Collects several works covering a variety of political subjects, including independence from Britain for the American colonies, service in the Continental army, ...

Shaun Gallagher [2019] argues for a ‘non-classical’ conception of nature, which includes subjects as irreducible constituents. As such, first-person phenomenology can be naturalised and at the same time resist reduction to the third-person. In the first part of this paper, I raise three concerns for the claim that nature is irreducibly subject-involving. In the second part of the paper, I suggest that embracing a process ontology could help strengthen Gallagher’s proposal.

Includes the complete texts of Common Sense; Rights of Man, Part the Second; The Age of Reason (part one); Four Letters on Interesting Subjects , published anonymously and just discovered to be Paine’s work; and Letter to the Abbé Raynal, Paine’s first examination of world events; as well as selections from The American Crises In 1776, America was a hotbed of enlightenment and revolution. Thomas Paine not only spurred his fellow Americans to action but soon came to symbolize the spirit (...) of the Revolution. His elegantly persuasive pieces spoke to the hearts and minds of those fighting for freedom. He was later outlawed in Britain, jailed in France, and finally labeled an atheist upon his return to America. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Protecting Human Research SubjectsThe Office for Protection from Research RisksJoan Paine Porter (bio)The office for Protection from Research Risks (OPRR), located within the National Institutes of Health, has two divisions: Human Subject Protections and Animal Welfare. This article will address the overall responsibilities and current projects relating to human subject protections.OPRR implements the Department of Health and Human Services' (HHS) regulations for the protection of human subjects (45 CFR (...) 46 (1991)). These regulations fulfill the responsibilities set forth in the Public Health Service (PHS) Act with regard to institutional review boards (IRB) and other protections for human subjects involved in biomedical and behavioral research conducted or supported by HHS. The PHS Act also mandates a program to clarify ethical issues in biomedical research involving human subjects and to address violations of the rights of human subjects of research (P.L. 99-158 (1985)).OPRR staff negotiate assurances of compliance with institutions conducting Federally-supported research involving human subjects. The assurances describe the policies and procedures each institution will follow to fulfill the requirements of the regulations, including specific IRB composition and functions.In addition, OPRR cosponsors with the Food and Drug Administration and awardee institutions a series of regional workshops that address human subject protections issues. These are attended by IRB members, institutional officials, research investigators, and others involved with human subject protections.Current ActivitiesNumerous activities are underway in OPRR. The following describes only a few of the initiatives and studies aimed at helping develop policies and procedures to protect human subjects of research."Points to Consider" DocumentsOPRR is currently working with the National Center for Human Genome Research (NCHGR) to develop a "points to consider" document for IRBs and others involved in large genetic pedigree studies. Many questions have emerged [End Page 279] on topics such as how subjects should be recruited, with whom information should be shared about others in the family, social risks of disclosure in employment and insurance, the circumstances and timing of informing subjects about study results, and involvement of children. OPRR and NCHGR hope to assemble a group this fall to review and refine the points that are now being developed jointly. A conference in South Carolina organized by the American Association for Advancement in the Sciences entitled "Project on the Ethical and Legal Implications of Genetic Testing," helped generate advice, and identified some of the more controversial issues in design and conduct of genetic research that involves large groups of family members.Another "points to consider" effort concerns enrollment of women and minorities in research. The PHS has established a policy that members of these groups must be included in research projects unless there are valid scientific justifications for their exclusion which can be made on a project by project basis (ADAMHA/NIH Policy 1990; NIH/ADAMHA Policy 1990). OPRR has commissioned several scholarly papers to help in developing "points to consider" for IRBs as they balance issues of equitable selection of subjects and protection of these selected individuals. Concerns about enrolling women of childbearing age in research that may be harmful to a fetus, and liability issues frequently dominate discussion in this area. The papers will address ethical, legal, and statistical aspects of enrollment of minorities and women as well as provide a description of various practices and roles of IRBs in addressing goals of fair selection of participants and appropriate protections.OPRR is also working with the PHS Panel on Women, Adolescents and Children to produce a document, also in the form of "points to consider" guidance, concerning enrollment of children who are wards of the state in HIV-related research. Subpart D of the regulations for the protection of human subjects (45 CFR 46) specifically addresses research involving children who are wards of the state, including the special protections that must be provided. State and local officials who have authority to enroll foster care children in research have indicated a desire to obtain advice in this area.The IRB GuidebookA major project that is now being completed under contract to the Poynter Center at Indiana University is the IRB Guidebook. It will revise and expand the current IRB Guidebook produced in the 1980s... (shrink)

