In lieu of an abstract, here is a brief excerpt of the content:Pleasure and Pain in LiteratureOliver ConollyWhy do we enjoy the depiction, in imaginative literature, of situations that typically arouse negative emotions such as pity, sadness, and horror? One view, which aims to dissolve rather than solve the problem, is that we do not enjoy them at all. According to this theory—the pure pain theory—the problem does not arise in the first place. But the theory must (...) explain why we chose to undergo such painful experiences. Are we simply aesthetic masochists? The pure pleasure theory, by contrast, denies that there are any painful aspects to our experience of such literature. This theory must explain how we can take pure delight in the literary depiction of suffering. Are we simply aesthetic sadists? Lying between both extremes is the hybrid theory, which asserts that there are both painful and pleasant aspects of such experiences. The hybrid theory must specify which aspects of the experience are painful and which pleasant. In this paper a version of the hybrid theory is advanced and defended.IThe pure pleasure theory denies that we feel painful emotional identification with fictional characters. Why take this view? One reason is that it is a way of resolving the paradox of fiction, as formulated by Colin Radford.1 The paradox asserts that there is an inconsistency between the propositions that: (1) we have emotions for fictional characters, (2) we know that they do not exist, (3) it is irrational to have emotions for non-existent objects. Each proposition seems plausible, yet one must be false. Whilst most of the participants in the debate have attacked the notion that feelings for fictions are irrational, some have [End Page 305] denied that we have such feelings in the first place. One intuition guiding this denial is that the depiction of a fictional horrible event is likely to be less painful than the depiction of an identical but real event. In other words, the mere fictionality of an event is liable, by itself, to diminish the pain we are liable to feel at its depiction in comparison with a real event: I label this the fictionality gap. If the fictionality gap exists, it applies across the board, to the sufferings of Pip in Great Expectations as well as those of King Lear. The characters in those works are fictional, and so the lessening of the pain we feel at their fates must, if the fictionality gap holds, hold merely in virtue of the fact that they are fictional.It has often been noted—rather than argued, but this is question of impression rather than logic—that one would feel more affected were the stories real rather than fictional. The kinds of events depicted in King Lear—ugly struggles for power, the manipulation of the naïve, the impotence of the good, inconsolable grief—are not in themselves other-worldly, and can be imagined taking place in reality. However it is much more difficult to imagine King Lear in its full particularity taking place in the real world, given the theatricality of its form and language. In order to imagine King Lear as real, one would have to rob it of Shakespeare's poetry, which is other-worldly in its eloquence. French proponents of the Three Unities thought that theatre should aim at, among other things, verisimilitude, but never overcame the problem that the fact that characters in French theatre speak in rhyming couplets might detract from that verisimilitude, which it clearly does. This worry about the transplantability of King Lear into the real world appears to be less of a problem in relation to realist novels, which, as their appellation suggests, are easier to imagine taking place in the real world. Not only is the language used in realist novels less exalted than that used in tragedies, the situations such novels depict tend to be more likely to occur. Clearly, the realist novel is capable of depicting horrible or unpleasant events. About such novels, say, Madame Bovary, it seems to make sense to ask ourselves how we would feel about them if we read them as true stories.I would like however to question the very intelligibility of the... (shrink)

Public’s concern about poor animal welfare provided by intensive farming systems has increased over the last decades. This study reviewed the interest of the scientific research on the pain issue in pig production to assess if the societal instances may be a driving force for the research activity. A literature search protocol was set up to identify the peer-reviewed papers published between 1970 and 2017 that covered the topic of ‘pain in pigs’ using Scopus®, database of Elsevier©. (...) One hundred and thirty papers were selected and they were mainly focused on the practice of castration followed by tail docking. The scientific community first focused on these painful practices as a way to improve production efficiency and quality issues while more recently, due to the increased pressure by the public opinion, turned its interest towards the search of alternative solutions. A text mining analysis on the abstract of the selected papers clearly indicated the effort of the research to explore solutions to alleviate pain. Evocative words of this target were the selected terms ‘pharmacological analgesic’ and ‘anaesthetic treatments’. The text mining highlighted vocalizations as the main pain indicators in pigs as this term was frequently associated to ‘acute stress’. Ethical issues were a minor research topic in the scientific literature on pig breeding but in the short run, they are supposed to become a major subject to justify the acceptance of the modern production systems at the eyes of the consumers. (shrink)

