation of consent is well established in Canadian law, but when the time comes to apply it to research on populations, which involves large number samples, it causes some impracticabilities. Access to personal data for populational research should be viewed as a common good contributing to improve life conditions. Hence, the collective interests generated by populational research should be better balanced against preferences and personal interests. (shrink)

Winner, 2020 Body and Embodiment Best Publication Award, given by the American Sociological Association Honorable Mention, 2020 Sociology of Sex and Gender Distinguished Book Award, given by the American Sociological Association How the female body has been racialized for over two hundred years There is an obesity epidemic in this country and poor Black women are particularly stigmatized as “diseased” and a burden on the public health care system. This is only the most recent incarnation of the fear of fat (...) Black women, which Sabrina Strings shows took root more than two hundred years ago. Strings weaves together an eye-opening historical narrative ranging from the Renaissance to the current moment, analyzing important works of art, newspaper and magazine articles, and scientific literature and medical journals—where fat bodies were once praised—showing that fat phobia, as it relates to Black women, did not originate with medical findings, but with the Enlightenment era belief that fatness was evidence of “savagery” and racial inferiority. The author argues that the contemporary ideal of slenderness is, at its very core, racialized and racist. Indeed, it was not until the early twentieth century, when racialized attitudes against fatness were already entrenched in the culture, that the medical establishment began its crusade against obesity. An important and original work, Fearing the Black Body argues convincingly that fat phobia isn’t about health at all, but rather a means of using the body to validate race, class, and gender prejudice. (shrink)

Niche construction denotes the alteration, destruction, or creation of environmental features through the activities of an organism, modifying the relation between organism and environment. The concept of niche construction found application in various fields of research: evolutionary biology, enculturation, ontogenetic development, and local organism-environment coordination. This is because it provides a useful tool emphasizing different aspects of the dynamic interplay between organisms and their actively constructed environment. Traditionally, niche construction is considered a positive mechanism in the complementarity of organism and (...) environment. In contrast, this paper sheds light on the dark side of niche construction, that is, the different manners in which organisms may modify environmental features that are in some way or another harmful to them. First, the paper introduces a paradigmatic distinction of four kinds of niche construction as commonly addressed in recent literature, using more or less extended spatio-temporal scales as the distinguishing feature. Second, the paper elaborates on the concept of negative niche construction, providing normative criteria of (mal)adaptation that are suitable for the evaluation of environmental alterations, given the chosen spatio-temporal scale. Of particular interest are inter-scale conflicts: those cases of environmental constructions which appear adaptive concerning one spatio-temporal scale but maladaptive concerning another. Third, the paper distinguishes the concept of niche construction as a valuable instrument to better understand central aspects of modern medicine and the entangled contribution of evolutionary, socio-cultural, personal, and situational aspects to different health issues, using chronic pain as an illustrative case study. (shrink)

Distributed Leadership (DL) is a feature of education in many jurisdictions. Similarly, in Ireland the principles of DL have been adopted as part of a quality framework to underpin a system that provides high quality student care, learning and teaching. This model necessitates an alignment of senior leaders (SLs) and middle leaders (MLs) whose actions are informed by the needs and priorities of their particular school. The traditional notion of the ML position as a management position is changing. The evolution (...) requires a reconceptualisation, a transformation of the role and how we support and develop it to ensure that MLs are an integral part of the leadership structure of the school. This pragmatic research explored the PD needs of MLs in Irish, Education and Training Board (ETB) post-primary schools. It involved a mixed-methods, exploratory sequential study. Stage one involved a set of five semi structured interviews with AP I post holders. These were used as an instrument to develop the online surveys. Stage two involved quantitative research. Online surveys were distributed to all ETB schools in the republic of Ireland. In stage three a summary of the findings of the survey were shared with ten AP Is who were subsequently interviewed to gain further insights. The study illustrated that the development of MLs requires the support of SLs, skills development, a supportive school culture and combined training for senior and middle leaders which should be facilitated by an independent person. (shrink)