This article examines the inherently ethical nature of resource allocation in policing. Decision-makers must make trade-offs between values such as efficiency vs. equity, individual vs. collective benefit, and adopt principles of distribution which allocate limited resources fairly. While resource allocation in healthcare has been the subject of extensive discussion in both practitioner and academic literature, ethical resource allocation in policing has received almost no attention. We first consider whether approaches used in healthcare settings would be suitable for policing. Whilst there (...) are some high-level similarities in the relevant ethical considerations and processes—such as aiming for efficient and equitable resource deployment—there are also fundamental differences between the two settings, which we argue necessitate a different approach. These differences include: (1) greater diversity and incommensurability of the benefits of policing, (2) more frequent non-linearity in returns on policing investment, (3) greater “ethical divisibility” (permissible scaling down) of programs in policing, (4) a requirement to assess “need” for policing resources at the collective (rather than individual) level, and (5) clearer primacy of equity considerations in policing. Having drawn out the implications of these differences, we sketch some tentative proposals for ethical resource allocation in policing. (shrink)

It was not until the nineteenth century that Western nations came to replace mutilation, corporal punishment, and banishment as the favored method of criminal punishment with the more humane concept of imprisonment. Even then, however, a convicted inmate was viewed as nothing more than a slave of the state, entitled only to the most basic of human rights and subject to the whim and peril of his jailor's desire. The shift to imprisonment gradually was accompanied by the additional humanitarian demand (...) that prisons avail their charges of some minimum standard of human decency and necessity, which, by the early part of the twentieth century, had come to encompass the provision of medical care. The courts later came to acknowledge this as a fundamental right grounded in the Eighth Amendment's proscription against cruel and unusual punishments.Although the scope of a prisoner's constitutional right to medical care has been the subject of much debate before the courts, the majority of cases have focused only on the circumstances under which the deprivation of care will amount to a violation of the rights guaranteed by the Eighth Amendment. (shrink)

It was not until the nineteenth century that Western nations came to replace mutilation, corporal punishment, and banishment as the favored method of criminal punishment with the more humane concept of imprisonment. Even then, however, a convicted inmate was viewed as nothing more than a slave of the state, entitled only to the most basic of human rights and subject to the whim and peril of his jailor's desire. The shift to imprisonment gradually was accompanied by the additional humanitarian demand (...) that prisons avail their charges of some minimum standard of human decency and necessity, which, by the early part of the twentieth century, had come to encompass the provision of medical care. The courts later came to acknowledge this as a fundamental right grounded in the Eighth Amendment's proscription against cruel and unusual punishments.Although the scope of a prisoner's constitutional right to medical care has been the subject of much debate before the courts, the majority of cases have focused only on the circumstances under which the deprivation of care will amount to a violation of the rights guaranteed by the Eighth Amendment. (shrink)

Resumo O fundamentalismo é um fenômeno relativamente recente, pelo menos como posição articulada e autoconsciente. O presente artigo apresenta, de início, uma reflexão sobre o surgimento do termo fundamentalismo, em breve resgate histórico. A seguir, identifica e analisa as características principais dessa atitude, tanto na sua configuração psicológica (subjetivismo fechado), como na sua teoria epistemológica implícita (fideísmo radical, fé ou submissão a uma autoridade religiosa como fonte exclusiva ou predominante de certeza epistemológica), na sua hermenêutica (liberalismo na interpretação de escrituras) (...) e na sua maneira de priorizar um ativismo radical, na perspectiva pragmática (tendência a medidas radicais, à militância e até ao terrorismo no prosseguimento efetivo dos seus fins). Aplicando essa análise, mostra que os debates atuais entre cristãos e "neoateus" parecem frequentemente fundamentalistas, mas não apenas do lado religioso da disputa. Talvez o nome de fundamentalista possa ser reivindicado por alguns que ficariam bem surpresos pela nova titulação. A última parte do artigo discute a religião "usada" e "abusada". Palavras-chave: Ateísmo; Fundamentalismo; Filosofia da religião.Fundamentalism is a relatively recent phenomenon, at least as an articulated and self-conscious position. The present article begins by reflecting on the origin of the term fundamentalism in a brief historical review. Then the principal characteristics of this attitude are identified and analyzed, both in its psychological configuration (a closed subjectivity), as well as in its implicit epistemological theory (radical fideism, faith or submission to a religiou authority as exclusive or predominant source of epistemological certitude), its hermeneutics (literalism in the interpretation of scriptures) and its manner of prioritizing radical activisim in its pragmatic perspective (tendency to radical means, to militancy and even terrorism in the effective persecution of its ends). Applying this analysis, current debates between Christians and "neo-atheists" appear frequently fundamentalist, but not only on the religious side of the dispute. Perhaps the name fundamentalist can be claimed even by some who would be quite surprised by the new christening. The last part of the article discusses "used" and "abused" religion. Key words : Atheism; fundamentalism; philosophy of religion. (shrink)

