In this article I clarify the concepts of ‘pain’, ‘suffering’. ‘pains of body’, ‘pains of soul’. I explore the relevance of an ethic to the clinical setting which gives patients a strong prima facie right to freedom from unnecessary and unwanted pain and which places upon medical professionals two concomitant moral obligations to patients. First, there is the duty not to inflict pain and suffering beyond what is necessary for effective diagnosis. treatment and research. Next, there is (...) the duty to do all that can be done to relieve all the pain and suffering which can be alleviated. I develop in some detail that individuality of pain sensitivity must be taken into account in fulfihing these obligations. I explore the issue of the relevance of informed consent and the right to refuse treatment to the matter of pain relief. And I raise the question of what conditions, if anv, should override the right to refuse treatment where pain relief is of paramount concern. (shrink)

- First book to describe what pain means in vulnerable or special groups of people - Clinical applications described in each chapter - Provides insight into the nature of pain experience across the lifespan -/- This book, the third and final volume in the Meaning of Pain series, describes what pain means to people with pain in “vulnerable” groups, and how meaning changes pain – and them – over time. -/- Immediate pain warns (...) of harm or injury to the person with pain. If pain persists over time, more complex meanings can become interwoven with this primitive meaning of threat. These cognitive meanings include thoughts and anxiety about the adverse consequences of pain. Such meanings can nourish existential sufferings, which are more about the person than the pain, such as loss, loneliness, or despair. -/- Although chronic pain can affect anyone, there are some groups of people for whom particular clinical support and understanding is urgently needed. This applies to “vulnerable” or “special” groups of people, and to the question of what pain means to them. These groups include children, women, older adults, veterans, addicts, people with mental health problems, homeless people, or people in rural or indigenous communities. Several chapters in the book focus on the lived experience of pain in vulnerable adults, including black older adults in the US, rural Nigerians, US veterans, and adults with acquired brain injury. The question of what pain experience could mean in the defenceless fetus, neonate, pre-term baby, and child, is examined in depth across three contributions. -/- This book series aspires to create a vocabulary on the “meanings of pain” and a clinical framework with which to use it. It is hoped that the series stimulates self-reflection about the role of meaning in optimal pain management. -/- Meanings of Pain is intended for people with pain, family members or caregivers of people with pain, clinicians, researchers, advocates, and policy makers. Volume I was published in 2016; Volume II in 2019. (shrink)

Medicine is a space to meet the weak and the defenseless. Its environment,professional object and the agents that participate directly or indirectly in the exercise of medicine have a potential generator of culture of life opposing the prevailing culture of death in today's world. In this paper we have described how the exercise of a profession, in this case of medicine, has the potential to evangelize culture. To do this, we delved into the concept of culture, its (...) current context, the generalities of the evangelization of culture, andthen to consider different angles in which medicine demonstrates its potential to evangelize culture. This potential is highlighted to sensitize young people who want to be doctors, who by being fully integrated, scientifically sound and based on ethical, moral and evangelical principles, have a significant impact on society. On the other hand, by generating a culture of solidarity, always seeking to heal escape from pain and suffering, attending mainly to the poorest and most needy. Finally, by generating spaces and initiatives to transmit ideas,reflections, knowledge and disseminating values in the exercise of the profession. -/- La medicina es un espacio para salir al encuentro del débil y el indefenso. Su entorno, objeto profesional y los agentes que participan directa o indirectamente en el ejercicio de la medicina posee un potencial generador de cultura de vida oponiéndose a la cultura de muerte imperante en el mundo de hoy. En este trabajo hemos descrito de qué manera el ejercicio de una profesión, en este caso de la medicina, tiene potencial para evangelizar la cultura. Para ello, se ahondó en el concepto de cultura, su contexto actual, las generalidades de la evangelización de la cultura, para luego al considerar diferentes ángulos en los que la medicina evidencia su potencial para evangelizar la cultura. Se destaca dicho potencial para sensibilizar a los jóvenes que quieren ser médicos, quienes, al formarse integralmente, científicamente sólidos y fundamentados en principios éticos, morales yevangélicos, ejercen un impacto significativo en la sociedad. Por otro lado, al generar una cultura de solidaridad, buscando salir siempre al encuentro del dolor y el sufrimiento,atendiendo principalmente a los más pobres y necesitados. Finalmente, al generar espacios e iniciativas para trasmitir ideas, reflexiones, conocimientos y difundiendo valores en el ejercicio de la profesión. (shrink)