We discuss the implementation of Responsible Research and Innovation (RRI) within a project for the development of an AI-supported exergame for assisted movement training, outline outcomes and reflect on methodological opportunities and limitations. We adopted the responsibility-by-design (RbD) standard (CEN CWA 17796:2021) supplemented by methods for collaborative, ethical reflection to foster and support a shift towards a culture of trustworthiness inherent to the entire development process. An embedded ethicist organised the procedure to instantiate a collaborative learning effort and implement RRI (...) in a translational context. Within the interdisciplinary setting of the collaboration and with the support of a technoethicist, we successfully identified relevant, project-specific challenges and developed a roadmap with derived actions, thus meaningfully integrating RRI into the development process. We discuss the methodological procedure in terms of its effectiveness and efficiency, the allocation of responsibilities and roles, particularly regarding potential frictions in the interdisciplinary context with embedded ethics, and the challenges of the translational context. We conclude that the responsibility-by-design standard effectively established a productive workflow for collaborative investigation and work on ethical challenges. We reflect on methodological difficulties and propose possible avenues to our approach. (shrink)

In this paper, we argue that the concept of environmental scaffolding can contribute to a better understanding of our affective life and the complex manners in which it is shaped by environmental entities. In particular, the concept of environmental scaffolding offers a more comprehensive and less controversial framework than the notions of embeddedness and extendedness. We contribute to the literature on situated affectivity by embracing and systematizing the diversity of affective scaffolding. In doing so, we introduce several distinctions that provide (...) classifications of different types of environmentally scaffolded affectivity. Furthermore, we differentiate eight dimensions that allow us to evaluate the quality and effectivity of scaffolds in particular applications. On that basis, we develop a taxonomy using paradigmatic examples of affective scaffolding. This taxonomy enriches the current debate by emphasizing distinctions that are often conflated and by identifying fields of application that are commonly overlooked. (shrink)

Pain continues to be one of the most controversial subjects in neurophilosophy. One focus of current debates is the apparent absence of an ideal brain‐based biomarker that could function as a coherent and distinct indicator for pain. One prominent reaction to this in the philosophical literature is scientific pain eliminativism. In this article, I argue for a non‐eliminative alternative that builds on family resemblances and provides a useful heuristic in the tradeoff between the idiosyncrasy of the neural processes corresponding to (...) different pain cases and the demand for generalizability in pain research. (shrink)

This book showcases Elisabeth of Bohemia, Princess Palatine, one of the foremost female minds of the 17th century. Best known today for her important correspondence with the philosopher René Descartes, Elisabeth was famous in her own time for her learning, philosophical acumen, and mathematical brilliance. She was also well-connected in the seventeenth-century intellectual circles. Elisabeth’s status as a woman philosopher is emblematic of both the possibilities and limitations of women's participation in the republic of letters and of their subsequent fate (...) in history. Few sources containing her own views survive, and until recently there has been no work on Elisabeth as a thinker in her own right. This volume brings together an international team of scholars to discuss her work from a cross-disciplinary perspective on the occasion of her fourth centenary. It is the first collection of essays to examine a range of her interests and to discuss them in relation to her historical context. The studies presented here discuss her educational background, her friendships and contacts, her interest in politics, religion, and astronomy, as well as her views on politics, her moral philosophy and her engagement with Cartesianism. The volume will appeal to historians of philosophy, historians of political thought, philosophers, feminists and seventeenth-century historians. (shrink)

The most common approach to understanding the semantics of the concept of pain is third-person thought experiments. By contrast, the most frequent and most relevant uses of the folk concept of pain are from a first-person perspective in conversational settings. In this paper, we use a set of linguistic tools to systematically explore the semantics of what people communicate when reporting pain from a first-person perspective. Our results suggest that only a pluralistic view can do justice to the way we (...) talk about pain from a first-person perspective: The semantic content of the folk concept of pain consists of information about both an unpleasant feeling and a disruptive bodily state. Pain linguistics thus provides new insights into ordinary pain language and poses an interesting challenge to the dominant unitary views of pain. (shrink)

The framework proposed by Dupras and Bunnik was developed in response to their recognition that standard regulations are increasingly inadequate to address the complex privacy issues created by the...