The paper aims to develop a phenomenology of pain on the basis of the insights introduced in Husserl’s phenomenology. First, I suggest that pain is given to intuition as an indubitable and a bodily localizable experience. Since these two characteristics are incompatible with each other, I argue that the experience of pain is paradoxical. Second, I contend that philosophy of pain provides six ways to resolve this paradox: semiological, causal, associationist, representational, perceptual, and phenomenological. Third, my (...) central goal is to develop the phenomenological resolution and to show that it culminates in the realization that the subject of pain is neither the disembodied consciousness nor the physiological body but the lived-body, conceived as the field of sensings. Fourth, I offer a phenomenological account of the structure of pain experience. I suggest that this structure could be characterized as the already appropriated body’s inner protest against its constitutive appropriation. (shrink)

Providing nursing care for people with dementia residing in long-term care facilities poses specific challenges regarding pain practices. With underlying communication barriers unique to dementia pathologies, this population is often unable to communicate verbal sentiments and descriptions of pain. In turn, nurses caring for older persons with dementia have difficulty assessing, managing and treating pain. Objectivity is an imperative factor in healthcare pain practices; however, it is difficult to objectively evaluate someone who cannot accurately communicate their (...) experience of pain. Therefore, the authors believe that subjectivity is also an essential part of evaluating the person with dementia's experience of pain. In this critical reflection, the authors explore objectivity and subjectivity in relation to pain practices for dementia in long-term care. A historical summary of pain is provided outlining the evolution of objectivity and subjectivity related to pain practices. The authors discuss the complexities of assessing and managing pain and offer a new perspective about the role of objectivity (and co-existence of subjectivity) for nurses treating pain in the older adults with dementia. (shrink)

Pain research is still dominated by biomedical perspectives and the need to articulate pain in ways other than those offered by evidence based medical models is pressing. Examining closely subjective experiences of pain, this book explores the way in which pain is situated, communicated and formed in a larger cultural and social context. Dimensions of Pain explores the lived experience of pain, and questions of identity and pain, from a range of different disciplinary (...) perspectives within the humanities and social sciences. Discussing the acuity and temporality of pain, its isolating impact, the embodied expression of pain, pain and sexuality, gender and ethnicity, it also includes a cluster of three chapters discusses the phenomenon and experience of labour pains. This volume revitalizes the study of pain, offering productive ways of carefully thinking through its different aspects and exploring the positive and enriching side of world-forming pain as well as its limiting aspects. It will be of interest to academics and students interested in pain from a range of backgrounds, including philosophy, sociology, nursing, midwifery, medicine and gender studies. (shrink)

Evaluativism is best thought of as a way of enriching a perceptual view of pain to account for pain’s unpleasantness or painfulness. Once it was common for philosophers to contrast pains with perceptual experiences (McGinn 1982; Rorty 1980). It was thought that perceptual experiences were intentional (or content-bearing, or about something), whereas pains were representationally blank. But today many of us reject this contrast. For us, your having a pain in your toe is a matter not of (...) your sensing “pain-ly” or encountering a sense-datum, but of your having an interoceptive experience representing (accurately or inaccurately) that your toe is in a particular experience-independent condition, such as undergoing a certain “disturbance” or being damaged or in danger (Armstrong 1962; Tye 1995). But even if such representational content makes an experience a pain, a further ingredient seems required to make the pain unpleasant. According to evaluativism, the further ingredient is the experience’s possession of evaluative content: its representing the bodily condition as bad for the subject. In this chapter, I elaborate evaluativism, locate it among alternatives, and explain its attractions and challenges. (shrink)

This essay attempts to think anew the relationship of pain with finitude and language. If man is that finite, mortal being whose being is essentially linguistic and being-in-communication, where language is not seen as mere attribute, property, or instrumental means of appropriation, then language cannot be understood in its cognitive disposal as categorical grasp of the “entities presently given,” but must be understood in a more originary manner as opening of the coming into presence, as the event of this (...) coming itself. If a certain dominant ontology, in its innermost ground, understands pain as the very grounding work of logos, then it is necessary to open up the closure of this logos of metaphysics to another, more originary experience of pain in relation to mortality that dispropriates us beforehand, and thereby grants us language itself as gift and promise which welcomes the incalculable event of the “not yet.” This essay reads Heidegger, Schelling and Benjamin to think of the promise of this redemptive, messianic language in relation to an originary finitude, outside the metaphysics of subjectivity, insofar as this metaphysics subsumes language to its cognitive disposal, to its categorical grasp of entities’ “given present.”. (shrink)