This essay argues that the representation of pain in Beckett’s writing exposes the paradox in his work concerning the relationship of the individual suffering subject and the community. Making reference to studies of pain and literature generally and to salient studies of Beckett, the essay shows how the narration of pain in Beckett’s prose works in particular is closely linked to its more general interrogation of subject-object relations. As the preeminent agent, source as well as repository (...) of pain, writing in Beckett itself comes to occupy, in a transpositional manner, the poles of subject, object and work. If ‘pain’ names the subject-object continuum, that very conjunction exposes the co-habitants to their own mutual espacement – qua subject and object. The common feeling is countermanded in advance by separation. The conjunction gives rise to a sapping, devastating and agonising attempt to conjure an image, an image which holds out the possibility of the felicity, or at least palliation, offered by community. The image is, however, both a wounding regime and a generative regime. The two components, pain and community, are illustrated with specific reference to Texts for Nothing, through an analysis of which a new conjuncture of the themes of pain, community and the role of the work of art is proposed. (shrink)

Thomas Paine was an English-American political activist, philosopher, political theorist, and revolutionary. One of the Founding Fathers of the United States, he authored the two most influential pamphlets at the start of the American Revolution, and he inspired the rebels in 1776 to declare independence from Britain. His ideas reflected Enlightenment-era rhetoric of transnational human rights. He has been called "a corsetmaker by trade, a journalist by profession, and a propagandist by inclination." Odin's Library Classics is dedicated to bringing the (...) world the best of humankind's literature from throughout the ages. Carefully selected, each work is unabridged from classic works of fiction, nonfiction, poetry, or drama. (shrink)

Though it reflects on the play of Paine's name and links it can establish, this essay is concerned with the role of fiction in the performativity of texts, both literary and nonliterary, and especially texts which, like Thomas Paine's Common Sense, affect to abjure any literariness for their political efficacy. The author reads Paine with Blanchot in elucidating the power of a certain fictionality, at work for instance in the performatives that found a democratic nation.

This paper examines the inferential framework employed by Palaeolithic cognitive archaeologists, using the work of Wynn and Coolidge as a case study. I begin by distinguishing minimal-capacity inferences from cognitive-transition inferences. Minimal-capacity inferences attempt to infer the cognitive prerequisites required for the production of a technology. Cognitive-transition inferences use transitions in technological complexity to infer transitions in cognitive evolution. I argue that cognitive archaeology has typically used cognitive-transition inferences informed by minimal-capacity inferences, and that this reflects a tendency to favour (...) cognitive explanations for transitions in technological complexity. Next I look at two alternative explanations for transitions in technological complexity: the demographic hypothesis and the environmental hypothesis. This presents us with a dilemma: either reject these alternative explanations or reject traditional cognitive-transition inferences. Rejecting the former is unappealing as there is strong evidence that demographic and environmental influences play some causal role in technological transitions. Rejecting the latter is unappealing as it means abandoning the idea that technological transitions tell us anything about transitions in hominin cognitive evolution. I finish by briefly outlining some conceptual tools from the philosophical literature that might help shed some light on the problem. (shrink)

One of the great classics on democracy, Rights of Man was published in England in 1791 as a vindication of the French Revolution and a critique of the British system of government. In direct, forceful prose, Paine defends popular rights, national independence, revolutionary war, and economic growth—all considered dangerous and even seditious issues. In his introduction Eric Foner presents an overview of Paine's career as political theorist and pamphleteer, and supplies essential background material to Rights of Man. He discusses how (...) Paine created a language of modern politics that brought important issues to the common man and the working classes and assesses the debt owed to Paine by the American and British radical traditions. For more than seventy years, Penguin has been the leading publisher of classic literature in the English-speaking world. With more than 1,700 titles, Penguin Classics represents a global bookshelf of the best works throughout history and across genres and disciplines. Readers trust the series to provide authoritative texts enhanced by introductions and notes by distinguished scholars and contemporary authors, as well as up-to-date translations by award-winning translators. (shrink)

This paper is an introduction to the new field of biorhetorics. Biorhetorics is an applied form of rhetoric that evolved from the study of classical rhetoric, particularly Aristotelian. The author illustrates the stages of development necessary for the creation of a species-specific rhetoric: by (1) formalising rhetoric so as to create a functional rhetoric, (2) then reducing this to a symbolic rhetoric that can be used in conjunction with the collected data of an organism’s Umwelt (including its genome) to form (...) (3) a species-specific rhetoric. The paper draws upon the latest research on bacterial and viral communication to show the possibilities of biorhetorics. In the course of discussing the nature of biorhetorics the author distinguishes it from argumentation theory and rhetoric/s of biology, and positions alongside other fields used in the life sciences such as biosemiotics, information theory, game theory, etc. (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)

The present article aims to introduce the field of “Zoorhetorics”, as a particular case of Biorhetorics, earlier introduced by the author in the academic world. A brief explanation will be provided of its aims, methods and models, while particular attention will be devoted to the concept of “sustainable good”, considered crucial in both the “Bio-” and “Zoorhetorics” formulations.