Evidence-Based Medicine has little consideration for mechanisms and philosophers of science and medicine have recently made pleas to increase the place of mechanisms in the medical evidence hierarchy. However, in this debate the notions of mechanisms seem to be limited to 'mechanistic processes' and 'complex-systems mechanisms,' understood as 'componential causal systems'. I believe that this will not do full justice to how mechanisms are used in biological, psychological and social sciences and, consequently, in a more biopsychosocial approach to (...) medicine. Here, I propose, following (Kuorikoski, 2009), to pay more attention to 'abstract forms of interaction' mechanisms. The present work scrutinized review articles on depression and medically unexplained pain, which are considered to be of multifactorial pathogenesis, for their use of mechanisms. In review articles on these disorders there seemed to be a range of uses between more 'abstract forms of interaction' and 'componential causal system' mechanisms. I therefore propose to expand the notions of mechanisms considered in medicine to include that of more 'abstract forms of interaction' to better explain and manage biopsychosocial disorders. (shrink)

Introduction Current treatments for pain have limited benefits and worrying side effects. Some studies suggest that pain is reduced when clinicians deliver positive messages. However, the effects of positive messages are heterogeneous and have not been subject to meta-analysis. We aimed to estimate the efficacy of positive messages for pain reduction. -/- Methods We included randomized trials of the effects of positive messages in a subset of the studies included in a recent systematic review of context factors (...) for treating pain. Several electronic databases were searched. Reference lists of relevant studies were also searched. Two authors independently undertook study selection, data extraction, risk of bias assessment, and analyses. Our primary outcome measures were differences in patient- or observer-reported pain between groups who were given positive messages and those who were not. -/- Results Of the 16 randomized trials (1703 patients) that met the inclusion criteria, 12 trials had sufficient data for meta-analysis. The pooled standardized effect size was −0.31 (95% confidence interval [CI] −0.61 to −0.01, p = 0.04, I2 = 82%). The effect size remained positive but not statistically significant after we excluded studies considered to have a high risk of bias (standard effect size −0.17, 95% CI −0.54 to 0.19, P = 0.36, I2 = 84%). -/- Conclusion Care of patients with chronic or acute pain may be enhanced when clinicians deliver positive messages about possible clinical outcomes. However, we have identified several limitations of the present study that suggest caution when interpreting the results. We recommend further high-quality studies to confirm (or falsify) our result. -/- FUNDING -/- Alexander Mebius research has been funded through the ERC grant "Philosophy of Pharmacology: Safety, Statistical Standards, and Evidence Amalgamation" (GA: 639276). (shrink)

There is disagreement among physicians and medical ethicists on the precise goals of Hospice and Palliative Medicine (HPM). Some think that HPM's goals should differ from those of other branches of medicine and aim primarily at lessening pain, discomfort, and confusion; while others think that HPM's practices should, like all other branches of medicine, aim at promoting health. I take the latter position: using the ars moriendi to set a standard for what it means to die (...) well, I argue that if HPM's practices were to aim at mitigating suffering with little regard to promoting health, some patients would die worse deaths than if HPM's practices were to aim at health. According to the ars moriendi, flourishing at the end of one's life requires that one exercise her agency and pursue the goods most important to her. On this view, HPM's practices should promote patients’ health to enable them to pursue these goods. (shrink)

Ong, Caroline Whilst the reason and purpose of suffering may never be fully understood, there are ways of enduring, transcending and growing resilience to how it affects us. Our experience of suffering lies in the web of perceptions that involve our physical, spiritual and cosmological beliefs. Referencing Pain Seeking Understanding: Suffering, Medicine and Faith, edited by Margaret E. Mohrmann and Mark J. Hanson, this article gives a brief exploration of some propositions as to why an all-powerful, good God (...) would allow suffering to exist. From these various perspectives and using examples cited in the book, the article proposes that the healing art of medicine, honed through years of experience, knowledge and wisdom, can help individual patients endure and transcend suffering, and be whole once again. (shrink)

Olfactory Virtual Reality (OVR) for Wellbeing and Reduction of Stress, Anxiety and Pain - Journal of Medical Research and Health Sciences.