Pain research is still dominated by biomedical perspectives and the need to articulate pain in ways other than those offered by evidence based medical models is pressing. Examining closely subjective experiences of pain, this book explores the way in which pain is situated, communicated and formed in a larger cultural and social context. Dimensions of Pain explores the lived experience of pain, and questions of identity and pain, from a range of different disciplinary (...) perspectives within the humanities and social sciences. Discussing the acuity and temporality of pain, its isolating impact, the embodied expression of pain, pain and sexuality, gender and ethnicity, it also includes a cluster of three chapters discusses the phenomenon and experience of labour pains. This volume revitalizes the study of pain, offering productive ways of carefully thinking through its different aspects and exploring the positive and enriching side of world-forming pain as well as its limiting aspects. It will be of interest to academics and students interested in pain from a range of backgrounds, including philosophy, sociology, nursing, midwifery, medicine and gender studies. (shrink)

Philosophers often assume that folk hold pain to be a mental state – to be in pain is to have a certain kind of feeling – and they think this state exhibits the classic Cartesian characteristics of privacy, subjectivity, and incorrigibility. However folk also assign pains (non-brain-based) bodily locations: unlike most other mental states, pains are held to exist in arms, feet, etc. This has led some (e.g. Hill 2005) to talk of the ‘paradox of pain’, (...) whereby the folk notion of pain is inherently conflicted. Recently, several authors have rejected the paradox view, arguing instead that folk hold a univocal, bodily view (i.e. pains are properties of various body parts, not of minds). This paper presents six objections to the bodily view of the folk concept of pain. We then outline a direction for future research – the ‘polyeidic approach’ – whereby the folk notion of pain is held to encompass various divergent (potentially conflicting) strands and we suggest that certain problems surrounding the treatment and communication of pain might be usefully be viewed through the lens of the polyeidic approach. (shrink)

In this book, public health ethicist Daniel S. Goldberg sets out to characterize the subjective experience of pain and its undertreatment within the US medical establishment, and puts forward public policy recommendations for ameliorating the undertreatment of pain. The book begins from the position that the overwhelming focus on opioid analgesics as a means for improving the undertreatment of pain is flawed, and argues instead that dominant Western models of biomedicine and objectivity delegitimize subjective knowledge of the (...) body and pain in the US. This general intolerance for the subjectivity of pain is part of a specific American culture of pain in which a variety of actors take part, including not only physicians and health care providers, but also pain sufferers, caregivers, and policymakers. Concentrating primarily on bioethics, history, and public policy, the book brings a truly interdisciplinary approach to an urgent practical ethical problem. Taking up the practical challenge, the book culminates in a series of policy recommendations that provide pathways for moral agents to move beyond contests over drug policy to policy arenas that, based on the evidence, hold more promise in their capacity to address the devastating and inequitable undertreatment of pain in the US. (shrink)

Appealing to theorists such as Judith Butler, Walter Benjamin, Michel Foucault, Donna Haraway, and Bibi Bakare-Yusef, the aim of the following is to show that, despite ongoing critique, Cartesian dualism continues to haunt our analyses of the relationship of the subject to embodiment, particularly with respect to the experience of pain. Taking Bakare-Yusef's critique of Elaine Scarry's account of institutionalized violence (slavery) as an example, I will argue, first, that the dualistic impulse which Bakare-Yusef identifies in Scarry's view has (...) deep historical roots in, for instance, Aristotle's hylomorphic concept of the subject. Second, I will consider the specific relevance of poststructuralist analyses of subjectification to our conceptions of violence. Lastly, I will explore some contemporary examples of pain in light of the question: can violence 'deconstruct the body' without desubjectifying the subject? I think that the answer is a qualified 'yes'. (shrink)

Bodily pain strikes many philosophers as deeply paradoxical. The issue is that pains seem to bear both physical characteristics, such as a location in the body, and mental characteristics, such being mind-dependent. In this paper I clarify and address this alleged paradox of pain. I begin by showing how a further assumption, Objectivism, the thesis that what one feels in one’s body when one is in pain is something mind-independent, is necessary for the generation of the paradox. (...) Consequently, the paradox can be avoided if one rejects this idea. However, doing so raises its own difficulties, for it is not obvious how anything can possess all of the features we typically associate with bodily pain. To address this puzzle and finally put the paradox of pain to rest, I develop the Embodied View, a novel metaphysical account on which pains are constitutively mind-dependent features of parts of a subject’s body. (shrink)

RésuméLa croyance que l'on est (ou pas) dans un état de douleur est singulière en ceci qu'elle semble pouvoir être qualifiée d'infaillibilité ou d'incorrigibilité logique, de même que le cogito. Mais comment se peut-il que l'existence d'une croyance (vraie) et l'existence du fait qui est l'objet de cette croyance puisssent constituer la même existence? Je propose ici une réponse à cette question. Parfois, une croyance peut être un désir.