The present article aims to introduce the field of “Zoorhetorics”, as a particular case of Biorhetorics, earlier introduced by the author in the academic world. A brief explanation will be provided of its aims, methods and models, while particular attention will be devoted to the concept of “sustainable good”, considered crucial in both the “Bio-” and “Zoorhetorics” formulations.

Interest in hypnotic treatment for pain conditions seems to be on the rise. Recent evidence shows that hypnotic analgesia interventions result in substantial cost savings following medical procedures. Experimental studies suggest that hypnosis can differentially modulate the sensory or affective dimension of pain, depending on the nature of the suggestions. However, there have been few systematic approaches to quantifying this effect across literature and less attention has been given to the specific procedures and suggestions used in hypnotic (...) treatment in research. The present paper evaluates the magnitude of the effect of hypnosis on the affective component of pain. A scientific background presents the usefulness of a hypnotic approach that uses emotion-specific wording that would elicit prior positive experience to intervene at both the sensory and affective dimensions of pain. Such an approach would enable patients who cannot effectively dissociate from the sensation of pain to diminish their affective response. The paper concludes with a discussion of the implications of the findings for future hypnosis research and for the clinical applications of hypnotic analgesia. (shrink)

Angus Fletcher is one of our finest theorists of the arts, the heir to I. A. Richards, Erich Auerbach, Northrop Frye. This, his grandest book since the groundbreaking Allegory of 1964, aims to open another field of study: how thought--the act, the experience of thinking--is represented in literature. Recognizing that the field of formal philosophy is only one demonstration of the uses of thought, Fletcher looks for the ways other languages (and their framing forms) serve the purpose of certain (...) thinking activities. What kinds of thinking accompany the writing of history? How does the gnomic sentence manage to represent some point of belief? The fresh insights Fletcher achieves at every turn suggest an anatomy of poetic and fictional strategies for representing thought--the hazards, the complications, the sufferings, the romance of thought. Fletcher's resources are large, and his step is sure. The reader samples his piercing vision of Milton's Satan, the original Thinker, leaving the pain of thinking as his legacy for mankind; Marvell's mysteriously haunting "green thought in a green shade"; Old Testament and Herodotus, Vico and Coleridge; Crane, Calvino, Stevens. Fletcher ranges over the heights of literature, poetry, music, and film, never losing sight of his central line of inquiry. He includes comments on the essential role of unclear, vague, and even irrational thinking to suggest that ideas often come alive as thoughts only in a process of considerable distress. In the end he gives us literature--not the content of thought, but its form, its shape, the fugitive colors taken on by the mind as represented in art. (shrink)

Competitor intelligence, information that helps managers understand their competitors, is highly valued in today's marketplace. Firms, large and small, are taking a more systematic approach to competitor intelligence collection. At the same time, information crimes and litigation over information disputes appear to be on the rise, and survey data show widespread approval of unethical and questionable intelligence-gathering methods. Despite these developments, few corporations address the ethics of intelligence gathering in their corporate codes of conduct. Neither managers nor management educators have (...) paid sufficient attention to this topic. From a review of questionable intelligence-gathering practices reported in various literatures, the author identifies some important ethical principles to help managers draw the line between legitimate and illegitimate methods of information acquisition. The paper also discusses the costs of failure to heed these principles and suggests steps managers can take to provide ethical leadership in this area. (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)

Theorists of human evolution are interested in understanding major shifts in human behavioural capacities (e.g. the creation of a novel technological industry, such as the Acheulean). This task faces empirical challenges arising both from the complexity of these events and the time-depths involved. However, we also confront issues of a more philosophical nature, such as how to best think about causation and explanation. This article considers such fundamental questions from the perspective of a prominent theory of causation in the philosophy (...) of science literature, namely, the interventionist theory of causation. A signature feature of this framework is its recognition of a family of distinct types of causes. We set out several of these causal notions and show how they can contribute to explaining transitions in human behavioural complexity. We do so, first, in a preliminary way, and then in a more detailed way, taking the origins of behavioural modernity as our extended case study. We conclude by suggesting some ways in which the approach developed here might be elaborated and extended. (shrink)

End-of-life decision making is fraught with ethical challenges. Withholding or withdrawing life support therapy is widely considered ethical in patients with high treatment burden, poor premorbid status, or significant projected disability even when such treatment is not ?futile.? Whether such withdrawal of therapy in the aftermath of attempted suicide is ethical is not well established in the literature. We provide a clinical vignette and propose criteria under which such withdrawal would be ethical. We suggest that it is appropriate to (...) withdraw life support, regardless of the cause of the critical illness or disability, when the following criteria are met: (1) Surrogates request withdrawal of care and the adequacy of surrogates is confirmed, (2) an external reasonability standard is met, (3) passage of time, perhaps 72 hours, to allow certainty regarding the patient's wishes, and (4) psychiatric morbidity should be considered as grounds for withdrawal only in truly treatment-refractory cases. Fundamentally, we believe the question to ask is, ?If this were not an attempted suicide, would a request to withdraw care be reasonable?? We believe that under these circumstances, such withdrawal of life support, even in an individual who has attempted suicide, does not constitute physician assistance with suicide and is distinct from physician aid-in-dying in several important respects. (shrink)

