PAIN, ETHICAL SIGNIFICANCE OF

Pain is a paradigm of an intrinsically bad mental state: It is an experience that is harmful to those who undergo it and makes their life go worse. Virtually all moral theories recognize norms to assist those who suffer from pain and to avoid inflicting unnecessary pain on others, though there is some disagreement about the source of these norms, their exact content, and their scope. The moral status of the pain of animals, for instance, remains a matter of controversy.

Pain has ethical significance when it is understood as an affective experience that is unpleasant or disliked in itself. Thus understood, pain belongs to a family of distinct but overlapping evaluative notions such as distress and suffering. The word "pain," however, is also used to refer to a type of bodily sensation typically associated with damage to body tissue. We normally find such sensations unpleasant, but when they are unaccompanied by an affective response (as reported by patients after frontal lobotomy) or when they are very mild, they are not experienced as unpleasant and no longer have this ethical significance. Furthermore, many hurtful experiences, both physical (nausea, electric shock) and mental (fear, regret) have a negative affective dimension without possessing the specific sensory quality common to cuts and burns. It is thus only pain in the broader, affective sense that is of direct interest to ethics.

The experience of pain is bad in itself but pain is also associated with other ills. Physical pain often accompanies bodily injury, and pain generally tends to incapacitate agents. It is important to distinguish the intrinsic badness of pain from these further harms. We also need to distinguish the badness of pain from a range of goods in which pain can play a part. Pain is instrumentally good insofar as it alerts us to bodily injury, for example. Many regard the painful aspect of just punishment as good, and some view pain as a necessary condition for the development of moral character and spiritual growth, for example. In all of these cases, however, pain can still be said to retain its badness for the agent. Thus pain justly inflicted on those who deserve it counts as punishment, and as good overall, only because it is also bad in itself for the offender. Other cases, such as masochism and the pain of grief, are harder to interpret.

Pain is often contrasted with hedonic states of positive value, such as pleasure and enjoyment. It should not be assumed, however, that pain and pleasure are simple contraries, since the occurrence or prospect of pain appears to have a different moral status, and to give reasons of greater force and urgency, than the occurrence or prospect of pleasure of equal intensity.

Pain also raises questions of ascription and measurement. It is often thought that subjects' sincere reports about their own pain are authoritative. There are also objective, largely behavioral criteria for ascribing pain. These used to be our exclusive means of detecting pain in animals and infants. These first- and third-person criteria seem ill-equipped, however, to deal with some of the cases reported by doctors and scientists, such as frontal lobotomy and hypnosis. The increased availability of devices that can directly detect the neural correlates of pain may present further challenges to our everyday practice of ascribing and assessing pain.

See also Happiness; Hedonism; Intrinsic Value; Pleasure.

Bibliography

Cassell, Eric J. The Nature of Suffering and the Goals of Medicine. New York: Oxford University Press, 1991.

Hare, Richard M. "Pain and Evil." In his Essays on the Moral Concepts. London: Macmillan, 1972.

Mayerfeld, Jamie. Suffering and Moral Responsibility. Oxford, U.K.: Oxford University Press, 1999.

Pitcher, George. "The Awfulness of Pain." Journal of Philosophy 68 (1970): 481–492.

Wall, Patrick. Pain: The Science of Suffering. London: Weidenfeld and Nicolson, 1999.

Guy Kahane (2005)