In the face of massively increased technological complexity, it is striking that so many of today’s computational and networked things follow design ideals honed decades ago in a much different context. These strong ideals prescribe a presentation of things as useful tools through design and a withdrawal of aspects of their functionality and complexity. Beginning in the mid-twentieth century, we trace this ‘withdrawal program’ as it has persisted in the face of increasing computational complexity. Currently, design is in a dilemma (...) where computational products can be seen as brilliantly designed and engaging to use yet can also be considered very problematic in how they support hidden agendas and often seem less than trustworthy. In this article, we analyse factors shaping this emergent ethical dilemma and reveal the concept of _a widening rift_ between what computational _things actually are and do_ and _the ways in which they are presented as things for use_. Against this backdrop, we argue that there is a need for a new orientation in design programs to adequately address this deepening rupture between the aesthetics and ethics in the design of computational things. (shrink)

Drawing upon two independent national samples of 201 and 241 psychology graduate students, this article describes the development and psychometric evaluation of 4 Web-based student self-report scales tapping student socialization in the responsible conduct of research (RCR) with human participants. The Mentoring the Responsible Conduct of Research Scale (MRCR) is composed of 2 subscales assessing RCR instruction and modeling by research mentors. The 2 subscales of the RCR Department Climate Scale (RCR-DC) assess RCR department policies and faculty and student RCR (...) practices. The RCR Preparedness scale (RCR-P) and the RCR Field Integrity scale (RCR-FI) measure respectively students' confidence in their ability to conduct research responsibly and their belief in the RCR integrity of psychology as a discipline. Factor analysis, coefficient alphas, correlations, and multiple regression analyses demonstrated each of the scales had good internal consistency and concurrent and construct validity. (shrink)

Although pain is one of the most fundamental and unique experiences we undergo in everyday life, it also constitutes one of the most enigmatic and frustrating subjects for many scientists. This book provides a detailed analysis of why this issue is grounded in the nature of pain itself. It also offers a philosophically driven solution of how we may still approach pain in a theoretically compelling and practically useful manner. Two main theses are defended: (i) Pain seems inscrutable because there (...) exists no property that is commonly shared by all types of pain and that is at the same time particular to pain, setting it apart from other bodily sensations. This applies irrespective of whether we consider the psychological dimensions, neural networks, causal relations or biological functions of pain. Consequently, it is impossible to refer to ideal far-reaching and ideal distinct generalizations on the matter of pain. (ii) Despite this challenge, by focusing on the resemblance relations that hold across pains, we can generate scientific progress in explaining, predicting and treating pain. In doing so, the book aims to provide a clear conceptual basis for interdisciplinary communication and a useful heuristic for future research. (shrink)

Pain is often used as the paradigmatic example of a phenomenal kind with a phenomenal quality common and unique to its instantiations. Philosophers have intensely discussed the relation between the subjective feeling, which unites pains and distinguishes them from other experiences, and the phenomenal properties of sensory, affective, and evaluative character along which pains typically vary. At the center of this discussion is the question whether the phenomenal properties prove necessary and/or sufficient for pain. In the empirical literature, sensory, affective, (...) and evaluative properties have played a decisive role in the investigation of psychophysical correspondence and clinical diagnostics. This paper addresses the outlined philosophical and empirical issues from a new perspective by constructing a multidimensional phenomenal space for pain. First, the paper will construe the phenomenal properties of pains in terms of a property space whose structure reflects phenomenal similarities and dissimilarities by means of spatial distance. Second, philosophical debates on necessary and sufficient properties are reconsidered in terms of whether there is a phenomenal space formed of dimensions along which all and only pains vary. It is concluded that there is no space of this kind and, thus, that pain constitutes a primitive phenomenal kind that cannot be analyzed entirely in terms of its varying phenomenal properties. Third, the paper addresses the utility of continued reference to pain and its phenomenal properties in philosophical and scientific discourses. It is argued that numerous insights into the phenomenal structure of pain can be gained that have thus far received insufficient attention. (shrink)