In this article, I seek to define the status and role of Thomas Paine’s Common Sense as a historical document. I argue that although Paine’s influential pamphlet offers no original ideas and seems simply to reinforce existing trends, its layered text transcends the regurgitation of propaganda and extends to literary achievement in its reflection of social and economic conditions, its deliberate narrative style, and its usage of literary devices and culture references grounded in historical context. Consequently, my methodology is necessarily (...) focused through literary discourse to achieve historical understanding of this key document from the American Revolution. (shrink)

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

A literature review of 98 articles concerning clinical pain research in newborn infants was conducted to evaluate how researchers report the ethical issues related to their studies and how journals guide this reporting. The articles were published in 49 different scientific journals. The ethical issues most often mentioned were parental informed consent (94%) and ethical review approval (87%). In 75% of the studies the infants suffered pain during the research when placebo, no treatment or otherwise inadequate (...) class='Hi'>pain management was applied. Discussion about benefits versus harm to research participants was lacking. A quarter of the journals did not have any ethical guidelines for submitted manuscripts. We conclude that ethical considerations did not play a significant role in the articles studied. Missing and superficial guidelines enable authors to offer studies with fragile research ethics. (shrink)

In light of the recent Abu Ghraib prison scandal, this paper examines various works of literature to reveal that people who have prisoners in their power tend to torment their victims. Richard Henry Dana and Herman Melville’s seafaring novels reveal how the captain and his mates assume brutal, godlike powers over the common sailors; T. E. Lawrence describes how the victim’s pain can become a masochistic pleasure; Franz Kafka imagines a state of universal guilt, where the victim, an (...) average man, suffers in the grip of an elaborate torture machine; Fyodor Dostoyevsky and Jacobo Timerman, both political prisoners who survived to describe their terror, and George Orwell, meditating on contemporary totalitarian regimes as he suffered the agonies of medical treatment, transform their pain into art. Such literary works provide insights into the morally ambiguous depths of punishment. Every scene of torture, based on the authors’ experience, observation and imagination, has the same context as those vividly captured in the Abu Ghraib snapshots. (shrink)

Across the world, pain is under-treated in emergency departments. We canvass the literature testifying to this problem, the reasons why this problem is so important, and then some of the main hypotheses that have been advanced in explanation of the problem. We then argue for the plausibility of two new hypotheses: pain's under-treatment in the ED is due partly to an epistemic preference for signs over symptoms on the part of some practitioners, and some ED practices that (...) themselves worsen pain by increasing patients' anxiety and fear. Our argument includes the following logic. Some ED practitioners depart from formal guidance in basing their acute pain assessments on observable features rather than on patient reports of pain. This is potentially due to an epistemic preference for signs over symptoms which aims to circumvent intentional and/or unintentional misrepresentation on the part of patients. However, conducting pain assessments in line with this epistemic preference contributes to the under-treatment of pain in at least three respects, which we detail. Moreover, it may do little to help the practitioner circumvent any intentional misrepresentation on the part of the patient, as we explain. Second, we examine at least four ED practices that may be contributing to the under-treatment of pain by increasing patient anxiety and fear, which can worsen pain. These practices include failing to provide orienting information and partially objectifying patients so as to problem-solve along lines pre-established by modern medical science. We conclude by touching on some potential solutions for ED practice. (shrink)

This book's importance is derived from three sources: careful conceptualization of teacher induction from historical, methodological, and international perspectives; systematic reviews of research literature relevant to various aspects of teacher induction including its social, cultural, and political contexts, program components and forms, and the range of its effects; substantial empirical studies on the important issues of teacher induction with different kinds of methodologies that exemplify future directions and approaches to the research in teacher induction.