BACKGROUND Patients with chronic pain face significant barriers in finding clinicians to manage long-term opioid therapy (LTOT). For patients on LTOT, it is increasingly common to have them sign opioid treatment agreements (OTAs). OTAs enumerate the risks of opioids, as informed consent documents would, but also the requirements that patients must meet to receive LTOT. While there has been an ongoing scholarly discussion about the practical and ethical implications of OTA use in the abstract, little is known about how (...) clinicians use them and if OTAs themselves modify clinician prescribing practices. OBJECTIVE To determine how clinicians use OTAs and the potential impacts of OTAs on opioid prescribing. DESIGN We conducted qualitative analysis of four focus groups of clinicians from a large Midwestern academic medical center. Groups were organized according to self-identified prescribing patterns: two groups for clinicians who identified as prescribers of LTOT, and two who did not. PARTICIPANTS 17 clinicians from General Internal Medicine, Family Medicine, and Palliative Care were recruited using purposive, convenience sampling. APPROACH Discussions were recorded, transcribed, and analyzed for themes using reflexive thematic analysis by a multidisciplinary team. KEY RESULTS Our analysis identified three main themes: (1) OTAs did not influence clinicians’ decisions whether to use LTOT generally but did shape clinical decision-making for individual patients; (2) clinicians feel OTAs intensify the power they have over patients, though this was not uniformly judged as harmful; (3) there is a potential misalignment between the intended purposes of OTAs and their implementation. CONCLUSION This study reveals a complicated relationship between OTAs and access to pain management. While OTAs seem not to impact the clinicians’ decisions about whether to use LTOT generally, they do sometimes influence prescribing decisions for individual patients. Clinicians shared complex views about OTAs’ purposes, which shows the need for more clarity about how OTAs could be used to promote shared decision-making, joint accountability, informed consent, and patient education. (shrink)

heart attack analysis & prediction dataset is a major cause of death worldwide. Early detection and intervention are essential for improving the chances of a positive outcome. This study presents a novel approach to predicting the likelihood of a person having heart failure using a neural network model. The dataset comprises 304 samples with 11 features, such as age, sex, chest pain type, Trtbps, cholesterol, fasting blood sugar, resting electrocardiogram results, maximum heart rate achieved, exercise-induced angina, oldpeak, ST_Slope, and (...) HeartDisease. A neural network model with four layers (1 input, 2 hidden, 1 output) was trained on the dataset and achieved an accuracy of 88% and an average error of 0078296. The most influential factors in heart failure prediction were found to be oldpeak, ST_Slope, sex, fastingBS, chestPainType, exerciseAngina, cholesterol, restingBP, maxHR, restingBP, and age. This study provides a valuable tool for early detection and intervention of heart failure, thereby contributing to the field of health and medicine. (shrink)

Alison Bailey’s The Weight of Whiteness: A Feminist Engagement with Privilege, Race, and Ignorance examines how whiteness misshapes our humanity, measuring the weight of whiteness in terms of its costs and losses to collective humanity. People of color feel the weight of whiteness daily. The resistant habits of whiteness and its attendant privileges, however, make it difficult for white people to feel the damage. White people are more comfortable thinking about white supremacy in terms of what privilege does for them, (...) rather than feeling what it does to them. The first half of the book focuses on the overexposed side of white privilege, the side that works to make the invisible and intangible structures of power more visible and tangible. Bailey discusses the importance of understanding privileges intersectionally, the ignorance-preserving habits of “white talk,” and how privilege and ignorance circulate in educational settings. The second part invites white readers to explore the underexposed side of white dominance, the weightless side that they would rather not feel. The final chapters are powerfully autobiographical. Bailey engages readers with a deeply personal account of what it means to hold space with the painful weight of whiteness in her own life. She also offers a moving account of medicinal genealogies, which helps to engage the weight she inherits from her settler colonial ancestors. The book illustrates how the gravitational pull of white ignorance and comfort are stronger than the clean pain required for collective liberation. The stakes are high: Failure to hold the weight of whiteness ensures that white people will continue to blow the weight of historical trauma through communities of color. -/- All rights reserved. No portion of this publication may be reproduced, stored in a retrieval system, or transmitted in any form by any means, electronic, mechanical, photocopying, recording or otherwise without the prior written permission of the publisher. -/- -/- . (shrink)

