Pain and Philosophy

Pain is a fascinating philosophical concept. We have been thinking about it for years, and many seminal philosophy papers deal with the nature of pain. What is it? Why does it happen? How do we quantify it? How do we experience it? Someday I'll probably study this again, but I wanted to share some specific questions that interest me in particular. In medicine, we regard it as a "fifth vital sign," yet unlike other vitals, it has a subjective element to it. A 10/10 pain is different to a child than to a woman who has had three children and kidney stones. The same surgical incision may elicit completely different pain scores from two different patients. It contains a relativistic component; when we say "a 10 is the worst pain you can imagine," imaginations differ widely and experiences differ widely. Pain is contained within the experience of the person who has it, and it must undergo some interpretation for that person to quantify or qualify it to someone else. Every other vital sign is objectively measured, but pain is not. Yet rapidly evolving sciences may someday devise a way to measure someone's pain with a device or instrument. Will we one day quantify the number of C-fiber neurons firing and correlate that with a severity of experience? What will that mean? Is that a fair thing to do?

Pain and suffering also have etiologic questions. Why do they exist? Certainly, there is a survival benefit to withdrawing one's hand if one encounters a fire. But there are a lot of other pains that don't seem to have an obvious Darwinian benefit. Are migraines protective in any way? Why does chronic neuropathic pain occur? Shouldn't a crucially important pain such as angina be more specifically felt by a patient than just "chest discomfort?"

These are just some of the philosophical issues about pain that fascinate me. Pain is much more than something to treat with morphine. It is an experience that profoundly changes patients' lives, their sense of well-being, their hormones, their psychology. Perhaps thinking of pain in a philosophical sense isn't for everyone, but for me, I find it enlightening.