This essay uses Solzhenitsyn’s Cancer Ward to explore the exilic effects of illness and pain. The novel is uniquely suited for such an analysis given the theme of exile that predominates both in the narrative and in the composition of multiple characters within that narrative. I argue that illness, and in particular pain, is a liminal state, an existential hinterlands. The ethical approach to literature and medicine may suggest, as a response to these exilic effects, the need (...) to cultivate connection and empathy by sharpening the moral imagination. If pain and illness exile the sufferer, the imperative to reach out takes on ethical content. (shrink)

The American School of Empire considers how an American idea of empire evolved in the 1790s and would shape and be shaped by the literature and art of the early US. Hamilton's introductory essay suggests that empire was as important to the foundation of the US as concepts like democracy, freedom, nation, and republic. This book thus begins from the premise that the history of empire in the United States can be traced back to the inception of the country, (...) if not earlier. It contends that the United States was conceived as an empire, culturally, politically, and legally. Empire, as a broad theory for organizing not only the state but also the understanding of difference and the relationship to space, in other words, was a crucial conceptual frame shaping the culture of the early US"--Provided by publisher. (shrink)

To the woman, God said, “I will greatly multiply your pain in child bearing; in pain you shall bring forth children, yet your desire shall be for your husband, and he shall rule over you.”Genesis 3:16There is now a well-established body of literature documenting the pervasive inadequate treatment of pain in this country. There have also been allegations, and some data, supporting the notion that women are more likely than men to be undertreated or inappropriately diagnosed (...) and treated for their pain.One particularly troublesome study indicated that women are more likely to be given sedatives for their pain and men to be given pain medication. Speculation as to why this difference might exist has included the following: Women complain more than men; women are not accurate reporters of their pain; men are more stoic so that when they do complain of pain, “it's real”; and women are better able to tolerate pain or have better coping skills than men. (shrink)

In Sin Sick, Joshua Pederson draws on the latest research about identifying and treating the pain of perpetration to advance and deploy a literary theory of moral injury that addresses fictional representations of the mental anguish of those who have injured or killed others. Pederson's work foregrounds moral injury, a recent psychological concept distinct from trauma that is used to describe the psychic wounds suffered by those who breach their own deeply held ethical principles. Complementing writings on trauma theory (...) that posit the textual manifestation of trauma as absence, Sin Sick draws argues that moral injury appears in literature in a variety of forms of excess. Pederson closely reads works by Dostoevsky (Crime and Punishment), Camus (The Fall), and veterans of the wars in Iraq and Afghanistan (Brian Turner's Here, Bullet; Kevin Powers' The Yellow Birds; Phil Klay's Redeployment; and Roy Scranton's War Porn), contending that recognizing and understanding the suffering of perpetrators, without condoning their crimes, enriches the experience of reading—and of being human. (shrink)

Part philosophical meditation, part cultural critique, The Body in Pain is a profoundly original study that has already stirred excitement in a wide range of intellectual circles. The book is an analysis of physical suffering and its relation to the numerous vocabularies and cultural forces--literary, political, philosophical, medical, religious--that confront it.Elaine Scarry bases her study on a wide range of sources: literature and art, medical case histories, documents on torture compiled by Amnesty International, legal transcripts of personal injury (...) trials, and military and strategic writings by such figures as Clausewitz, Churchill, Liddell Hart, and Kissinger, She weaves these into her discussion with an eloquence, humanity, and insight that recall the writings of Hannah Arendt and Jean-Paul Sartre.Scarry begins with the fact of pain's inexpressibility. Not only is physical pain enormously difficult to describe in words--confronted with it, Virginia Woolf once noted, "language runs dry"--it also actively destroys language, reducing sufferers in the most extreme instances to an inarticulate state of cries and moans. Scarry analyzes the political ramifications of deliberately inflicted pain, specifically in the cases of torture and warfare, and shows how to be fictive. From these actions of "unmaking" Scarry turns finally to the actions of "making"--the examples of artistic and cultural creation that work against pain and the debased uses that are made of it. Challenging and inventive, The Body in Pain is landmark work that promises to spark widespread debate. (shrink)

Pain is the most frequently communicated complaint among elderly people. Discussion of the ethics of pain management in nursing home residents has not appeared in the literature. The purpose of this article is to present an ethically-based pain management action plan for elderly nursing home residents. Nurses empowered with the latest information and cognizant and comfortable with their own views about pain are likely to effectuate a positive patient outcome. Further research will add to the (...) current knowledge base while laying the groundwork for new interventions. (shrink)

The intriguing issue of pain and suffering in patients with disorders of consciousness (DOCs), particularly in Unresponsive Wakefulness Syndrome/Vegetative State (UWS/VS) and Minimally Conscious State (MCS), is assessed from a theoretical point of view, through an overview of recent neuroscientific literature, in order to sketch an ethical analysis. In conclusion, from a legal and ethical point of view, formal guidelines and a situationist ethics are proposed in order to best manage the critical scientific uncertainty about pain and (...) suffering in DOCs and ensure the best possible care for the patient. (shrink)