Heart failure is a major cause of death worldwide. Early detection and intervention are essential for improving the chances of a positive outcome. This study presents a novel approach to predicting the likelihood of a person having heart failure using a neural network model. The dataset comprises 918 samples with 11 features, such as age, sex, chest pain type, resting blood pressure, cholesterol, fasting blood sugar, resting electrocardiogram results, maximum heart rate achieved, exercise-induced angina, oldpeak, ST_Slope, and HeartDisease. A (...) neural network model with four layers (1 input and 1 output) was trained on the dataset and achieved an accuracy of 90% and an average error of 0.009. The most influential factors in heart failure prediction were found to be oldpeak, ST_Slope, sex, fastingBS, chestPainType, exerciseAngina, cholesterol, restingBP, maxHR, restingBP, and age. This study provides a valuable tool for early detection and intervention of heart failure, thereby contributing to the field of health and medicine. (shrink)

In a recent article, ―The Lacuna of Hermeneutics: Notes on the Freedom of Thought, Marcia Sá Cavalcante Schuback raises an important question regarding the limitations of philosophical hermeneutics to be critical and attentive to the reality of current, concrete socio-political issues. In response, I claim that Gadamerian hermeneutics is well positioned to address current and controversial instances of epistemic injustice. In this article, I focus on the contemporary and controversial example of testimony of those who have been injured by the (...) COVID-19 vaccines. In turning to selections from Gadamer‘s Truth and Method, as well his lectures and essays on health and medicine, I argue that Gadamer‘s emphasis on hermeneutic openness and readiness, as well as an attunement to the linguistic and embodied experience of pain, allow us to consider a responsible approach to testimonies of the vaccine injured. Instead of providing a set of criteria or a particular method for distinguishing true from false testimony, Gadamerian hermeneutics calls for an examination and transformation of one‘s prejudices, especially prejudices which may impede one‘s ability to interpret and understand the subject matter in the first place. (shrink)

It is undeniable that human beings seek happiness and have difficulty finding it. This is not a new phenomenon: ever since ancient times man has wondered about what happiness is, where it lies and how to achieve it. For the Greeks, a people of deep pessimism, the search for happiness (eudaimonia) was a traditional theme of philosophy and it was precisely in Greece where Epicurus ́ (341-270 BC) doctrine of happiness emerged. A cursed and manipulated author (just like his admirer (...) Nietzsche), Epicurus has probably been the thinker who has most lucidly approached the question of eudaimonia. Its doctrine seeks and promises its followers happiness through pleasure (hedoné), self-sufficiency (autarky), friendship (philía) and mental calm (ataraxia), offering itself as medicine against the pain of flesh and the sufferings of the mind. But Epicurean hedonism, which harmonizes well with the ancient Apollonian maxim that wisdom consists of moderation and the knowledge of limits, is totally removed from both the tyranny of the happycracy and from the noxious culture of unrestrained and vacuous desire of contemporary postmodernity. This is precisely why Epicurus's timeless proposal for authentic happiness deserves to be known for everyone: for constituting an effective therapy against the ills that afflict the nihilistic human being of the neoliberal era. (shrink)

The sunflower seed is the seed of the sunflower (Helianthus annuus). The methanol extract of seeds of Helianthus annuus were screened for analgesic activity in mice model to systematically explore the medicinal values of the plant. Acetic acid induced writhing and hot plate methods were used to confirm the central and peripheral analgesic action. In case of acetic acid-induced writhing test the extract showed significant (P <0.05) analgesic potential at doses 100 and 200 mg/kg body weight (50.35 and 57.85% inhibition, (...) respectively). In the hot plate method, increase (p < 0.05) of latency period was also observed in comparison to standard aspirin. At 60 minutes, the latency period of two different doses (100 and 200 mg/kg body weight) was found at 13 ± 0.91 and 16.5 ± 1.55 second. The results obtained support the use of Helianthus annuus seeds in painful conditions acting both centrally and peripherally. (shrink)

I argue that embryonic stem cell research is fair to the embryo, even on the assumption that the embryo has attained full personhood and an attendant right to life at conception. This is because the only feasible alternatives open to the embryo are to exist briefly in an unconscious state and be killed or to not exist at all. Hence, one is neither depriving the embryo of an enduring life it would otherwise have had nor is one causing the embryo (...) pain. I also argue that a rational agent in a situation relevantly similar to that of the embryo would consent to such research, and I use this insight to ground two justice-based arguments in favor of this research. (shrink)