The purpose of this paper is to highlight an aspect of Elisabeth’s intellectual life that has received little scholarly attention so far, namely Elisabeth’s involvement with the sciences of her day. Firstly, this paper provides a survey of Elisabeth’s interest in and engagement with various scientific disciplines, such as mathematics, medicine, natural philosophy, and microscopy, drawing on her letter exchange with Descartes and several other intellectuals as well as additional documents, such as dedications of scientific works to Elisabeth. Secondly, this (...) paper investigates Elisabeth’s involvement with one particular scientific discipline, namely astronomy. Analyzing Elisabeth’s letter exchange with Andreas Colvius and Constantijn Huygens and additional letters and testimonies, I show that Elisabeth played an active part in at least three current debates in astronomy, namely concerning the discoveries of the satellites of Jupiter, the emerging maps of the moon, and the invention of the new telescopes. Based on the evidence provided in this paper, it is argued that Elisabeth’s intellectual biography should be broadened. It is not sufficient to perceive her only as a critic of Descartes’ philosophy, as this characterization does not accommodate her scientific commitments, but rather as a multitalented intellectual. (shrink)

This book is a conceptualization of the literary aesthetic in relation to ethics, in particular, an ethics for a concern for the Self. Bringing Gilles Deleuze and Felix Guattari's constructivist thinking into a practical domain, Sabrina Achilles rethinks the ways in which literature is understood and taught. Through an interdisciplinary approach, literature is viewed from the position of a problem without any pre-given frame.

Since Russell and Burch (1959) suggested the principles of replacement, reduction, and refinement (3Rs) as a foundation for animal research, their influence has only grown in the research community. In this paper, we discuss whether the 3Rs can be constructively used as a prism to analyse decisions regarding the welfare of animals housed in zoos and aquariums (henceforth “zoo animals”). We analyse opportunities and challenges for each of the three Rs when applied to zoo animals. We discuss the following reasons (...) to consider the use of the 3Rs in relation to zoo animals: (1) there are similarities between motivations for housing animals in zoos and using them in research that are ethically relevant to consider; (2) the professional zoo community has committed to progress towards evidence-based best practice models to ensure and enhance the welfare of animals housed in zoos; and (3) there is a growing public concern regarding the welfare of zoo animals which can, to some extent, be met by viewing current practices through the prism of the 3Rs. (shrink)

Studies in the yeast Saccharomyces cerevisiae have validated the major features of the double‐strand break repair (DSBR) model as an accurate representation of the pathway through which meiotic crossovers (COs) are produced. This success has led to this model being invoked to explain double‐strand break (DSB) repair in other contexts. However, most non‐crossover (NCO) recombinants generated during S. cerevisiae meiosis do not arise via a DSBR pathway. Furthermore, it is becoming increasingly clear that DSBR is a minor pathway for recombinational (...) repair of DSBs that occur in mitotically‐proliferating cells and that the synthesis‐dependent strand annealing (SDSA) model appears to describe mitotic DSB repair more accurately. Fundamental dissimilarities between meiotic and mitotic recombination are not unexpected, since meiotic recombination serves a very different purpose (accurate chromosome segregation, which requires COs) than mitotic recombination (repair of DNA damage, which typically generates NCOs). (shrink)

O estudo apresenta o resultado da experiência em mediação familiar desenvolvida em um Núcleo de Práticas Judiciárias numa instituição pública de ensino, através de projeto de extensão. O objetivo deste trabalho é compartilhar as vivências do serviço de psicologia inserido em um espaço eminentemente ..

Extant research provides compelling conceptual and empirical arguments that company-external as well as company-internal CSR efforts positively affect employees, but does so largely in studies assessing effects from the two CSR types independently of each other. In contrast, this paper investigates external–internal CSR jointly, examining the effects of consistent external–internal CSR strategies on employee attitudes, intentions, and behaviors. The research takes a social and moral identification theory view and advances the core hypothesis that inconsistent CSR strategies, defined as favoring external (...) over internal stakeholders, trigger employees’ perceptions of corporate hypocrisy which, in turn, lead to emotional exhaustion and turnover. In Study 1, a cross-industry employee survey indicates that inconsistent CSR strategies with larger external than internal efforts increase employees’ turnover intentions via perceived corporate hypocrisy and emotional exhaustion. In Study 2, a multi-source secondary dataset demonstrates that inconsistent CSR strategies increase firms’ actual employee turnover. Combined, the two studies demonstrate the importance of taking into account the interests of both external and internal stakeholders of the firm when researching and managing CSR. (shrink)