The Violence of Reading: Literature and Philosophy at the Threshold of Pain expounds the scene of reading as one that produces an overwhelmed body exposed to uncontainable forms of violence. The book argues that the act of reading induces a representational instability that causes the referential function of language to collapse. This breakdown releases a type of “linguistic pain” (Scarry; Butler; Hamacher) that indicates a constitutive wounding of the reading body. The wound of language marks a rupture (...) between linguistic reality and the phenomenal world. Exploring this rupture in various ways, the book brings together texts and genres from diverse traditions and offers close examinations of the rhetoric of masochism (Sacher-Masoch; Deleuze), the relation between reading and abuse (Nietzsche; Proust; Jelinek), the sublime experience of reading (Kant; Kafka; de Man), the “novel of the institution” (Musil; Campe), and literary suicide (Bachmann; Berryman; Okkervil River). (shrink)

This book argues that the negotiation of agency is central not only to the experience of war but also to its representation in cultural expressions, ranging from a notion of disablement, expressed in victimization, immobilization, traumatization, and death, to enablement, expressed in the perpetration of heroic, courageous, skillful, and powerful actions of assertion and dominance. In order to illustrate this thesis, it provides a comprehensive analysis of literary representations of the American War of Independence from 1775, the beginning of the (...) war, up until roughly 1860, when the Civil War marked a decisive historical turning point. As the first national war, it has an unquestionably exemplary status for the development of American conceptions of war. The in-depth study of exemplary texts from a variety of genres and by authors like Thomas Paine, Benjamin Franklin, James Fenimore Cooper, Catharine Sedgwick, William Gilmore Simms, and Herman Melville, demonstrates that the overall character of Revolutionary War literature presents the war as a forum in which collective and individual agency is expressed, defended, and cultivated. It uses the military environment in order to teach the values of discipline and self-subordination to a communal good, which are perceived as basic principles of a Republican virtue to guide the actions of the autonomous individual in a popular democracy. (shrink)

Those who write about pain management have focused almost entirely on delivery issues, paying essentially no attention to the federal regulatory challenges that affect the development of pain relief technologies — namely, pharmaceuticals and medical devices indicated for analgesic uses. The academic literature is strangely devoid of any sophisticated discussion of the difficulties that attend, first, the product approval decisions of the Food and Drug Administration and, second, the scheduling decisions made by the Drug Enforcement Administration. If (...) a “bottleneck” develops upstream, it could have serious repercussions downstream — without pain relief technologies, the issues of access that have preoccupied previous commentators would have little practical consequence.The modern pharmaceutical industry traces its origins back more than a century, around the time that the German company Bayer first synthesized aspirin and began marketing it as an analgesic. (shrink)

Philosophers think of pain less and less as a paradigmatic instance of mentality, for which they seek a general account, and increasingly as a rich and fruitful topic in its own right. Pain raises specific questions: about mentality and consciousness certainly, but also about embodiment, affect, motivation, and value, to name but a few. The growth of philosophical interest in pain has gone hand-in-hand with the growth of pain science, which burgeoned in the 1960s. This is (...) no accident: developments in pain science have prompted philosophers to take account of empirical data, and to revisit their assumptions about pain. Pain, in short, demands interdisciplinary investigation, hence while this entry focuses on the philosophy of pain, it makes liberal reference to empirical literature along the way. This entry’s focus is on physical pains, that is pains that are felt in bodily locations, not emotional suffering more broadly, such as grief or disappointment. The entry also does not address pain’s place in ethical theories; its focus is rather on issues that arise within philosophy of mind. Even so, part of what makes pain such an interesting and important topic is that the questions it raises span boundaries, and normative questions concerning pain’s badness, on the one hand, and its value, on the other, are never far away. (shrink)

Charles Dickens began one of his many great works of literature with this seemingly paradoxical, self-contradictory statement. Reflecting on a jury verdict in Northern California in June of 2001, in the context of what has transpired during the decade of the 1990s with regard to the care of dying patients, observations in the genre of Dickens come readily to mind. In 1991, two of the most compelling books on the subject of pain, medicine, and society were published: Eric (...) Cassell's The Nature of Suffering and the Goals of Medicine and David Morris's The Culture of Pain. Both works unflinchingly recognized and explored the implications of the vast clinical literature documenting the failure of modern medicine to respond compassionately and effectively to what had by then become an epidemic of undertreated pain. (shrink)

