Pain is commonly explained in terms of the perceptual activity of a distinct sensory modality, the function of which is to enable us to perceive actual or potential damage to the body. However, the characterization of pain experience in terms of a distinct sensory modality with such content is problematic. I argue that pain is better explained as occupying a different role in relation to perception: to indicate when the stimuli that are sensed in perceiving anything by (...) means of a sensory modality exceed a significant level of intensity. Viewing the system underlying pain experience as an integral and functionally integrated feature of all the senses provides a new perspective on the diverse forms of pain, what it is like to experience pain and the contrasting natures of pain and pleasure. (shrink)

The paper argues that pain is not a good counter-example to the privation theory of evil. Objectors to the privation thesis see pain as too real to be accounted for in privative terms. However, the properties for which pain is intuitively thought of as real, i.e. its localised nature, intensity, and quality are features of the senso-somatic aspect of pain. This is a problem for the objectors because, as findings of modern science clearly demonstrate, the (...) senso-somatic aspect of pain is neurologically and clinically separate from the emotional-psychological aspect of suffering. The intuition that what seems so real in pain is also the source of pain’s negative value thus falls apart. As far as the affective aspect of pain, i.e. ”painfulness’ is concerned, it cannot refute the privation thesis either. For even if this is indeed the source of pain’s badness, the affective aspect is best accounted for in privative terms of loss and negation. The same holds for the effect of pain on the aching person. (shrink)

Our pains can be more or less intense, our mental imagery can be more or less vivid, our perceptual experiences can be more or less striking. These degrees of intensity of conscious experiences are all manifestations of a phenomenal property I call mental strength. In this article, I argue that mental strength is a domain-general phenomenal magnitude; in other words, it is a phenomenal quantity shared by all conscious experiences that explains their degree of felt intensity. Mental strength has been (...) largely overlooked in favor of mental states’ type, representational contents, domain-specific phenomenology, or processes such as attention. Considering mental strength in our reflections about the mind illuminates debates about the relation of representational contents and phenomenal character, and it also helps address questions about the structure and functions of consciousness. Mental strength provides a unifying construct to model what is shared in the phenomenology of different types of conscious experiences. (shrink)

One use of the noun ‘pain’ is exemplified in sentences like ‘There is a pain in my foot’. According to the Experiential Theory, ‘pain’ in this context refers to an experience located in the mind or brain. According to the Bodily Theory, it refers to an extra-cranial bodily occurrence located in a body part. In this paper, I defend the Bodily Theory. Specifically, I argue that pains are proximal activations of nociceptors that cause experiences (...) of pain. This view is preferable to the Experiential Theory, because it accords better with common sense and offers a better interpretation or semantics of ordinary pain reports. (shrink)

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

Tracking representationalism explains the negative affective character of pain, and its capacity to motivate action, by reference to the representation of the badness for us of bodily damage. I argue that there is a more fitting instantiation of the tracking relation – the badness for us of extremely intense stimuli – and use this to motivate a non-reductive approach to the negative affective character of pain. The view of pain proposed here is supported by consideration of three (...) related topics: the pain caused when the body is damaged, reparative pain, and the messenger-shooting objection to tracking representationalism. (shrink)

A collection, edited by David Bain, Michael Brady, and Jennifer Corns, originating in our Pain Project. Table of Contents: Colin Klein and Manolo Martínez – ‘Imperativism and Pain Intensity’; Murat Aydede and Matthew Fulkerson – ‘Pain and Theories of Sensory Affect’; Dan-Mikael Ellingson, Morten Kringlebach, and Siri Leknes – ‘A Neuroscience Perspective on Pleasure and Pain’; Michael Brady – ‘The Rationality of Emotional and Physical Suffering’; Jennifer Corns – ‘The Placebo Effect’; Jesse Prinz – ‘What is (...) the Affective Component of Pain?’; Adam Shriver – ‘The Unpleasantness of Pain for Humans and Other Animals’; Valerie Gary Hardcastle – ‘When is a Pain Not a Pain? The Challenge of Disorders of Consciousness’; Frédérique de Vignemont – ‘The First-Person in Pain’. (shrink)

In What the Body Commands, Colin Klein proposes and defends a novel theory of pain. Klein argues that pains are imperative; they are sensations with a content, and that content is a command to protect the injured part of the body. He terms this view "imperativism about pain," and argues that imperativism can account for two puzzling features of pain: its strong motivating power and its uninformative nature. Klein argues that the biological purpose of pain (...) is homeostatic; like hunger and thirst, pain helps solve a challenge to bodily integrity. It does so by motivating you to act in ways that help the body recover. If you obey pain's command, you get better. He develops his account to handle a variety of pain phenomena and applies it to solve a number of historically puzzling cases. Klein's intent is to defend the imperativist view in a pure form -- without requiring pain to represent facts about the world.Klein presents a model of imperative content showing that intrinsically motivating sensations are best understood as imperatives, and argues that pain belongs to this class. He considers the distinction between pain and suffering; explains how pain motivates; addresses variations among pains; and offers an imperativist account of maladaptive pains, pains that don't appear to hurt, masochism, and why pain feels bad. (shrink)

The essential logical deficiency of the perceptual theory of pain, as I tried to show in my paper,1 is that feeling pain cannot be perceiving anything. The conceptual framework that would make it possible for us to understand “feel” in this use to be a perception concept does not exist. The concept of a glimpse, which George Pitcher relies upon to supply this framework,2cannot begin to do so because it is a secondary perception concept entirely dependent upon (...) that of seeing. This primary concept of visual perception is tied up with actions and supporting concepts like looking, glancing, gazing, glimpsing, watching, and the like. These are different ways in which one's visual perceiving may be characterized. Without the primary concept and the actions connected with it, there would be nothing to characterize. The word “feel” in contexts involving pain is not a perception concept and efforts to make it one are doomed to fail. The supporting actions and concepts do not exist. (shrink)

A recent widely reported study found that some participants would prefer to self-administer a small electric shock than be bored. This flawed study serves as a departure point to diagram pain and sensation beyond the boundaries of the individual body, consisting of four sections. First, in terms of laboratory-based experimentation and auto-experimentation with pain, there is a long history of viewing pain and touch through introspective means. Second, later theories of pain successively widened the scope of (...) the physiological mechanisms and external influences on the organism, such as Melzack and Wall’s cybernetics-influenced gate control theory. Third, we briefly consider the nervous system as a homeostatic system, which finds an historical parallel in explanations of the milieu intérieur of the organism, via Claude Bernard and Kurt Goldstein. Fourth, pain helps tip the organism as a whole from perception to action, but also operates beyond the organism as a biopsychosocial phenomenon. (shrink)