The scientific study of socio-cultural phenomenon requires a translocation of topics elaborated from the social perspective of the individual to a rationally ordered rendition of processes suitable for comprehension from a scientific perspective. Scholarly curiosity seeded from exposure in the natural setting to economic, political, socio-cultural, evolutionary, processes dictates that study of the self, should be a science with a necessary place in the body of world literatures; yet it has proven difficult to find a perspective to contain discussions of (...) topics in a coherent manner for scientific approach: for example, anthropology, the study of mankind, finds difficulty elaborating definition for the orientation of study; it is a member of the same set that contains it. In this presentation, based on features indigenous to a supposed distant perspective that is exposed employing experiences of history and criteria of common sensory perception, it is conjectured that a civilization lifetime pathology is contemporarily active. Example is taken from philosophical and sociological discourses, modern science theory, medicine in pursuit of international health issues, to capture conceptually a role of motions of external agents occurred within the interval of observation, elaboration of concepts, choice of directions, as a source of paradox and confusion. In supposition that does not escape simple logic, ubiquitously appealing to the experience bound senses for understanding, hidden motions, common to both observer and observed, are hypothesized to render from a sense of familiarity, a continued frustration in attaining an understanding of the self and nature. A psychical seduction is proposed to exist, related to historical behaviors associated with centrism and asceticism, produces eccentric interpretations that are bound modernly to logical circular, centric geometrical reasonings; world conceptualizations are conjectured to acquire an avoidance of a state of ‘motionless’ rather than death within selection processes. Projection by the imagination upon the unknown is conjectured to result in a seduction by an active ‘live-wire” embodied to motions occurred to a distant surface. (shrink)

We propose a pluralist account of content for predictive processing systems. Our pluralism combines Millikan's teleosemantics with existing structural resemblance accounts. The paper has two goals. First, we outline how a teleosemantic treatment of signal passing in predictive processing systems would work, and how it integrates with structural resemblance accounts. We show that the core explanatory motivations and conceptual machinery of teleosemantics and predictive processing mesh together well. Second, we argue this pluralist approach expands the range of empirical cases to (...) which the predictive processing framework might be successfully applied. This is because our pluralism is practice-oriented. A range of different notions of content are used in the cognitive sciences to explain behaviour, and some of these cases look to employ teleosemantic notions. As a result, our pluralism gives predictive processing the scope to cover these cases. (shrink)

Male genital problems and injuries may occur quite simply because of the scrotum and penis are not protected like other organs. Genital problems and injuries normally happen through: recreational activities (like Football, Hooky, biking, basketball), workrelated tasks (like contact to irritating chemicals), downhill drop, and sexual activity. A genital injury frequently causes harsh pain that typically disappear fast without causing enduring harm. Home handling is generally all that is required for trivial problems or injuries. Pain, inflammation, staining, or (...) rashes that are coexist with other symptoms might be a source for concern. Genital problems in men is one of the most common problems which requires fast intervention. In this paper we present an expert system that help men diagnose their genital problems and give them the proper treatment. SL5 Object expert system language was used to design and implement this expert system. (shrink)

Recent work by Stout and colleagues indicates that the neural correlates of language and Early Stone Age toolmaking overlap significantly. The aim of this paper is to add computational detail to their findings. I use an error minimisation model to outline where the information processing overlap between toolmaking and language lies. I argue that the Early Stone Age signals the emergence of complex structured representations. I then highlight a feature of my account: It allows us to understand the early evolution (...) of syntax in terms of an increase in the number and complexity of models in a cognitive system, rather than the development of new types of processing. (shrink)

Male genital problems and injuries may occur quite simply because of the scrotum and penis are not protected like other organs. Genital problems and injuries normally happen through: recreational activities (like Football, Hooky, biking, basketball), work- related tasks (like contact to irritating chemicals), downhill drop, and sexual activity. A genital injury frequently causes harsh pain that typically disappear fast without causing enduring harm. Home handling is generally all that is required for trivial problems or injuries. Pain, inflammation, staining, (...) or rashes that are coexist with other symptoms might be a source for concern. Genital problems in men is one of the most common problems which requires fast intervention. In this paper we present an expert system that help men diagnose their genital problems and give them the proper treatment. SL5 Object expert system language was used to design and implement this expert system. (shrink)

Hutto and Myin claim that teleosemantics cannot account for mental content. In their view, teleosemantics accounts for a poorer kind of relation between cognitive states and the world but lacks the theoretical tools to account for a richer kind. We show that their objection imposes two criteria on theories of content: a truth-evaluable criterion and an intensionality criterion. For the objection to go through, teleosemantics must be subject to both these criteria and must fail to satisfy them. We argue that (...) teleosemantics meets the truth-evaluable criterion and is not required to meet the intensionality criterion. We conclude that Hutto and Myin’s objection fails. (shrink)