This article describes the results of qualitative research into the moral issues faced by social work professionals working in projects targeted at teenage mothers. The research is part of the tradition of empirical and practice-driven ethics. The main questions were: How does morality become visible in the social services for teenage mothers and how do social workers deal with the moral dimension of their work? (How) can education, training and peer review offer space for moral reflection? Interviews and group meetings (...) ('focus groups') were held to answer these questions. Nineteen professionals (front-line professionals as well as professionals in executive roles) participated in the research. The findings describe the moral issues and the moral actions of professionals and the organizational context respectively. The results reveal that the everyday practice of social work professionals can raise complex issues inherent to their work and that there is often no explicit reflection on the moral dimension of these issues. The authors argue that there needs to be greater focus on the complexity of moral issues and elaborate on three dimensions of this complexity. (shrink)

Bodily sensations, such as pain, hunger, itches, or sexual feelings, are commonly characterized in terms of their phenomenal character. In order to account for this phenomenal character, many philosophers adopt strong representationalism. According to this view, bodily sensations are essentially and entirely determined by an intentional content related to particular conditions of the body. For example, pain would be nothing more than the representation of actual or potential tissue damage. In order to motivate and justify their view, strong representationalists often (...) appeal to the reliable causal covariance between bodily sensations and certain kinds of bodily conditions or to the corresponding biological function that these bodily sensations are supposed to fulfill. In this paper, I argue on the basis of recent empirical research that arguments from reliable causal covariance and biological function cannot motivate the introduction of corresponding intentional content. In particular, I argue that bodily sensations are caused by a heterogeneous class of physiological and psychological factors and their biological functions are too diverse to be reduced to the representation of a particular bodily condition. Responses are available to strong representationalists, but they either require substantial alterations to their core assumptions or incur a significant empirical burden. (shrink)

Elisabeth of Bohemia, Princess Palatine was famous in her own time for her learning, her philosophical acumen and her mathematical brilliance. Her wide-ranging interests extended to religion, science, politics and philosophy, and she was well-connected with seventeenth-century intellectual circles. But she has since suffered the fate of so many brilliant women of the past.

According to pure imperativism, pain experiences are experiences of a specific phenomenal type that are entirely constituted by imperative content. As their primary argument, proponents of imperativism rely on the biological role that pain experiences fulfill, namely, the motivation of actions whose execution ensures the normal functioning of the body. In the paper, I investigate which specific types of action are of relevance for an imperative interpretation and how close their link to pain experiences actually is. I argue that, although (...) imperative theories constitute an apparently promising version of strong intentionalism, they cannot provide an imperative content that meets their own criteria of both sufficiency and necessity. I further argue that this issue cannot be solved by impure imperative theories either. (shrink)

In recent years, the societal and personal impacts of pain, and the fact that we still lack an effective method of treatment, has motivated researchers from diverse disciplines to try to think in new ways about pain and its management. In this paper, we aim to develop an enactive approach to pain and the transition to chronicity. Two aspects are central to this project. First, the paper conceptualizes differences between acute and chronic pain, as well as the dynamic process of (...) pain chronification, in terms of changes in the field of affordances. This is, in terms of the possibilities for action perceived by subjects in pain. As such, we aim to do justice to the lived experience of patients as well as the dynamic role of behavioral learning, neural reorganization, and socio-cultural practices in the generation and maintenance of pain. Second, we aim to show in which manners such an enactive approach may contribute to a comprehensive understanding of pain that avoids conceptual and methodological issues of reductionist and fragmented approaches. It proves particularly beneficial as a heuristic in pain therapy addressing the heterogenous yet dynamically intertwined aspects that may contribute to pain and its chronification. (shrink)

Maddie’s story illustrates the critical importance of healthcare teams (HCTs) having inclusive multidisciplinary provider meetings prior to siloed conversations with families. It is paramount that...