The ancient Neoplatonic doctrine that the rational soul has one or more vehicles—bodies of a semi-material nature which it acquires during its descent through the spheres—plays a crucial part in Marsilio Ficino’s philosophical system, especially in his theory of sense-perception and in his account of the afterlife. Of the soul’s three vehicles, the one made of more or less rarefied air is particularly important, according to Ficino, during the soul’s embodied existence, for he identifies it with thespiritus, the pneumatic (...) substance based in the brain which was believed to serve as an instrument for perception and imagination. He refers to the vehicles in his arguments against the theory of the transmigration of souls into the bodies of animals, claiming that the imaginative suffering experienced after death by souls in their aerial bodies are much more acute than the physical pain they might feel in bodies made of flesh and blood. Since the power of the imagination, for Ficino, is stronger than that of the four senses, the soul’s perceptive activity is more intense after death, when it has lost its earthly body and lives instead in a body made of air. The vehicles, moreover, provided Ficino with evidence for the individual immortality of souls, a doctrine that he was attempting to demonstrate philosophically against the position of Averroes and his followers. In his view, the vehicles ensured the survival after death of two faculties which were intimately connected to personal identity: the imagination and memory. By pointing out the role of the vehicles in transporting the soul’s innermost representations and memories through the universe, Ficino was able to show that the distinguishing traits of our personality are not lost with bodily death, but survive along with the vehicle that carries them. (shrink)

This paper aims to provide a theoretical framework for explaining the subjective character of pain experience in terms of what we will call ‘embodied predictive processing’. The predictive processing (PP) theory is a family of views that take perception, action, emotion and cognition to all work together in the service of prediction error minimisation. In this paper we propose an embodied perspective on the PP theory we call the ‘embodied predictive processing (EPP) theory. The EPP (...) class='Hi'>theory proposes to explain pain in terms of processes distributed across the whole body. The prediction error minimising system that generates pain experience comprises the immune system, the endocrine system, and the autonomic system in continuous causal interaction with pathways spread across the whole neural axis. We will argue that these systems function in a coordinated and coherent manner as a single complex adaptive system to maintain homeostasis. This system, which we refer to as the neural-endocrine-immune (NEI) system, maintains homeostasis through the process of prediction error minimisation. We go on to propose a view of the NEI ensemble as a multiscale nesting of Markov blankets that integrates the smallest scale of the cell to the largest scale of the embodied person in pain. We set out to show how the EPP theory can make sense of how pain experience could be neurobiologically constituted. We take it to be a constraint on the adequacy of a scientific explanation of subjectivity of pain experience that it makes it intelligible how pain can simultaneously be a local sensing of the body, and, at the same time, a more global, all-encompassing attitude towards the environment. Our aim in what follows is to show how the EPP theory can meet this constraint. (shrink)

This paper aims to provide a theoretical framework for explaining the subjective character of pain experience in terms of what we will call ‘embodied predictive processing’. The predictive processing (PP) theory is a family of views that take perception, action, emotion and cognition to all work together in the service of prediction error minimisation. In this paper we propose an embodied perspective on the PP theory we call the ‘embodied predictive processing (EPP) theory. The EPP (...) class='Hi'>theory proposes to explain pain in terms of processes distributed across the whole body. The prediction error minimising system that generates pain experience comprises the immune system, the endocrine system, and the autonomic system in continuous causal interaction with pathways spread across the whole neural axis. We will argue that these systems function in a coordinated and coherent manner as a single complex adaptive system to maintain homeostasis. This system, which we refer to as the neural-endocrine-immune (NEI) system, maintains homeostasis through the process of prediction error minimisation. We go on to propose a view of the NEI ensemble as a multiscale nesting of Markov blankets that integrates the smallest scale of the cell to the largest scale of the embodied person in pain. We set out to show how the EPP theory can make sense of how pain experience could be neurobiologically constituted. We take it to be a constraint on the adequacy of a scientific explanation of subjectivity of pain experience that it makes it intelligible how pain can simultaneously be a local sensing of the body, and, at the same time, a more global, all-encompassing attitude towards the environment. Our aim in what follows is to show how the EPP theory can meet this constraint. (shrink)

Introduction: Traditionally, empathy has been studied from two main perspectives: the theory-theory approach and the simulation theory approach. These theories claim that social emotions are fundamentally constituted by mind states in the brain. In contrast, classical phenomenology and recent research based on enactive theories consider empathy as the basic process of contacting others’ emotional experiences through direct bodily perception and sensation. Objective: This study aims to enrich knowledge of the empathic experience of pain by using an (...) experimental phenomenological method. Method: Implementing an experimental paradigm used in affective neuroscience, we exposed 28 healthy adults to a video of sportspersons suffering physical accidents while practicing extreme sports. Immediately after watching the video, each participant underwent a phenomenological interview to gather data on embodied, multi-layered dimensions (bodily sensations, emotions, and motivations) and temporal aspects of empathic experience. We also performed quantitative analyses of the phenomenological categories. Results: Experiential access to the other person’s painful experience involves four main-themes. Bodily resonance: participants felt a multiplicity of bodily, affective, and kinesthetic sensations. Attentional focus: some participants centered their attention more on their own personal discomfort and sensations of rejection, while others on the pain and suffering experienced by the sportspersons. Kinesthetic motivation: some participants experienced the feeling in their bodies to avoid or escape from watching the video, while others experienced the need to help the sportspersons avoid suffering any injury while practicing extreme sports. Temporality of experience: participants witnessed temporal fluctuations in their experiences, bringing intensity changes in their bodily resonance, attentional focus, and kinesthetic motivation. Finally, two experiential structures were found: one structure is self-centered empathic experience, characterized by bodily resonance, attentional focus centered on the participant’s own experience of seeing the sportsperson suffering, and self-protective kinesthetic motivation; the other structure is other-centered empathic experience, characterized by bodily resonance, attentional focus centered on the sportsperson, and prosocial kinesthetic motivation to help them. Discussion: We show how phenomenological data may contribute to comprehending empathy for pain in social neuroscience. In addition, we address the phenomenological aspect of the enactive approach to the three dimensions of embodiment of human consciousness, especially the intersubjective dimension. Also, based on our results, we suggest an extension of the enactive theory for non-interactive social experience. (shrink)

Philosophers disagree about what the folk concept of pain is. This paper criticises existing theories of the folk concept of pain, i.e. the mental view, the bodily view, and the recently proposed polyeidic view. It puts forward an alternative proposal – the polysemy view – according to which pain terms like “sore,” “ache” and “hurt” are polysemous, where one sense refers to a mental state and another a bodily state, and the type of polysemy at issue reflects (...) two distinct but related concepts of pain. Implications with respect to issues in philosophy of pain are also drawn. (shrink)