The free energy principle is notoriously difficult to understand. In this paper, we relate the principle to a framework that philosophers of biology are familiar with: Ruth Millikan’s teleosemantics. We argue that: systems that minimise free energy are systems with a proper function; and Karl Friston’s notion of implicit modelling can be understood in terms of Millikan’s notion of mapping relations. Our analysis reveals some surprising formal similarities between the two frameworks, and suggests interesting lines of future research. We hope (...) this will aid further philosophical evaluation of the free energy principle. (shrink)

We challenge an argument that aims to support Aesthetic Realism by claiming, first, that common sense is realist about aesthetic judgments because it considers that aesthetic judgments can be right or wrong, and, second, that becauseAesthetic Realism comes from and accounts for “folk aesthetics,” it is the best aesthetic theory available.We empirically evaluate this argument by probing whether ordinary people with no training whatsoever in the subtle debates of aesthetic philosophy consider their aesthetic judgments as right or wrong. Having shown (...) that the results do not support the main premise of the argument, we discuss the consequences for Aesthetic Realism and address possible objections to our study. (shrink)

Over the last fifteen years, an ambitious explanatory framework has been proposed to unify explanations across biology and cognitive science. Active inference, whose most famous tenet is the free energy principle, has inspired excitement and confusion in equal measure. Here, we lay the ground for proper critical analysis of active inference, in three ways. First, we give simplified versions of its core mathematical models. Second, we outline the historical development of active inference and its relationship to other theoretical approaches. Third, (...) we describe three different kinds of claim -- labelled mathematical, empirical and general -- routinely made by proponents of the framework, and suggest dialectical links between them. Overall, we aim to increase philosophical understanding of active inference so that it may be more readily evaluated. -/- This the final submitted version of the Introduction to the Topical Collection "The Free Energy Principle: From Biology to Cognition", forthcoming in Biology & Philosophy. (shrink)

In their landmark 2010 paper, “The weirdest people in the world?”, Henrich, Heine, and Norenzayan outlined a serious methodological problem for the psychological and behavioural sciences. Most of the studies produced in the field use people from Western, Educated, Industrialised, Rich and Democratic (WEIRD) societies, yet inferences are often drawn to the species as a whole. In drawing such inferences, researchers implicitly assume that either there is little variation across human populations, or that WEIRD populations are generally representative of the (...) species. Yet neither of these assumptions is justified. In many psychological and behavioural domains, cultural variation begets cognitive variation, and WEIRD samples are recurrently shown to be outliers. In the years since the article was published, attention has focused on the implications this has for research on extant human populations. Here we extend those implications to the study of ancient _H. sapiens_, their hominin forebears, and cousin lineages. We assess a range of characteristic arguments and key studies in the cognitive archaeology literature, identifying issues stemming from the problem of sample diversity. We then look at how worrying the problem is, and consider some conditions under which inferences to ancient populations via cognitive models might be provisionally justified. (shrink)

Relying on euthanasia’s definitionally derived set of propositions to provide its purpose, claims, and benefit, we obtain the core concept. Nonetheless, given its core concept, euthanasia is demonstrated to provide no benefit to the animal to justify its use. Euthanasia 1) cannot possibly, and therefore does not, end unbearable suffering, 2) it fails to hasten death, and 3) it, therefore, provides no perceptible relief to the patient. These findings are significant because the argument’s validity does not permit euthanasia to satisfy (...) its definitionally derived purpose, claims, or benefit on logical grounds. In other words, the argument is that as a form of legalized assisted suicide, euthanasia is wrong but not in the way principled arguments would suggest. Additionally, irrespective of euthanasia actually doing what it claims, if it is allowed to be provisioned, then euthanasia will affect vulnerable populations exactly like nonprincipled arguments claim. Therefore, despite sharing aspects with each type of argument in the extant literature, my argument against euthanasia can be categorized as neither principled nor nonprincipled, which makes it significant because it may be the first of a new category of argument against the concept and practice to enter the discourse on euthanasia. As a corollary, since we prove that unbearable suffering logically entails death, when it is authentic signifying that death is imminent, because euthanasia’s only purpose is to end unbearable suffering by inducing death, euthanasia is completely obviated. (shrink)