The overwhelming majority of commentary on fetal pain has looked at the maturation of cortical pathways to decide a lower age limit for fetal pain. This approach assumes pain can be felt directly from neural activation and ignores psychological development. Here we propose that neural activation is a necessary but not a sufficient condition for phenomenological experience, including pain. Isolated neural activation is just one physical fact amongst an infinity of physical facts that requires order or (...) structure to be isolated and experienced. A new theoretical approach is necessary to understand essential phenomenological experience. We conjecture that infant caregiver interaction provides the necessary order or structure so that the infant can isolate fundamental sense experiences delivered by neural activity. Cortical structures provide the necessary neural basis for qualia but qualia are revealed as phenomenological only as the infant becomes a subjective self. (shrink)

The ability to feel pain is a property of human beings that seems to be based entirely in our biological natures and to place us squarely within the animal kingdom. Yet the experience of pain is often used as an example of a mental attribute with qualitative properties that defeat attempts to identify mental events with physiological mechanisms. I will argue that neurophysiology and psychology help to explain the interwoven biological and subjective features of pain and recommend (...) a view of pain which differs in important respects from the one most commonly accepted. (shrink)

At first sight, pain seems to be an unhistorical phenomenon: in its intrusive nagging presence, nothing refers to the past, and to remember one’s pain is only possible in an abstract sense. However, one’s individual sensitivity as well as one’s relation to pain are shaped biographically, even though we usually are not aware of this: pains are inscribed into body memory and thus unfold a lasting impact. The memory of the subject may thus also be conceived as (...) a history of painful confrontations with the world, in the course of which the borders of self and non-self are constituted and accentuated. These interrelations are the topic of the paper. (shrink)

The phenomenon of pain presents problems and puzzles for philosophers who want to understand its nature. Though pain might seem simple, there has been disagreement since Aristotle about whether pain is an emotion, sensation, perception, or disturbed state of the body. Despite advances in psychology, neuroscience, and medicine, pain is still poorly understood and multiple theories of pain abound. The Routledge Handbook of Philosophy of Pain is an outstanding reference source to the key topics, (...) problems and debates in this exciting and interdisciplinary subject and is the first collection of its kind. Comprising over thirty chapters by a team of international contributors the Handbook is divided into nine clear parts: Modelling pain in philosophy Modelling pain in neuroscience Modelling pain in psychology Pain in philosophy of mind Pain in epistemology Pain in philosophy of religion Pain in ethics Pain in medicine Pain in law. As well as fundamental topics in the philosophy of pain such as the nature, role, and value of pain, many other important topics are covered including the neurological pathways involved in pain processing, biopsychosocial and cognitive behavioural models of pain; chronic pain; pain and non-human animals; pain and knowledge; controlled substances for pain; pain and placebo effects; and pain and physician assisted suicide. The Routledge Handbook of Philosophy of Pain is essential reading for students and researchers in philosophy of mind, philosophy of psychology and ethics. It will also be very useful to researchers of pain from any field, especially those in psychology, medicine, and health studies. (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 paper examines the question of whether a fetus can feel pain. The question is divided into four sub questions: What is pain? What is the neurology of pain processing? What is the fetus? Are there good reasons for holding that fetuses feel pain? Pain is suggested to be a multi‐dimensional phenomenon drawing on emotional and sensory processes – a consequence of a gradual development involving a number of noxious events rather than an automatic consequence (...) of injury or disease. The non‐automaticity of pain is emphasised in the discussion of pain neurology that defies explanations based on a specialised neuronal ‘pain‐centre’. The development of the fetus is considered with respect to developmental neurobiology, behavioural and neurological responses to stimulation, and hormonal and neurochemical responses to noxious stimulation. While acknowledging that the development of the fetus is complex, especially after 26 weeks gestation, considerable development is still to occur, even after birth. The fetal pain literature is criticised for tending to exaggerate fetal development. Finally, the difficulty of explaining the subjectivity of pain in materialist terms is discussed. Pain is suggested to arise with development of the necessary neurological, cognitive and emotional structures. Pain experience is placed at approximately 12 months of age, though this is within the context of a continuum of awareness rather than a straight ‘on‐off’ switch. The major moral implication of this stance is to place the burden of proof for analgesic use onto clinical measures, rather than relying upon the, so far, poorly supported assumption of pain awareness. (shrink)