It is evident, in the face of the COVID-19 pandemic that has physicians confronting death and dying at unprecedented levels along with growing data suggesting that physicians who care for dying patients face complex emotional, psychological and behavioural effects, that there is a need for their better understanding and the implementation of supportive measures. Taking into account data positing that effects of caring for dying patients may impact a physician’s concept of personhood, or “what makes you, ‘you’”, we adopt Radha (...) Krishna’s Ring Theory of Personhood (RToP) to scrutinise the experiences of physicians working in intensive care units (ICU) using a fictional scenario that was inspired by real events. The impact of death and dying, its catalysts, internal constituents, external factors, dyssynchrony, and buffers, specific to ICU physicians, were identified and explored. Such a framework allows for ramifications to be considered holistically and facilitates the curation of strategies for conflict resolution. This evaluation of the RToP acknowledges the experience and wide-ranging effects it has on ICU physicians. As such, our findings provide insight into their specific needs and highlight the importance of support on a personal and organisational level. Although further research needs to be conducted, the RToP could serve as the basis for a longitudinal assessment tool supported by the use of portfolios or mentorship due to their provision of personalised, appropriate, specific, timely, accessible and long-term support. (shrink)

Table of Contents: Olivier Massin, 'Pleasure and Its Contraries'; Colin Klein, 'The Penumbral Theory of Masochistic Pleasure'; Siri Leknes and Brock Bastian, 'The Benefits of Pain'; Valerie Gray Hardcastle, 'Pleasure Gone Awry? A New Conceptualization of Chronic Pain and Addiction'; Richard Gray, 'Pain, Perception and the Sensory Modalities: Revisiting the Intensive Theory'; Jonathan Cohen and Matthew Fulkerson, Affect, Rationalization, and Motivation; Murat Aydede, 'How to Unify Theories of Sensory Pleasure: An Adverbialist Proposal'; Adam Shriver, (...) 'The Asymmetrical Contributions of Pleasure and Pain to Subjective Well-Being'. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Feminist Studies 44, no. 3. © 2018 by Feminist Studies, Inc. 699 Jennifer C. Nash The Political Life of Black Motherhood In 1976, Adrienne Rich wrote, “We know more about the air we breathe, the seas we travel, than about the nature and meaning of motherhood.”1 In the four decades since the publication of Rich’s now-canonical Of Woman Born, Andrea O’Reilly has argued for the advent of “maternal (...) class='Hi'>theory” as an academic discipline, the maternal memoir has become a highly popular (and profitable) literary genre, and there has been sustained attention to maternal activism with scholarly analyses of such organizations as Mothers Against Drunk Driving and Mothers of the Movement.2 If Mamie Till Bradley boldly “let the world see” her son’s mutilated body in a 1955 public plea to make visible black suffering and antiblack violence, Valerie Castile’s statement after a jury found a police officer not guilty in the death of her son continued in the tradition of 1. Adrienne Rich, Of Woman Born: Motherhood as Experience and Institution (New York: W. W. Norton, 1995), 11. 2. See Andrea O’Reilly, ed., Maternal Theory: A Reader (New York: Demeter Press, 2007); Ann Hulbert, “The Real Myth of Motherhood,” Slate, March 8, 2005; Jennifer C. Nash and Samantha Pinto, “Strange Intimacies: Reading Black Mothering Memoirs,” Public Culture (forthcoming); Danielle Poe, Maternal Activism: Mothers Confronting Injustice (Albany: SUNY Press, 2016); and Ruth Feldstein, Motherhood in Black and White: Race and Sex in American Liberalism, 1930–1965 (Ithaca, NY: Cornell University Press, 2000). 700 Jennifer C. Nash Books Discussed in This Essay Revolutionary Mothering: Love on the Front Lines. Edited by Alexis Pauline Gumbs, China Martens, and Mai’a Williams. Oakland, CA: PM Press, 2016. Laboring Positions: Black Women, Mothering and the Academy. Edited by Sekile Nzinga-Johnson. Bradford, ON: Demeter Press, 2013. How All Politics Became Reproductive Politics: From Welfare Reform to Foreclosure to Trump. By Laura Briggs. Oakland: University of California Press, 2017. Birthing Justice: Black Women, Pregnancy, and Childbirth. Edited by Julia Oparah and Alicia Bonaparte. New York: Routledge, 2016. making black (male) pain visible through grief-stricken black motherhood. Castile said, My son loved this state. He had one tattoo on his body and it was of the twin cities, the state of Minnesota with “TC” on it. My son loved this city, and this city killed my son and the murderer gets away.... We’re not evolving as a civilization, we’re devolving, we have taken steps forward, people have died for us to have these rights and now we’re devolving, we’re going back to 1969.3 Her emotional plea reveals the political currency of black maternal suffering, one of the few spaces in which black pain is readily culturally visible. Indeed, there has been intensified scholarly and popular interest in representing black motherhood as both a site constituted by grief and expected loss and as a political position made visible (only) because of its proximity to death. It is certainly the case that a cultural inattention to motherhood has been replaced by an intense investment in representing at least some aspects of “the nature and meaning of motherhood” and 3. “Philando Castile’s Mother Reacts to Verdict,” Washington Post video on YouTube, posted on June 16, 2017, https://www.youtube.com/watch?v=RJsD4cCpUA. Jennifer C. Nash 701 in representing certain mothers—particularly black mothers—as symbols of trauma and injury, of pain that can be mobilized for “legitimate” political ends and social change. If, as O’Reilly suggests, maternal theory is now a distinct field, it has been fundamentally shaped by the intellectual and political labor of black feminists—Dorothy Roberts, bell hooks, Alice Walker, Patricia Hill Collins, Hortense Spillers, and Audre Lorde—who have captured the myriad ways that black maternity is cast as pathological, excessive, and marked by aberrant performances of gender and heterosexuality that threaten both the nuclear family and the heterosexual state. Drawing on a varied archive from the Moynihan Report to cultural panics about “kids having kids,” from ongoing representations of black women’s “failure” to breastfeed as a public health crisis to the racialized underpinnings of birth control, black feminist theory... (shrink)

This chapter contains sections titled: The Moral Version of the Labor Theory of Value The Labor Theory of the Difference Principle Finding a Just Distribution Is the Difference Principle Biased? Answering Narveson and Cohen on Incentives.