Pain asymbolia is a rare condition caused by brain damage, usually in adulthood. Asymbolics feel pain but appear indifferent to it, and indifferent also to visual and verbal threats. How should we make sense of this? Nikola Grahek thinks asymbolics’ pains are abnormal, lacking a component that make normal pains unpleasant and motivating. Colin Klein thinks that what is abnormal is not asymbolics’ pains, but asymbolics: they have a psychological deficit making them unresponsive to unpleasant pain. I (...) argue that an illuminating account requires elements of both views. Asymbolic pains are indeed abnormal, but they are abnormal because asymbolics are. I agree with Klein that asymbolics are incapable of caring about their bodily integrity; but I argue against him that, if this is to explain not only their indifference to visual and verbal threat, but also their indifference to pain, we must do the following: (i) take asymbolics’ lack of bodily care not as an alternative to, but as an explanation of their pains’ missing a component, and (ii) claim that the missing component consists in evaluative content. Asymbolia, I conclude, reveals not only that unpleasant pain is composite, but that its ‘hedomotive component’ is evaluative. (shrink)

Imperativism is the view that the phenomenal character of the affective component of pains, orgasms, and pleasant or unpleasant sensory experience depends on their imperative intentional content. In this paper I canvass an imperativist treatment of pains as reason-conferring states.

We suggest that pain processing has a modular architecture. We begin by motivating the (widely assumed but seldom defended) conjecture that pain processing comprises inferential mechanisms. We then note that pain exhibits a characteristic form of judgement independence. On the assumption that pain processing is inferential, we argue that its judgement independence is indicative of modular (encapsulated) mechanisms. Indeed, we go further, suggesting that it renders the modularity of pain mechanisms a default hypothesis to be (...) embraced pending convincing counterevidence. Finally, we consider what a modular pain architecture might look like, and question alleged counterevidence to our proposal. (shrink)

Functionalism of robot pain claims that what is definitive of robot pain is functional role, defined as the causal relations pain has to noxious stimuli, behavior and other subjective states. Here, I propose that the only way to theorize role-functionalism of robot pain is in terms of type-identity theory. I argue that what makes a state pain for a neuro-robot at a time is the functional role it has in the robot at the time, and (...) this state is type identical to a specific circuit state. Support from an experimental study shows that if the neural network that controls a robot includes a specific 'emotion circuit', physical damage to the robot will cause the disposition to avoid movement, thereby enhancing fitness, compared to robots without the circuit. Thus, pain for a robot at a time is type identical to a specific circuit state. (shrink)

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

Nikola Grahek's influential book Feeling Pain and Being in Pain introduced philosophers to the strange phenomenon of pain asymbolia. Subsequent philosophical debate around asymbolia has been partly taxonomic: the deep question is whether it is best understood as a specific neurological deficit or part of a broader syndrome. This paper looks to the history of asymbolia, positioning the origin of the term within broader historical trends. It shows that strange phenomena about pain and motivation have always (...) presented interpretive challenges, and suggests that the current debate mirrors a historical split between German and French traditions. This does not resolve the debate, but does help place it within broader scientific and philosophical contexts. (shrink)

Barbara Montero considers whether or not we are able to remember what pain feels like. In order to properly answer this question, she introduces a new type of memory called 'qualitative memory', which seems common to exteroceptive sensations. Having concluded that there is arguably no qualitative memory for pain and other bodily sensations, Montero considers possible philosophical implications for areas including rational choice-making and empathy. In addressing the relationship between pain and memory, the paper raises an issue (...) that has not received much attention and indicates various interesting fields of research for which the apparent inability to remember pain might prove relevant. My comment primarily focuses on the core concepts of pain and qualitative memory which are foundational for the paper. I argue that a deeper engagement with some key aspects of these concepts is necessary. A more fine-grained discussion could have made Montero's argument more convincing. (shrink)

In (Owesen 2022), Owesen purportedly argues that pains are activations of nociceptors. In these comments I show that much of what Owesen says is consistent with pains being nociceptors themselves.

[Penultimate draft] I present the perceptualist/representationalist theories of pain in broad outline and critically examine them in light of a competing view according to which awareness of pain is essentially introspective. I end the essay with a positive sketch of a naturalistic proposal according to which pain experiences are intentional but not fully representational. This proposal makes sense of locating pains in body parts as well as taking pains as subjective experiences.