This paper proposes that human expression of pain in the presence or absence of caregivers, and the detection of pain by observers, arises from evolved propensities. The function of pain is to demand attention and prioritise escape, recovery, and healing; where others can help achieve these goals, effective communication of pain is required. Evidence is reviewed of a distinct and specific facial expression of pain from infancy to old age, consistent across stimuli, and recognizable as (...) pain by observers. Voluntary control over amplitude is incomplete, and observers can better detect pain that the individual attempts to suppress rather than amplify or simulate. In many clinical and experimental settings, the facial expression of pain is incorporated with verbal and nonverbal vocal activity, posture, and movement in an overall category of pain behaviour. This is assumed by clinicians to be under operant control of social contingencies such as sympathy, caregiving, and practical help; thus, strong facial expression is presumed to constitute an attempt to manipulate these contingencies by amplification of the normal expression. Operant formulations support skepticism about the presence or extent of pain, judgments of malingering, and sometimes the withholding of caregiving and help. To the extent that pain expression is influenced by environmental contingencies, however, could equally plausibly constitute the release of suppression according to evolved contingent propensities that guide behaviour. Pain has been largely neglected in the evolutionary literature and the literature on expression of emotion, but an evolutionary account can generate improved assessment of pain and reactions to it. (shrink)

The coronavirus disease 2019 (COVID-19) pandemic is associated with various painful symptoms and could potentially lead to a significant increase in patients experiencing chronic pain. While churches had to close their doors during the pandemic, emerging scientific data suggest that, when our spiritual needs are not met, our well-being can be in jeopardy, and it could also increase the experience of physical pain. The aim of this article is, therefore, to explore the role that spirituality and religion could (...) play in addressing physical pain. An interdisciplinary approach is used with the goal of integrating different insights so as to construct a more comprehensive understanding of the problem. Literature in the disciplines of humanities, health sciences, as well as social sciences is explored to identify the concepts of physical, social and spiritual pain and to explore the link between the different dimensions of pain. It became clear that physical, social, and spiritual pain can influence one another, and addressing one kind of pain can also improve pain in another dimension. Several spiritual and religious interventions were found in the literature and confirmed to be valuable in helping patients cope with physical pain, such as accepting and giving meaning to pain, prayer, meditation, scripture, music, support from the religious community and helping others.Contribution: This article highlights the importance of an interdisciplinary approach that incorporates religion and/or spirituality to address physical pain during and after the COVID-19 pandemic. (shrink)

Harold Sonny Ladoo’s 1972 novel No Pain Like This Body has been analyzed for its seminal representation of the traumas experienced by a formerly indentured Indo-Trinidadian family in the early twentieth century. However, relatively little attention has been given to Ladoo’s experimentation with multiple languages, particularly English, Trinidadian Creole, and Hindi. This article argues that Ladoo’s multilingualism offers a guide for approaching the traumatic experiences he represents. While some aspects of the novel, such as its glossary, make the characters’ (...) language more comprehensible, others, such as the orthography Ladoo chooses to represent Creole speech, deliberately distance the reader. Using decolonial theorists of language, particularly Édouard Glissant's writing on multi­lingualism and opacity, this article considers Ladoo’s use of multilingualism both as a limit to readers’ understanding as well as an invitation to continued engagement with those aspects of the text that are resistant to easy comprehension. This article contrasts opacity as a reading methodology with some of the dominant paradigms for understanding linguistic difference in the field of comparative literature, which rely on linguistic and textual mastery. Ultimately, the article proposes reading multilingual texts through opacity as a model for decolonial reading in which creative, active engagement with the text can produce solidarity without requiring complete transparency. (shrink)

Learning new movement patterns is a normal part of daily life, but of critical importance in both sport and rehabilitation. A major question is how different sensory signals are integrated together to give rise to motor adaptation and learning. More specifically, there is growing evidence that pain can give rise to alterations in the learning process. Despite a number of studies investigating the role of pain on the learning process, there is still no systematic review to summarize and (...) critically assess investigations regarding this topic in the literature. Here in this systematic review, we summarize and critically evaluate studies that examined the influence of experimental pain on motor learning. Seventeen studies that exclusively assessed the effect of experimental pain models on motor learning among healthy human individuals were included for this systematic review, carried out based on the preferred reporting items for systematic reviews and meta-analyses statement. The results of the review revealed there is no consensus regarding the effect of pain on the skill learning acquisition and retention. However, several studies demonstrated that participants who experienced pain continued to express a changed motor strategy to perform a motor task even 1 week after training under the pain condition. The results highlight a need for further studies in this area of research, and specifically to investigate whether pain has different effects on motor learning depending on the type of motor task. (shrink)