Revolutionary violence stems from the conatus of survival, from the appetite for life and joy rather than from the desire to destroy and the hubristic pretension to punish. It is an incursion of one's desire to affirm life and annihilate pain. Following Laruelle's methodology of nonstandard philosophy, I conclude that revolutionary violence is the product of an intensive expansion of life. Pure violence, conceived in non-philosophical terms, is a pre-lingual, presubjective force affected by the “lived,; analogous to Badiou's (...) void and it is radically revolutionary. It is fundamentally different from Benjamin's lawmaking “divine violence; and its appropriations by Žižek. Revolutionary experience is inevitably translated into language. What preserves the revolutionary substance in a post-revolution political discourse is that it is constantly checked by the sense of fidelity to the experience of the revolutionary event. Agamben, Benjamin, Schmidt and Žižek are discussed from an essentially non-philosophical stance, informed by Laruelle's theory that has been supplemented in some aspects by Badiou's concept of the pre-lingual event. (shrink)

Recent brain imaging studies using functional magnetic resonance imaging (fMRI) have implicated insula and anterior cingulate cortices in the empathic response to another’s pain. However, virtually nothing is known about the impact of the voluntary generation of compassion on this network. To investigate these questions we assessed brain activity using fMRI while novice and expert meditation practitioners generated a loving-kindness-compassion meditation state. To probe affective reactivity, we presented emotional and neutral sounds during the meditation and comparison periods. Our main (...) hypothesis was that the concern for others cultivated during this form of meditation enhances affective processing, in particular in response to sounds of distress, and that this response to emotional sounds is modulated by the degree of meditation training. The presentation of the emotional sounds was associated with increased pupil diameter and activation of limbic regions (insula and cingulate cortices) during meditation (versus rest). During meditation, activation in insula was greater during presentation of negative sounds than positive or neutral sounds in expert than it was in novice meditators. The strength of activation in insula was also associated with self-reported intensity of the meditation for both groups. These results support the role of the limbic circuitry in emotion sharing. The comparison between meditation vs. rest states between experts and novices also showed increased activation in amygdala, right temporo-parietal junction (TPJ), and right posterior superior temporal sulcus (pSTS) in response to all sounds, suggesting, greater detection of the emotional sounds, and enhanced mentation in response to emotional human vocalizations for experts than novices during meditation. Together these data indicate that the mental expertise to cultivate positive emotion alters the activation of circuitries previously linked to empathy and theory of mind in response to emotional stimuli.. (shrink)

The scientific investigation of consciousness generates new findings at a rapid pace. We argue that we need a novel theoretical framework, which we call the ALARM theory of consciousness, in order to account for all central observations. According to this theory, we need to distinguish two levels of consciousness, namely basic arousal and general alertness. Basic arousal functions as a specific alarm system, keeping a biological organism alive under sudden intense threats, and general alertness enables flexible learning and (...) behavioural strategies. This two-level theory of consciousness helps us to account for (i) recent discoveries of subcortical brain activities with a central role of thalamic processes, (ii) observations of differences in the behavioural repertoire of non-human animals indicating two types of conscious experiences. Furthermore, the framework enables us (iii) to unify the neural evidence for the relevance of subcortical processes, on the one hand, and of cortico-cortical loops, on the other, and finally (iv) to clarify the evolutionary and actual functional role of conscious experiences. (shrink)

What constitutes a “good” life—not necessarily a morally good life, but a life that is good for the person who lived it? In response to this question of “well-being," philosophers have offered three significant answers: A good life is one in which a person can satisfy their desires (“Desire-Satisfaction” or “Preferentism”), one that includes certain good features (“Objectivism”), or one in which pleasurable states dominate or outweigh painful ones (“Hedonism”). To adjudicate among these competing theories, moral philosophers traditionally gather data (...) from thought experiments and intuition. In this chapter, we supplement that traditional approach with a pair of experimental studies that examine whether the three theories reflect laypeople’s intuitions about well-being. The empirical studies yield two primary findings. First, they provide evidence for lay "well-being pluralism": laypeople treat desire satisfaction, positive objective conditions, and happiness as all constitutive of well-being. Second, the studies provide evidence of "hedonic dominance": laypeople evaluate an individual’s happiness as more important to an individual’s overall well-being than desire satisfaction or objective conditions. (shrink)

The Nyãya philosophy is primarily concerned with the conditions of valid thought and the means of acquiring true knowledge of objects. Its ultimate end, like that of the other systems of Indian philosophy, is liberation-a state of pure existence- which is free from both pleasure and pain. For the attainment of this liberation, a true knowledge of objects is the surest means. Hence the theory of knowledge is the very foundation of the Nyãya system. The Nyãya Theory (...) of Knowledge is the first systematic, critical and comparative treatment of the Nyãya epistemology. It reveals how, as a thorough-going realistic view of the universe, the Nyãya philosophy supplies an important Eastern parallel to the triumphant modern Realism of the West, and contains anticipations of as well as possible alternatives to many contemporary realistic theories. This book is important as much for the correct understanding of ancient Indian philosophy, as for the evaluation of modern Western philosophy. (shrink)

Imagine that Socrates gets a cavity treatment. The drilling is painful, but he also knows that it is best to get it done and so he stays. Callicles is not so smart. Once the dentist starts drilling, Callicles takes off. I argue that this scenario presents a puzzle that interpreters have missed, namely: why does Socrates have an aversion to pain? To us, this might not be puzzling at all. Socrates, however, believes that we have an aversion only to (...) bad things and that pain is not in fact bad. If Socrates knows that pain is not bad, why does he still feel aversive pain from drilling? I argue that the Protagoras and Hippias Major suggest that pain immediately appears to be bad to us. So even though pain is not in fact bad, it appears and feels that way, and thus even Socrates has an aversion to it. Pain is a felt evaluation. My interpretation contributes to the debates in the literature in two ways. First, it fills an explanatory gap. Interpreters have acknowledged that a Socratic theory of motivation has room for pain aversions as “itches,” but they leave unexplained why we have an aversion to pain, i.e., why those itches itch. Second, I offer an alternative account of Socratic motivation by proposing that pain aversions can motivate some of our actions. (shrink)

Most modern writers accept that a privation theory of evil should explicitly account for the evil of pain. But pains are quintessentially real. The evil of pain does not seem to lie in an absence of good. Though many directly take on the challenges this raises, the metaphysics and axiology of their answers is often obscure. In this paper I try to straighten things out. By clarifying and categorizing the possible types of privation views, I explore the (...) ways in which privationists about evil are—or should or could be—privationists about pain’s evil. (shrink)

This chapter defends an axiological theory of pain according to which pains are bodily episodes that are bad in some way. Section 1 introduces two standard assumptions about pain that the axiological theory constitutively rejects: (i) that pains are essentially tied to consciousness and (ii) that pains are not essentially tied to badness. Section 2 presents the axiological theory by contrast to these and provides a preliminary defense of it. Section 3 introduces the paradox of (...) pain and argues that since the axiological theory takes the location of pain at face value, it needs to grapple with the privacy, self-intimacy and incorrigibility of pain. Sections 4, 5 and 6 explain how the axiological theory may deal with each of these. (shrink)