By definition, pain is a sensory and emotional experience that is felt in a particular part of the body. The precise relationship between somatic events at the site where pain is experienced, and central processing giving rise to the mental experience of pain remains the subject of debate, but there is little disagreement in scholarly circles that both aspects of pain are critical to its experience. Recent experimental work, however, suggests a public view that is at (...) odds with this conceptualisation. By demonstrating that the public does not necessarily endorse central tenets of the “mental” view of pain (subjectivity, privacy, and incorrigibility), experimental philosophers have argued that the public holds a more “body-centric” view than most clinicians and scholars. Such a discrepancy would have important implications for how the public interacts with pain science and clinical care. In response, we tested the hypothesis that the public is capable of a more “mind-centric” view of pain. Using a series of vignettes, we demonstrate that in situations which highlight mental aspects of pain the public can, and does, recognize pain as a mental phenomenon. We also demonstrate that the public view is subject to context effects, by showing that the public’s view is modified when situations emphasizing mental and somatic aspects of pain are presented together. (shrink)

Understanding the nature of pain depends, at least partly, on recognizing its subjectivity (thus, its first-person epistemology). This in turn requires using a first-person experiential method in addition to third-person experimental approaches to study it. This paper is an attempt to spell out what the former approach is and how it can be integrated with the latter. We start our discussion by examining some foundational issues raised by the use of introspection. We argue that such a first-person method (...) in the scientific study of pain (as in the study of any experience) is in fact indispensable by demonstrating that it has in fact been consistently used in conjunction with conventional third-person methodologies, and this for good reasons. We show that, contrary to what appears to be a widespread opinion, there is absolutely no reason to think that the use of such a first-person approach is scientifically and methodologically suspect. We distinguish between two uses of introspective methods in scientific experiments: one draws on the subjects’ introspective reports where any investigator has equal and objective access. The other is where the investigator becomes a subject of his own study and draws on the introspection of his own experiences. We give examples using and/or approximating both strategies that include studies of second pain summation and its relationship to neural activities, and brain imaging- psychophysical studies wherein sensory and affective qualities of pain are correlated with cerebral cortical activity. We explain what we call the experiential or phenomenological approach that has its origins in the work of Price and Barrell (1980). This approach capitalizes on the scientific prospects and benefits of using the introspection of the investigator. We distinguish between its vertical and horizontal applications. Finally, we conclude that integrating such an approach to standard third-person methodologies can only help us in having a fuller understanding of pain and of conscious experience in general. (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 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)

The ability to feel pain is a property of human beings that seems to be based entirely in our biological natures and to place us squarely within the animal kingdom. Yet the experience of pain is often used as an example of a mental attribute with qualitative properties that defeat attempts to identify mental events with physiological mechanisms. I will argue that neurophysiology and psychology help to explain the interwoven biological and subjective features of pain and recommend (...) a view of pain which differs in important respects from the one most commonly accepted. (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 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 essay provides an explanation and interpretation of the undertreatment of pain by discussing some of the scientific, clinical, cultural, and philosophical aspects of this problem. One reason why pain continues to be a problem for medicine is that pain does not conform to the scientific approach to health and disease, a philosophy adopted by most health care professionals. Pain does not fit this philosophical perspective because (1) pain is subjective, not objective; (2) the causal (...) basis of pain is often poorly understood; (3) pain is often regarded as a mere symptom, not as a disease; (4) there often are no magic bullets for pain; (5) pain does not fit the expert knowledge model. In order for health care professionals to do a better job of treating pain, some changes need to occur in medical philosophy, education, and practice. (shrink)

This chapter contains sections titled: Mill's Liberal Feminism Objection: Mill's Defense of Gendered Division of Labor Further Reading.

