The official definition of ‘pain’ by the International Association for the Study of Pain (IASP) hasn’t seen much revision since its publication in 1979. There have been various criticisms of the definition in the literature from different quarters: that the definition implies a dubious metaphysical dualism, that it requires a strong form of consciousness as well as linguistic abilities, that it excludes many vulnerable groups that are otherwise perfectly capable of experiencing pain, that it has therefore unacceptable practical as well (...) as ethical consequences, that it is unhelpful to the health-care professional as an operational definition, that it is too narrow, and many others. In my view, most of these criticisms depend on misunderstandings or on uncharitable interpretations. My aim is to go over the definition, clarify some potential ambiguities, and argue that these criticisms don’t cut much ice. At the end, I will present a few slightly reworded versions of the definition that I claim are more felicitous and capture the original intended meaning by the members of the taxonomic committee in a much better and transparent way that avoids all the major extant criticisms in the literature. (Written for interdisciplinary audiences.). (shrink)

Two clusters of essays in this issue of The Journal of Medicine and Philosophy provide a critical gaze through which to explore central moral, phenomenological, ontological, and political concerns regarding human moral agency and personal responsibility. The first cluster challenges common assumptions in bioethics regarding the voluntariness of human actions. The second set turns the debate towards morally responsible choice within the requirements of distributive justice. The force of their collective analysis leaves us with a well-founded basis critically to approach (...) any account of bioethics or health policy that is insufficiently attentive to the central challenges of human freedom and responsible free choice. (shrink)

In my thesis, I challenge existing philosophical and scientific accounts of pain to explain certain constitutional, functional and empirical problems. Though difficult, some of these problems will be familiar. Unlike perceptual experiences, pains are strikingly affective and when we are in pain we are primarily concerned with the experience itself rather than mind-independent objects. The obvious explanation, that pain is not a perceptual experience, would be appealing if it were not for the fact that pains vary in quality, intensity and (...) location. These seem to be features of paradigmatic perceptual experiences. The magnitude of another problem, the weakness of the correlation between pain and the stimulus, has been under-played. It is widely observed that those with chronic conditions experience pain in the absence of the stimulus and in circumstances like sport and war severe injuries occur in the absence of pain. I argue that the variable relationship between pain and the stimulus is normal; it is not confined to abnormal cases or circumstances. As no existing account proves explanatorily adequate, I develop a novel position called ‘near-motivationalism’ from a revisionary approach to the conceptual models of pain science. This has the power to solve the problems I set. (shrink)