This dissertation is devoted to empirically contrasting the Suppositional Theory of conditionals, which holds that indicative conditionals serve the purpose of engaging in hypothetical thought, and Inferentialism, which holds that indicative conditionals express reason relations. Throughout a series of experiments, probabilistic and truth-conditional variants of Inferentialism are investigated using new stimulus materials, which manipulate previously overlooked relevance conditions. These studies are some of the first published studies to directly investigate the central claims of Inferentialism empirically. In contrast, the Suppositional (...) Theory of conditionals has an impressive track record through more than a decade of intensive testing. The evidence for the Suppositional Theory encompasses three sources. Firstly, direct investigations of the probability of indicative conditionals, which substantiate “the Equation” (P(if A, then C) = P(C|A)). Secondly, the pattern of results known as “the defective truth table” effect, which corroborates the de Finetti truth table. And thirdly, indirect evidence from the uncertain and-to-if inference task. Through four studies each of these sources of evidence are scrutinized anew under the application of novel stimulus materials that factorially combine all permutations of prior and relevance levels of two conjoined sentences. The results indicate that the Equation only holds under positive relevance (P(C|A) – P(C|¬A) > 0) for indicative conditionals. In the case of irrelevance (P(C|A) – P(C|¬A) = 0), or negative relevance (P(C|A) – P(C|¬A) < 0), the strong relationship between P(if A, then C) and P(C|A) is disrupted. This finding suggests that participants tend to view natural language conditionals as defective under irrelevance and negative relevance (Chapter 2). Furthermore, most of the participants turn out only to be probabilistically coherent above chance levels for the uncertain and-to-if inference in the positive relevance condition, when applying the Equation (Chapter 3). Finally, the results on the truth table task indicate that the de Finetti truth table is at most descriptive for about a third of the participants (Chapter 4). Conversely, strong evidence for a probabilistic implementation of Inferentialism could be obtained from assessments of P(if A, then C) across relevance levels (Chapter 2) and the participants’ performance on the uncertain-and-to-if inference task (Chapter 3). Yet the results from the truth table task suggest that these findings could not be extended to truth-conditional Inferentialism (Chapter 4). On the contrary, strong dissociations could be found between the presence of an effect of the reason relation reading on the probability and acceptability evaluations of indicative conditionals (and connate sentences), and the lack of an effect of the reason relation reading on the truth evaluation of the same sentences. A bird’s eye view on these surprising results is taken in the final chapter and it is discussed which perspectives these results open up for future research. (shrink)

Pain, pain talk and pain ascriptions seem to be universal features of human experience and to have little to do with politics. It is often assumed that pain is always bad, a sign of a malfunctioning machine, that pain talk describes this malfunction and that the humane thing to do is to seek to ameliorate or excise pain. I argue that this viewpoint is one-sided at best and imperialistic at worst. In section I, I (...) outline what I term the ‘prima facie model of pain’ and adumbrate later Wittgenstein’s criticism of it. In section II, I marshal ethnographic evidence that deepens Wittgenstein’s reimagining of pain and acknowledgment. In section III, I link this to ‘progressive’ politics and its normative understanding of the self. Finally, in section IV, I turn to Martin Luther King’s writing and discuss a use of pain that undermines this normative conception of the self and aligns with Wittgenstein’s account. (shrink)

Surgical patients under anesthesia can wake up unpredictably and be exposed to intense, traumatic pain. Current medical techniques cannot maintain depth of anesthesia at a perfectly stable and safe level; the depth of unconsciousness may change from moment to moment. Without an effective consciousness monitor anesthesiologists may not be able to adjust dosages in time to protect patients from pain. An estimated 40,000 to 200,000 midoperative awakenings may occur in the United States annually. E. R. John and coauthors (...) present the scientific basis of a practical ''consciousness monitor'' in two articles. One article is empirical and shows widespread and consistent electrical field changes across subjects and anesthetic agents as soon as consciousness is lost; these changes reverse when consciousness is regained afterward. These findings form the basis of a surgical consciousness monitor that recently received approval from the U.S. Food and Drug Administration. This may be the first practical application of research on the brain basis of consciousness. The other John article suggests theoretical explanations at three levels, a neurophysiological account of anesthesia, a neural dynamic account of conscious and unconscious states, and an integrative field theory. Of these, the neurophysiology is the best understood. Neural dynamics is evolving rapidly, with several alternative points of view. The field theory sketched here is the most novel and controversial. (shrink)

The Liberal Theory of Science, best articulated by Michael Polanyi, held that science advanced when autonomous scientists followed their best hunches and spontaneously coordinated their efforts as a result of their mutual dependence, in a setting devoted to scientific truth with a tradition supporting it, in a quest for a comprehensive understanding of reality. Pure science was for him an international community with the characteristics of the Republic of Letters of the past. This image of science was an idealization (...) at the time he wrote, and became less applicable as science grew and became more dependent on funding decisions, and therefore also on peer review, which compromised autonomy. From the painful attempts to make sense of these changes, particularly in the writings of John Ziman, we can reconstruct the effects of these changes: initially from a focus on discovery to the production of “reliable knowledge” for sponsors. This change made science more useful, but at a price, and made the Liberal Theory of Science increasingly irrelevant to actual science, but still useful as a basis for critique. (shrink)

Traditional hedonists like Epicurus, Bentham and Sidgwick were quantitative hedonists who assumed that pleasures and pains differ, not just from each other, but also from other pleasures and pains only in such quantitatively measurable ways as intensity, duration, and nearness or remoteness in time. They also differ with respect to their sources or causes. John Stuart Mill introduced an interesting and important complication into the modern theory of hedonism by insisting that pleasures also differ qualitatively as well as quantitatively. (...) This article thoroughly and critically examines Mill’s attempt to explain what qualitative differences might mean, and it proposes, defends, and extends a plausible theory of qualitative differences. (shrink)