Fibromyalgia is a chronic pain syndrome characterized by dysfunctional processing of nociceptive stimulation. Neuroimaging studies have pointed out that pain-related network functioning seems to be altered in these patients. It is thought that this clinical symptomatology may be maintained or even strengthened because of an enhanced expectancy for painful stimuli or its forthcoming appearance. However, neural electrophysiological correlates associated with such attentional mechanisms have been scarcely explored. In the current study, expectancy processes of upcoming laser stimulation (painful and (...) non-painful) and its further processing were explored by event-related potentials (ERPs). Nineteen fibromyalgia patients and twenty healthy control volunteers took part in the experiment. Behavioral measures (reaction times and subjective pain perception) were also collected. We manipulated the pain/no pain expectancy through an S1–S2 paradigm (cue-target). S1 (image: triangle or square) predicted the S2 appearance (laser stimulation: warmth or pinprick sensation). Laser stimuli were delivered using a CO2 laser device. Temporal and spatial principal component analyses were employed to define and quantify the ERP component reliability. Statistical analyses revealed the existence of an abnormal pattern of pain expectancy in patients with fibromyalgia. Specifically, our results showed attenuated amplitudes at posterior lCNV component in anticipation of painful stimulation that was not found in healthy participants. In contrast, although larger P2 amplitudes to painful compared to innocuous events were shown, patients did not show any amplitude change in this laser-evoked response as a function of pain predictive cues (as occurred in the healthy control group). Additionally, analyses of the subjective perception of pain and reaction time indicated that laser stimuli preceded by pain cues were rated as more painful than those signaling non-pain expectancy and were associated with faster responses. Differences between groups were not found. The present findings suggest the presence of dysfunction in pain expectation mechanisms in fibromyalgia that eventually may make it difficult for patients to correctly interpret signs that prevent pain symptoms. Furthermore, the abnormal pattern in pain expectancy displayed by fibromyalgia patients could result in ineffective pain coping strategies. Understanding the neural correlates of pain processing and its modulatory factors is crucial to identify treatments for chronic pain syndromes. (shrink)

The English word ‘pain’ is commonly used by lay people in a ‘messy’ life-world of imprecise meanings. It has a complex etymology, including legal and political uses as ‘punishment’. Understandings of pain in the political theory of Hobbes and Bentham are summarized. This wider historical and philosophical account of the uses of ‘pain’ means the IASP definition can be seen in relation to medical history and to present-day clinical challenges. We can consider the misunderstandings that may occur (...) between clinicians and pain sufferers, and the ways in which ‘pain’, although ‘subjective’, is inescapably a political concern. Using Wittgenstein’s approach to meaning, however, we can envisage a context-sensitive and flexible approach to communication about pain. (shrink)

Since pain, as a phenomenon, is accessible only to the person who experiences it, when patients want to make it available to their interlocutors, they describe it with very detailed and elaborate metaphorical scenarios, most often those relating to a form of body damage. Using such embodied metonymic and metaphorical definitions, they provide an adequate imaginative simulation of their subjective experience for their recipients. The paper presents an overview of philosophical insights on the phenomenology of pain as well (...) as a review of contemporary neuroscience research on a social dimension of pain, but also the results of cognitive linguistic analysis of pain vocabulary based on descriptors from the McGill Questionnaire as well as on the corpus of authentic doctor-patient dialogues. (shrink)

According to strong representationalism it is in virtue of having a particular representational content that an experience has the specific phenomenal character that it has. This paper argues that representationalism does not have the resources to explain the most salient aspect of the phenomenal character of pain – it is bound to leave out the painfulness of pain or its negative affect. Its central argument proceeds by analysing the rationalising role of pains. According to it, representationalism is committed (...) to a false picture on which a subject who knowingly acts so as to get rid of her pain without thereby getting rid of the bodily condition it represents always behaves irrationally – in so acting she is shooting the messenger. Thus, there can be no viable representationalist account of the phenomenal character of pain. (shrink)

To give oneself over to the essence of pain is to give oneself over to the world. Pain is a fact of the world and in accepting this fact, in entering that world, we break with the tradition of metaphysical subjectivity that dates back to the Greek determination of the human as zôon logon echon. For Heidegger, pain is the surest sign that we wholly belong to this world; in fact, pain is nothing other than (...) our contact with the world and our “openness” to it. In what follows I will first present those aspects of Heidegger's view of pain…. (shrink)