The paradox of pain refers to the idea that the folk concept of pain is paradoxical, treating pains as simultaneously mental states and bodily states. By taking a close look at our pain terms, this paper argues that there is no paradox of pain. The air of paradox dissolves once we recognize that pain terms are polysemous and that there are two separate but related concepts of pain rather than one.

The surface grammar of reports such as ‘I have a pain in my leg’ suggests that pains are objects which are spatially located in parts of the body. We show that the parallel construction is not available in Mandarin. Further, four philosophically important grammatical features of such reports cannot be reproduced. This suggests that arguments and puzzles surrounding such reports may be tracking artefacts of English, rather than philosophically significant features of the world.

I argue that pain sensations are perceptual states, namely states that represent (actual or potential) damage. I defend this position against the objection that pains, unlike standard perceptual states, do not allow for an appearance-reality distinction by arguing that in the case of pain as well as in standard perceptual experiences, cognitive penetration or malfunctions of the underlying sensory systems can lead to a dissociation between the sensation on the one hand, and what is represented on the other (...) hand. Moreover, I refute the objection that the allegedly weak correlation between pain and bodily damage forces intentionalist accounts of pain to postulate so many malfunctions (misrepresentations respectively) that such accounts become implausible. I also rebut Murat Aydede’s objection that our linguistic practice supposedly shows that there is a conceptual difference between standard perceptual experiences and pain sensations by challenging Aydede’s premise that we always withdraw standard perceptual reports in case of counterevidence, while we never do that with pain reports. At the end, I propose an explanation as to why we do not express perceptual reports of (potential) bodily damage in objectivist, but in mental terms. (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)

Recent work on signaling has mostly focused on communication between organisms. The Lewis–Skyrms framework should be equally applicable to intra-organismic signaling. We present a Lewis–Skyrms signaling-game model of painful signaling, and use it to argue that the content of pain is predominantly imperative. We address several objections to the account, concluding that our model gives a productive framework within which to consider internal signaling.

Amid criticism of medicine's scientific rigor and patient care, this book offers a philosophical examination of the nature and aims of medicine, and new perspectives on how these challenges can be addressed. It offers input for rethinking the agenda of medical research, healthcare delivery, and the education of healthcare personnel.

I distinguish between two claims of transparency of experiences. One claim is weaker and supported by phenomenological evidence. This I call the transparency datum. Introspection of standard perceptual experiences as well as bodily sensations is consistent with, indeed supported by, the transparency datum. I formulate a stronger transparency thesis that is entailed by representationalism about experiential phenomenology. I point out some empirical consequences of strong transparency in the context of representationalism. I argue that pain experiences, as well as some (...) other similar experiences like itches, tickles, orgasms, hedonic valence, etc., are not transparent in this strong sense. Hence they constitute empirical counterexamples to representationalism. Given that representationalism is a general metaphysical doctrine about all experiential phenomenology for good reasons, I conclude that representationalism about phenomenal consciousness is false. Then, I outline a general framework about how the introspection of phenomenal qualities in perceptual experience works in light of the transparency datum, but consistent with the rejection of strong transparency. The result is a form of qualia realism that is naturalist and intentionalist, and has close affinities to the adverbialist views developed in the latter part of the last century. I then apply this framework to pain experiences and their bodily locations. (shrink)

This work proposes that pain meets the requirements of being characterized as a secondary quality, as it covers, like a color, a determined extension. The argument seeks to establish a literal pain-color analogy through an inquiry into the intensity and location of the pain. From the classic intensity/location relationship reported by patients with acute appendicitis, three degrees of pain are distinguished: mild, moderate, and severe. The objective is only achieved by examining the Body’s extensional determinations (primary (...) quality) insofar as each of these degrees of pain covers three particular measures. Once these three measures have been explored according to the perforation process (tissue damage), the work ends by identifying pain as a transcendent moment. (shrink)

Why are pains bad for us? A natural answer is that it is just because of how they feel (or their felt-qualities). But this answer is cast into doubt by cases of people who are unbothered by certain pains of theirs. These pains retain their felt-qualities, but do not seem bad for the people in question. In this paper, I offer a new response to this problem. I argue that in such cases, the pains in question have become “just more (...) of the same,” and for this reason have ceased to be bad for the relevant individuals. It is because they (implicitly) recognise this that they are unbothered by such pains. (shrink)

That pain and suffering are unwanted is no truism. Like the sadist, the masochist wants pain. Like sadism, masochism entails an irrational, abnormal attitude toward pain. I explain this abnormality.