Chapter 1 First Person Access to Mental States. Mind Science and Subjective Qualities -/- Abstract. The philosophy of mind as we know it today starts with Ryle. What defines and at the same time differentiates it from the previous tradition of study on mind is the persuasion that any rigorous approach to mental phenomena must conform to the criteria of scientificity applied by the natural sciences, i.e. its investigations and results must be intersubjectively and publicly controllable. In Ryle’s view, philosophy (...) of mind needs to adopt an antimentalist stance to achieve this aim. Antimentalism not only definitively rejects the idea that mind is a substance separated from the body, it also denies that mental phenomena radically differ from physical phenomena by virtue of several unique features. Most problematically, mental phenomena have a conscious character (mental states are related to specific qualitative feelings) and are accessible only to the first-person (only the subject knows directly what s/he is experiencing inside his/her mind). Ryle takes a strong stance on antimentalism going so far as to maintain that an approach to mind which aims to meet the criteria of scientificity set by the natural sciences must avoid any reference to internal, unobservable mental states. In his view (which is considered a specifically philosophical version of psychological behaviorism and also addresses questions put forward in psychological research), mental states can be redescribed in terms of behavioral dispositions. In this chapter, we address the historical roots of the antimentalist view and analyze its relation to the later tradition of research on mind. We show that, compared to the antimentalist stance, functionalism and cognitivism take a step back when they maintain that direct reference to mental states is necessary since mental states cause and therefore explain human behavior. This step backwards is often interpreted as a return to mentalism. However, this is only partially true. Indeed, we suggest that these later traditions retain one important element of Ryle’s antimentalism, i.e. the idea that mental states must be uniquely identified using external and publicly observable criteria, while excluding any reference to introspection and those qualitative dimensions of a mental state, which are accessible only to the first-person. According to the perspective we put forward, this epistemological stance has continued to influence contemporary research on mind and current philosophical and psychological theories which both tend to exclude the subjective qualities of human experience from their accounts of how the mind works. The issue we raise here is whether this is legitimate or whether subjective qualities do play a role with respect to the way our mind works. The conclusion of this chapter anticipates the argument the book makes in in favor of this latter position, starting from a particular angle, i.e. the problem of how we categorize concepts related to our internal states. -/- Chapter 2 The Misleading Aspects of the Mind/Computer Analogy. The Grounding Problem and the Thorny Issue of Propriosensitive Information -/- Abstract. After the crisis of behaviorism, cognitivism and functionalism became the predominant models in the field of psychology and of philosophy, respectively. Their success is mainly due to the new key they use for interpreting mental processes: the mind/computer analogy. On the basis of this analogy, mental operations are seen as cognitive processes based on computations, i.e. on manipulations of abstract symbols which are in turn understood as informational unities (representations). This chapter identifies two main problems with this model. The first is how these symbols can relate to and communicate with perception and thus allow us to identify and classify what we perceive through the senses. Here we limit ourselves to presenting this issue in relation to the classical symbol grounding problem originally put forward by Harnad on the basis of Searle’s Chinese room argument. An attempt to address the problem raised here will be made in chap. 3. The second point we discuss in relation to the mind/computer analogy concerns the idea of information it fosters. Indeed, following this analogy, information is something available in the external world which can be captured by the senses and transmitted to the central system without being influenced or modified by the procedures of transmission. This perspective does not take into account that – unlike computers – in living beings information is acquired by means of the body. As Ulric Neisser has already pointed out, the body is itself an informational source that provides us with additional sensory experience that influences (modifies or complements) the information extracted from the external world by the senses. To develop this line of analysis and to determine exactly what information is provided by the body and how this might influence cognition, we examine Sherrington’s and Gibson’s positions. Moving on from their views, we qualify bodily information in terms of ‘proprioception’. We use ‘proprioception’ in a broad sense to describe any kind of experience we have of our internal states (including postural information as well as sensations related to the general state of the body and its parts). Following Damasio’s and Craig’s studies, we further elaborate this position, arguing that living beings are equipped with an internal propriosensitive monitoring system which maps all the changes that constantly occur in our body and that give us perceptual (‘proprioceptive’ or propriosensitive) information about what happens inside us. Moreover, relying on Goldie’s and Ratcliffe’s view, we show that emotional information can also be considered as a form of ‘proprioception’ which contributes to determining everything we perceive. This analysis leads us to the second main thesis of this book: ‘proprioception’ is a form of internal perception and it is an essential component of the sensory information we can access and use for all cognitive purposes. -/- Chapter 3 Semantic Competence from the Inside: Conceptual Architecture and Composition -/- Abstract. Concepts are essential constituents of thought: they are the instruments we use to categorize our experience, i.e. to classify things and group them together in homogeneous sets. Here we define concepts as the internal mental information (representations) that allows us, among other things, to master words in natural language. By analyzing the way in which individuals master word meanings we explore a number of hypotheses regarding the nature of concepts. Following Diego Marconi’s research, we differentiate between two kind of abilities that underpin lexical competence – so-called ‘referential’ and ‘inferential competence’ – and we suggest that, in order to support these abilities, concepts must also include two corresponding kinds of information, i.e. inferential and referential information. We point out that the most widely used and acknowledged theories of concepts do not make this distinction, instead broadly characterizing the information used for categorization in terms of propositionally described feature lists. However, we show that while feature lists can explain inferential competence, they do not account for referential competence. To address the issue of referential competence we examine Ray Jackendoff’s hypothesis that to account for the possibility of linking perceptual and conceptual information we need to assume the existence of a (visual) representation that encodes the geometric and topological properties of objects and bridges the gap between the percept and the concept. Furthermore, we analyze the extension of this work by Jesse Prinz who introduced the notion of a proxytype, a perceptual representation of a class of objects that incorporates structural and parametric information related to their appearance. However, as we point out, proxytypes can only explain the relationship between perception and concepts with respect to instances that can be perceived through the senses and that belong to the same class by virtue of their physical similarity. We suggest that this notion be extended to include larger conceptual classes. To accomplish this, we further develop Mark Johnson, George Lakoff and Jean Mandler’s idea of a schematic image and argue that conceptual representations include a perceptual schema. Perceptual schemata are non-linguistic, structured experiential gestalts (patterns or maps) that make use of information taken from all sensory modalities, including body perception. They accomplish a quasi-conceptual function: they allow us to recognize and to classify different instances. In this work, we hypothesize that perceptual schemata are an essential component of concepts, but not identical to them. Instead, we suggest that concepts include both perceptual and propositional information with perceptual schemata providing the ‘perceptual core concept’ that grounds related propositional information. -/- Chapter 4 In the Beginning There Were Categories. The Bodily Origin of Prelinguistic Categorical Organization: The Example of Folkbiological Taxonomies -/- Abstract. Studies of categorization in psychology and the cognitive sciences have made use of the notions of ‘category’ and ‘concept’ without precisely defining what is meant by either; in fact, often these terms have been used as synonyms, making it difficult to address specific issues related to conceptual development. This chapter begins by discussing the definitions of, as well as the distinctions between, ‘categories’ and ‘concepts’ in the classical philosophical tradition (Aristotle, Kant and Husserl). We introduce our view of categories with reference to Husserl. Categorization is defined as the way in which our experience is originally (pre-linguistically) organized in a passive and fully unconscious manner on the basis of universal structuring principles. Conceptualization is explained as a later process in which the earlier categorical macro-classes are further subdivided into more specific and detailed sets; this later process also relies on linguistic learning and exposure to culture. On the basis of Ray Jackendoff, Jean Mandler, George Lakoff and Mark Johnson’s work, we hypothesize that categorization is a two-step process that begins with the formation of homogeneous sets of entities partitioned into regions that describe the ontological boundaries of the objects that humans perceive (categories) and continues at a later stage with the development of more specific classifications (concepts). In this chapter, we mainly address three related issues: Why should we assume that there is categorical organization which precedes the development of a conceptual system? How do categories and concepts relate to each other? Shall we hypothesize that categories are innate or that they are formed before concepts on the basis of information and organizational structure available at a very early developmental stage? We show that categorical partitions are necessary for categorization and, following Mandler, that the general categories we form at an early age do not match our adult superordinate concepts. As for the third issue, we argue that there might be no need to assume that categories are innately present in the human mind, since their formation can be explained – at least in certain cases – by basic mechanisms that work on body (propriosensitive) information. This hypothesis will not be discussed in general, but in relation to a particularly relevant example of categorical partition, i.e. the folk-biological dichotomy between ANIMATE/INANIMATE. This is compared with other dichotomies that derive from it, but are not directly categorical such as LIVING/NON-LIVING and BIOLOGICAL/NON-BIOLOGICAL. -/- Chapter 5 Internal States: From Headache to Anger. Conceptualization and Semantic Mastery -/- Abstract. Here we ask if we can also apply the distinction between referential and inferential competence we introduced in Chapter 3 to words that do not refer to things that are perceived using the external senses, especially to words/concepts that denote bodily experiences (such as pain, thirst, hunger, etc.) or emotions. We introduce and discuss the hypothesis that – even though such words/concepts do not refer to intersubjectively identifiable entities in the external world – they do have a kind of referent that can be accessed via direct perception, more specifically ‘proprioception’, as we have defined it in terms of all propriosensitive information we can consciously access. In the first part of the chapter, we specifically consider terms denoting bodily experiences such as ‘pain’ or ‘hunger’ and argue that their referents are identified and classified from a first-personal point of view on the basis of four main characteristics: their specific intensity, their localization in the body, their co-occurrence with other signals and above all their specific qualitative sensations. Emotions are addressed in the second part of the chapter. We suggest that there is a continuity between bodily experiences and emotions. In particular, we argue for a perceptual theory of emotions in line with that proposed by James and Lange at the end of the 19th century and developed more recently by authors such as Damasio (see also chap. 2§5, §6). The hypothesis we put forward is that the referential information that supports the categorization of emotions and therefore also our mastery of terms referring to emotions consists in the perception (i.e. the ‘proprioception’) of those bodily states and changes in bodily states which constitute our emotional experience. In the context of this discussion we examine some objections to this line of reasoning that arise from a cognitivist perspective and following authors such as Oatley, Johnson-Laird and Frijda, we distinguish between basic emotions that can be identified and classified solely on the basis on how they feel and complex emotions whose identification and classification additionally depends on cognitive factors. To describe how emotions are identified and classified on the basis of how they feel, we rely on Marcel and Lambie’s distinction between an ‘emotion state’ and an ‘emotion experience’. Both notions indicate kinds of feelings that we consciously experience. However, they describe first-order and second order emotion awareness respectively. The emotion state is the feeling we have of the bodily states and changes that occur when we are experiencing an emotion, while the emotion experience is the fully developed and integrated emotion we both experience and are, with reflection, aware of experiencing. On the basis of this differentiation, we also show that the same characteristics that aid in the identification and classification of bodily experiences (specific qualitative sensations; somatic localization; specific intensity; presence/absence of specific concomitant sensations) can also be used for the identification and classification of emotions – at least basic emotions. In the last two sections of the chapter we present some clinical evidence on the semantic competence of people who suffer from Alexithymia and Autism Spectrum Disorder which supports the conclusions of our preceding analyses. -/- Chapter 6 The ‘Proprioceptive’ Component of Abstract Concepts -/- Abstract. In this chapter, we address the issue of whether the mastery of abstract words requires only inferential knowledge and thus, if the concepts that support the mastery of abstract words include only linguistic information. We start by differentiating the notions of ‘abstract’ and ‘general’ which are often erroneously confused. We then identify a strict definition of abstract, as contrasted with ‘concrete’, that applies to words or concepts whose referent cannot be experienced by the senses. We argue that abstract words/concepts would be better described as theoretical, because they are usually conceived as structured sets of inferential knowledge expressed linguistically; that is, as small theories. Pointing out parallels with Carnap’s analysis of this issue in philosophy of science, we hypothesize that words/concepts denoting non-observable entities are not all ‘equally theoretical’, because their link to sensory experience can be stronger or weaker. We revive the distinction, inspired by Quine, between theoretical and intertheoretical concepts/words. This distinction relies on the fact that the former – unlike the latter – retains a strong, although indirect, connection with perception. In Quine’s discussion, perception is understood uniquely in terms of observability, i.e. of external sensory experience. Here we argue, however, that bodily, ‘proprioceptive’ (i.e. propriosensitive) experience can also serve to referentially ground theoretical (i.e. abstract) concepts/words. We frame this issue using the example of the theoretical concept ‘freedom’ and Lakoff’s hypothesis that this concept is developed on the basis of bodily information. We contrast this with the example of ‘democracy’ which more closely resembles an intertheoretical concept/word. Furthermore, we show that one of the classical views put forward in psycholinguistic research to explain how abstract concepts are mentally represented – i.e. Paivio’s Dual Coding Theory – points in the same direction as our analysis. The same is true of Barsalou’s work suggesting that we use internal information to understand at least some abstract words. To sustain this position, we put forward two lines of evidence: the first comes from psycholinguistic studies while the second examines deficits of semantic competence exhibited by people with Autism Spectrum Disorder. On the basis of our analysis, we put forward a classification that distinguishes between different kinds of concreteness and different degrees of abstraction: concepts/words referring to body experiences and basic emotions are described as analogous to concrete concepts/words because they are grounded in perceptual (i.e. propriosensitive) experience, while abstract concepts/words are considered more or less abstract depending on whether they are intratheoretical (and rely entirely on inferential information) or theoretical (and are partially grounded in perceptual – or more often in propriosensitive perceptual – information). In the last section of the chapter we consider two scales that have been used in psycholinguistic research to measure the degree of concreteness vs. abstractness of words and we show that – used conjointly – they can provide a measure of the internal vs. external grounding of specific words. (shrink)