Our commentary aims to show that the COVID-19 pandemic has amplified existing barriers to healthcare in England for ethnic minority and migrant women. We expose how the pandemic has affected the allocation of healthcare resources leading to the prioritisation of COVID-19 patients and suspending the equal access to healthcare services approach. We argue that we must look beyond this disruption in provision by examining existing barriers to access that have been amplified by the pandemic in order to understand the poorer (...) health outcomes for women in ethnic minority and migrant communities. The reflection focuses on racialised medical perceptions, gendered cultural norms including information barriers and stigma, and specific legal barriers. (shrink)

El último jefe de gobierno republicano durante la guerra civil de España, Juan Negrín, tuvo que gestionar el exilio republicano. Consciente desde el otoño de 1938 de las debilidades de la República para vencer a los franquistas, inició un proceso cuya meta era usar parte de las riquezas de la República para subvenir a las necesidades de los refugiados en México. El exilio republicano a México ocasionó una división multilateral. Se exponen aquí algunos de los orígenes de las divisiones políticas (...) y cómo Negrín se refirió al final de la guerra en algunos manuscritos que forman parte de sus memorias. (shrink)

Juxtaposing Cherríe Moraga's Loving in the War Years and Luce Irigaray's Speculum of the Other Woman, I explore the ways that sex and race intersect to complicate an Irigarayan account of the relations between mother and daughter. Irigaray's work is an effective tool for understanding the disruptive and potentially healing desire between mothers and daughters, but her insistence on sex as primary difference must be challenged in order to acknowledge the intersectionality of sex and race. Working from recent work on (...) the psychoanalysis of race, I argue that whiteness functions as a master signifier in its own right, and as a means of differentiation between the light-skinned Moraga and her brown-skinned mother. Irigaray's concept of blood deepens Moraga's account of her healing and subversive return to her mother. The juxtaposition of Moraga, Irigaray, and contemporary psychoanalysis of race can allow for a necessary revision of Irigaray's psychoanalysis that acknowledges the ways in which sexual difference is indexed by race and sheds new light on her account of the mother–daughter relation. (shrink)

Chronic pain is one of the most disabling conditions globally, yet we are still missing a satisfying theoretical framework to guide research and clinical practice. This is highly relevant as research and practice are not taking place in a vacuum but are always shaped by a particular philosophy of pain, that is, a set of implicitly or explicitly prevailing assumptions about what chronic pain is and how it is to be addressed. In looking at recent history, we identify a promising (...) trend from neuro-centrism to the application of the biopsychosocial model. Unfortunately, due to its limited theoretical foundation, the biopsychosocial model is too often implemented in a reductionist, fragmented, and linear manner. In particular, it remains too vague concerning the relationship between involved biological, psychological, and social processes. Sanneke de Haan prominently labeled this the integration problem. In this paper, we introduce five different facets of the integration problem that every philosophy of pain needs to address: (i) ontological, (ii) conceptual, (iii) explanatory, (iv) methodologicalMethodological, and (v) therapeutic. We develop an enactive theory of chronic pain and outline how far it provides solutions to these different integration challenges. (shrink)

Pain is often used as the paradigmatic example of a phenomenal kind with a phenomenal quality common and unique to its instantiations. Philosophers have intensely discussed the relation between the subjective feeling, which unites pains and distinguishes them from other experiences, and the phenomenal properties of sensory, affective, and evaluative character along which pains typically vary. At the center of this discussion is the question whether the phenomenal properties prove necessary and/or sufficient for pain. In the empirical literature, sensory, affective, (...) and evaluative properties have played a decisive role in the investigation of psychophysical correspondence and clinical diagnostics. This paper addresses the outlined philosophical and empirical issues from a new perspective by constructing amultidimensional phenomenal spacefor pain. First, the paper will construe the phenomenal properties of pains in terms of a property space whosestructurereflects phenomenal similarities and dissimilarities by means of spatial distance. Second, philosophical debates on necessary and sufficient properties are reconsidered in terms of whether there is a phenomenal space formed of dimensions along which all and only pains vary. It is concluded that there is no space of this kind and, thus, that pain constitutes aprimitivephenomenal kind that cannot be analyzed entirely in terms of its varying phenomenal properties. Third, the paper addresses theutilityof continued reference to pain and its phenomenal properties in philosophical and scientific discourses. It is argued that numerous insights into the phenomenal structure of pain can be gained that have thus far received insufficient attention. (shrink)