This paper is an attempt to spell out what makes the scientific study of pain so distinctive from a philosophical perspective. Using the IASP definition of ‘pain’ as our guide, we raise a number of questions about the philosophical assumptions underlying the scientific study of pain. We argue that unlike the study of ordinary perception, the study of pain focuses from the very start on the experience itself and its qualities, without making deep assumptions about whether (...) pain experiences are perceptual. This in turn puts scientific explanation in a curious position due to pain’s inherently subjective epistemic nature. The reason for this focus on the experience itself and its qualities, we argue, has to do with pain’s complex phenomenology involving an affective/motivational dimension. We argue for the scientific legitimacy of first‐person phenomenological studies and attempts to correlate phenomenology with neural events. We argue that this methodological procedure is inevitable and has no anti‐physicalist ontological implications when properly understood. We end the paper by commenting on a discussion between two prominent pain scientists in the field, Don Price and Howard Fields, about the need to distinguish more dimensions in the phenomenology of pain and how to classify them vis‐à‐vis the recent scientific findings. Our interest in this discussion is not only to introduce some clarifications but also to show how “neurophenomenology” has already been shaping the scientific research and to back our claim about why this methodology is inevitable with an example. (shrink)

Historically, treatment for pain relief has varied according to the social status of the sufferer. A similar tendency to make arbitrary distinctions affecting pain relief was found in an ethnographic study of animal research laboratories. The administration of pain-relieving drugs for animals in laboratories differed from standard practice for humans and, perhaps, for companion animals. Although anesthesia was used routinely for surgical procedures, its administration was sometimes haphazard. Analgesics, however, were rarely used. Most researchers had never thought (...) about using analgesics and did not consider the subject worthy of serious attention. Scientists interviewed for this study agreed readily that animals are capable offeeling pain, but such assertions were muted by an overriding view of lab animals as creatures existing solely for the purposes of research. As a result, it was the exceptional scientist who was able to focus on anything about the animal's subjective experience that might lie outside the boundaries of the research protocol. (shrink)

What does feeling a sharp pain in one's hand have in common with seeing a red apple on the table? Some say not much, apart from the fact that they are both conscious experiences. To see an object is to perceive an extramental reality -- in this case, a red apple. To feel a pain, by contrast, is to undergo a conscious experience that doesn't necessarily relate the subject to an objective reality. Perceptualists, however, dispute this. They say (...) that both experiences are forms of perception of an objective reality. Feeling a pain in one's hand, according to this view, is perceiving an objective condition of one's hand. Who is closer to truth? Because of such metaphysical issues, the subjectivity of pains combined with their clinical urgency raises methodological problems for pain scientists. How can a subjective phenomenon be studied objectively? What is the role of the first-person method in science? Some suggest that the subjectivity of pains is due to their metaphysical irreducibility to purely physical processes in the nervous system. Can this be true? The study of pain and its puzzles offers opportunities for understanding such larger issues as the place of consciousness in the natural order and the methodology of psychological research. In this book, leading philosophers and scientists offer a wide range of views on how to conceptualize and study pain. The essays include discussions of perceptual and representationalist accounts of pain; the affective-motivational dimension of pain; whether animals feel pain, and how this question can be investigated; how social pain relates to physical pain; whether first-person methods of gathering data can be integrated with standard third-person methods; and other methodological and theoretical issues in the science and philosophy of pain. (shrink)

Traditional western conceptions of pain have commonly associated pain with the inability to communicate and with the absence of the self. Thus pain, it seems, must be avoided, since it is to blame for alienating the body from subjectivity and the self from others. Recent work on pain, however, has began to challenge these assumptions, mainly by discerning between different kinds of pain and by pointing out how some forms of pain might even (...) constitute a crucial element in the production of subjectivity. This article deals with the specific form of pain that is labour pain. Pain in labour has been investigated in medicine and lately, copiously, within the social sciences. Analyses from a more philosophical perspective are still very much missing, however, and in developing such analyses, de Beauvoir’s ideas on subjectivity as inherently embodied, as situated, and as profoundly ambiguous when authentically lived, appear to be of significant use. (shrink)

Why is unpleasant pain bad for us? Evidently because of how it feels. This bit of commonsense is a challenge for well-being perfectionism, since pain doesn’t look anything like failure to fulfill human nature. Here, I sketch a new version of perfectionism that avoids this problem. To explain what is basically good for us, it appeals to the capacities whose functioning defines who we are, or our subjective nature, instead of human nature. I argue that these capacities have (...) a telic structure, so that practical reason, for example, constitutively aims at competently realizing valuable ends that are in harmony. According to telic perfectionism, we do well when such formal aims are realized and badly when they’re frustrated. Crucially, our subjective nature is defined not only by how we reason but also by how we feel. And valenced experience, too, has built-in directionality, according to the most plausible views about the nature of pleasure and pain. The phenomenal character of unpleasant pain is inseparable from its setting for us the end of eliminating itself. As long as we are in pain, then, the formal aim of our self-defining capacity for valenced experience is frustrated. For telic perfectionism, unpleasant pain is thus robustly bad for us, and the explanation of its badness makes essential reference to how it feels. (shrink)