The nineteenth century saw the development of reductive views of attention. The German philosopher and psychologist Carl Stumpf (1848-1936) proposed an original reductive view according to which attention is nothing but interest and interest itself is a positive feeling. Stumpf’s view was developed by Francis Bradley (1846-1924), George Frederick Stout (1860-1944), and Josiah Royce (1855-1916), but has been overlooked in the recent literature. In this paper, I will expound Stumpf’s view of attention, trace it back to its Aristotelian roots and (...) defend the version offered by Stout and Royce. In this version a new kind of feeling, feelings of interest, and value, intellectual value, take centre stage. (shrink)

Various prominent theories of pain assume that it is pain’s biological function to inform organisms about damage to their bodies. I argue that this is a mistake. First, there is no biological evidence to support the notion that pain was originally selected for its informative capacities, nor that it currently contributes to the fitness of organisms in this specific capacity. Second, neurological evidence indicates that modulating mechanisms in the nociceptive system systematically prevent pain from serving a (...) primarily informative role. These considerations threaten to undermine standard perceptual and representational accounts of pain. (shrink)

Augustine’s privation theory of evil maintains that something is evil in virtue of a privation, a lack of something which ought to be present in a particular nature. While it is not evil for a human to lack wings, it is indeed evil for a human to lack rationality according to the end of a rational nature. Much of the literature on the privation theory focuses on whether it can successfully defend against counterexamples of positive evils, such as (...) pain. This focus of the discussion is not surprising, given that the privation theory is a theory about the nature of evil. But it is also a theory that protects venerable theological concerns, namely, that God is the good creator of everything, and that everything is good. It is the purpose of this article to further this discussion on both fronts. I argue that the counterexample of pain still defeats the privation theory despite the most recent defense. What is more, I suggest, this is not theologically disastrous. The individual who rejects the privation theory is not obligated to reject the theological theses which motivate it. To show how a rejection of the privation theory is a live option, I offer an alternative view of evil that also maintains these theological theses and encompasses both privative and positive evils. (shrink)

In a recent article in Philosophy of Science, De Vignemont and Jacob defend the view that empathy involves interpersonal similarity between an empathizer and a target person with respect to internal affective states. Focusing on empathy for pain, they propose a theory of the neural substrate of pain empathy. We point out several flaws in their interpretation of the data and argue that currently available data do not differentiate between De Vignemont and Jacob’s model and alternative models. (...) Finally, we offer some suggestions about how this might be achieved in future research. (shrink)

forthcoming in The Journal of Philosophy.

This is a slightly more polished version of a presentation I wrote for the Author-Meets-Critics session on Colin's book at the Eastern APA session on Jan 4, 2017, in Baltimore. I’ve decided to post this commentary online pretty much as is -- I am afraid I don't have time to prepare a version suitable for publication. I hope the reader will find it helpful. At any rate, please treat this piece as a rough draft originally intended to be delivered to (...) a live audience. Although my commentary is mostly critical, I admire Colin's book for its originality, breadth, and depth. It stimulated my thought like no other books in recent years. (shrink)

What follows raises objections to some arguments that claimthat a principle of applicability of ordinary pain talkconstrains developments in the pain sciences. A more apt pictureof lay use of pain language shows its non-theoretic character.Since instrumentalism and eliminativism are philosophical viewsabout the status of theories of pain, neither is a threatto clinical use of standard pain lingo. Perfected pain theoryis likely to enhance and improve pain language in clinicalsettings, should such theory find (...) its way into popular ideasand talk of pain. (shrink)

We agree with Smrdu that pain cannot be reduced to a neurophysiological event and we welcome a (micro-)phenomenological investigation of pain experience. However, we do not think such an investigation can provide sufficient support for either a 5E theory of pain, or (just) an enactive one. A 5E theory of pain would require a clarification of how the 5Es fit together. An enactive account would require a “circulation” between first- and third-person data.

Transposing differences -- Meta(l)morphoses: women, aliens, and machines -- Animals and other anomalies -- The cosmic buzz of insects -- Matter-realist feminism -- Intensive genre and the demise of gender -- Postsecular paradoxes -- Against methodological nationalism -- Nomadic European citizenship -- Powers of affirmation -- Sustainable ethics and the body in pain -- Forensic futures -- A secular prayer.

While extensive scholarship has been dedicated to the emotional experiences of transplant patients, little is known about the emotional experiences of transplant co‐ordinators. Semi‐structured face‐to‐face interviews conducted with ten transplant co‐ordinators who have worked for more than 20 years in this job. The transplant co‐ordinators spoke of negative feelings and moral distress with regard to futile care of deceased donor family members as well as of living donors. Transplant co‐ordinators experience intense negative feelings, emotional pain, and moral distress on (...) a daily basis. Transplant co‐ordinators play a pivotal role in the process of obtaining consent for live or dead donation of organ; however, their well‐being and job satisfaction are impaired by contradictions between their moral values and the tasks they are instructed to perform. The study exposes the silent emotional suffering of transplant co‐ordinators; main findings show that the transplant co‐ordinators are torn between contradictory expectations and a gap between values and praxis. It is recommended to offer them training and support for the sake of their retention. (shrink)

During the COVID‐19 pandemic, national triage guidelines were developed to address the anticipated shortage of life‐saving resources, should ICU capacities be overloaded. Rationing and triage imply that in addition to individual patient interests, interests of population health have to be integrated. The transfer of theoretical and empirical knowledge into feasible and useful practice models and their implementation in clinical settings need to be improved. This paper analyzes how triage protocols could translate abstract theories of distributive justice into concrete material and (...) procedural criteria for rationing intensive care resources during a pandemic. We reconstruct the development and implementation of a rationing protocol at a German university hospital: describing the ethical challenge of triage, clarifying the aspirational norms, and summarizing specific norms of fair triage and allocation for developing an institutional policy and practice model and implementing it. We reflect on how critical topics are seen by clinicians and what helped manage the perceived burdens of the triage dilemma. We analyze what can be learned from this debate regarding the difficult issues around triage protocols and their potential implementation into clinical settings. Analyzing the ought‐to‐is gap of triage, integrating abstract ethical principles into practical concepts, and evaluating those should clarify the benefits and risks of different allocation options. We seek to inform debates on triage concepts and policies to ensure the best possible treatment and fair allocation of resources as well as to help protect patients and professionals in worst‐case scenarios. (shrink)

The main goal of this paper is to present a theory of the most salient aspect of the phenomenal character of pain – namely, the painfulness of pain or its negative affective quality. This task involves developing an account of the evaluative structure of pain, according to which painfulness is constituted by a frustrated conative attitude that is directed towards the bodily condition the obtaining of which the pain represents. The argument for the proposed Attitudinal-Representational (...) Theory of Pain proceeds by presenting an explanatory challenge that concerns crucial aspects of the reason-giving force of pain, and showing that, unlike extant theories of pain, it successfully accounts for them. (shrink)

It is widely thought that functionalism and the qualia theory are better positioned to accommodate the ‘affective’ aspect of pain phenomenology than representationalism. In this paper, we attempt to overturn this opinion by raising problems for both functionalism and the qualia theory on this score. With regard to functionalism, we argue that it gets the order of explanation wrong: pain experience gives rise to the effects it does because it hurts, and not the other way around. (...) With regard to the qualia theory, we argue that it fails to capture the sense in which pain 's affective phenomenology rationalises various bodily-directed beliefs, desires, and behaviours. Representationalism, in contrast, escapes both of these problems: it gets the order of explanation right and it explains how pain 's affective phenomenology can rationalise bodily-directed beliefs, desires, and behaviours. For this reason, we argue that representationalism has a significant advantage in the debates about pain 's affective phenomenology. We end the paper by examining objections, including the question of what representationalists should say about so-called ‘disassociation cases’, such as pain asymbolia. (shrink)