Pains that persist long after damaged tissue hasrecovered remain a perplexing phenomenon. Theseso-called chronic pains serve no useful function foran organism and, given its disabling effects, mighteven be considered maladaptive. However, a remarkablesimilarity exists between the neural bases thatunderlie the hallmark symptoms of chronic pain andthose that subserve learning and memory. Bothphenomena, wind-up in the pain literature andlong-term potentiation (LTP) in the learning andmemory literature, are forms of neuroplasticity inwhich increased neural activity leads to a longlasting (...) increase in the excitability of neuronsthrough structural modifications at pre- andpost-synaptic sites. Moreover, the synapticmodifications of wind-up and LTP share a commonmechanism: a glutamate N -methyl-D-aspartate(NMDA) receptor interaction that initiates a calciummediated biochemical cascade that ultimately enhancessignal processing at the -amino-3-hydroxy-5-methyl-4-isoxazoleproprionic acid (AMPA) receptor. This paper arguesthat chronic pain, which has no adaptive value, canbe accounted for in terms of the highly adaptivephenomenon of activity-dependent neural plasticity;hence, some cases of chronic pain can beconceptualized as a memory trace in spinal neurons. (shrink)

The pain-assessment literature often claims that pain is subjective. However, the meaning and implications of this claim are left to the reader’s imagination. This paper attempts to make sense of the claim and its problems from the history and philosophy of science perspective. It examines the work of Henry Beecher, the first person to operationalize “pain” in terms of subjective measurements. First, I reconstruct Beecher’s operationalization of “pain.” Next, I argue this operationalization fails. Third, I (...) salvage Beecher’s insights by repositioning them in an intersubjective account. Finally, I connect these insights to current pain-assessment approaches, showing that they enrich each other. (shrink)

According to berkley's review, women have a higher risk of suffering from pain than men. If this is true, there should be more frequent and more intense activity both in the pain excitatory system and in the pain inhibitory system of women than of men. Consequently, it remains unclear whether the overall effect at the end is more pain or less pain in women. This conclusion fits the weak sex differences observed for experimental and clinical (...) pain as shown by BERKLEY's review of the literature. (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)

The standard view of pains among philosophers today holds that their existence consists in being experienced, such that there can be no unfelt pains or pain hallucinations. The typical line of support offered for this view is that it corresponds with the ordinary or commonsense conception of pain. Despite this, a growing body of evidence from experimental philosophers indicates that the ordinary understanding of pain stands in contrast to the standard view among philosophers. In this paper, we (...) will survey this literature and add to it, detailing the results of seven new studies on the ordinary understanding of pain using both corpus analysis and questionnaire methods. (shrink)

In this paper, I argue that clinically-oriented practical and theoretical approaches to the problem of pain should more carefully heed narrative and phenomenological research. I begin with the work of S. Kay Toombs, contending that her phenomenological account of multiple sclerosis demonstrates how a degenerative condition attendant with pain ultimately effect a constriction of one’s world. Drawing upon two of artist Yosl Bergner’s depictions of the story, I then present a reading of Kafka’s “The Vulture” as a literary (...) account of the constrictive movement of acute, localized pain to chronic, systemic pain. I conclude by discussing the implications of literary and phenomenological accounts of pain for its diagnosis, management, and treatment. (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)

Despite its lack of conceptual clarity and uniform definition, the term drug‐seeking is used frequently by nurses from a variety of practice environments. The drugs patients are referred to as seeking are often pain medications. This is important because nursing has widely adopted a patient‐centric definition of pain. Nursing also has a robust ethical code that places high value on human dignity and nurses’ role in patient advocacy. A review of literature was conducted with the aims of (...) describing whether/how the term drug‐seeking has changed over time and to determine whether the use of the term in nursing literature is consistent with nursing values. Use of the term has shifted from objective counts of patient requests for medication to a confusing mixture of observable patient behavior and subjective interpretations of patient motivation. Its use is not consistent with nursing values. It is, in fact, a good illustration of stigmatization in nursing. Stigmatization is contrary to nursing values. Nurses in practice, research, education, authors, reviewers, and editors all have a role in ending this stigmatization. (shrink)

The purpose of this article is to describe the main ethical issues in paediatric nontherapeutic qualitative pain research. It is based on an analysis of the research literature related to ethical issues in research and on experiences from a family interview study focusing on pain assessment and management in children aged 1-6 years. In addition, different views concerning obtaining informed consent from children, as published in the research literature, are compared. Ethical challenges occur during all stages (...) of qualitative research. The risks of emotional distress and possible benefits of the results must be assessed prior to conducting a study. However, risks and harm are difficult to avoid in a study in which the research area, pain, raises emotional distress in both parents and children. The children’s assent and parental permission are both required. It is essential to obtain informed consent from all family members when family research is conducted. Participants’ privacy and confidentiality should be protected during data collection, analysis and publication. Protecting children from harm may be impossible during pain research in which they are required to recall a painful postoperative period. However, after data collection they can be assisted to focus on pleasant activities, for example, by engaging in playful activities with them. Finally, the role of the nurse and the researcher should be carefully assessed, especially in qualitative research, in order to be able to analyse the data and report the findings in an unbiased manner. (shrink)