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There are people who say that we negative utilitarians are obsessed with pain, and they are right. These people say that there is not only physical pain (or “pain”) but also the psychological pain (or “suffering”) and that this suffering can also be horrible, and they are right. They also say there are more things in life. That there are other interests, not only the interest in ceasing to suffer, but also the interest in enjoying, and here also are right.They also say that there is not only (physical) pleasure, but a whole range of very complex psychological satisfactions that are desirable, and that’s right. They say that there are masochists for whom small “pains” can be cause of satisfaction and pleasure and the relevant thing is not simply “pain”, but the interest in what happens or stops happening, and they are right as well. For example, there are deadly carcinogenic radiations that are not noticeable, do not produce pain. In some place, these radiations can occur and maybe we can experience pleasure going to that place, but deep down that does not interest us, even if we do not know it.

They also say that pain is useful: it can lead to personal growth, sometimes it can serve us to appreciate the value of positive things, and above all serves as an alert to avoid negative. Proof of this are the people who suffer some type of hereditary neuropathies, a congenital insensitivity to pain with anhidrosis, a rare disease that affects some beings making them insensitive to physical pain, whose bodies end up being damaged inadvertently, reducing long life expectancy. They are right.

There are those who say that focusing on suffering is depressing, and in some cases may be true. They also say that ignoring pain and not paying attention to it is a way to relieve it, and it is true that in some cases this psychological mechanism works. But extending this idea and propose to apply a “positive thinking” (it would be better to call it a “wishful thinking“) to all circumstances of life, ignoring the suffering, is cruel and one of the most stupid things that we might do. If we did not pay attention to pain and suffering, there would be no anesthesia, and palliative care would not exist. In fact, there would not be medicine at all.

There are two types of interests: positive and negative. Interest in “going” and interest in “escape”. Interest in something happening and interest in something that does not happen. The former are usually associated with pleasure (interest in eating, having sex). Seconds to pain (avoid a predator or a burn). In this article I develop more the idea of the different utility of these two types of experiences (p. 5-7).

I consider that there is no substantial, essential difference between physical and psychic pain. But for the privileged rich humans of our time, the difference is relevant. Why? Because we have managed to avoid physical pain so well with anesthetics, painkillers and other drugs, that what concerns us and obsesses us now is pain of psychological origin. The most relevant aspect of the psychological pain, now, is that it is “that pain that we have not been able to avoid yet.”

In my case, when I write, every time I speak about “pain” I also refer to psychological pain. And every time I speak about “pleasure” I also mean the most sublime satisfaction that can be imagined, like to be admired, or the sense of transcendence, spirituality, etc. If there is someone who enjoys small pains, I classify it as a “pleasure”, as “things I want to happen.” That is really the important thing: interests.

An illustrative example

Imagine that I “sacrifice” myself for another person whom I appreciate, experiencing myself some suffering to avoid it to another one, even when that suffering that I experience is greater than the one I am avoiding to the other person.

If I decide to suffer myself (a suffering that I will call S1) so that other loved one do not suffer (a suffering that I will call S2), even though my individual suffering (S1) is greater than the potential suffering I am avoiding in my loved one (S1> S2), I am choosing between two evils a lesser evil, since in reality my overall assessment of the situation is that it is worse for the loved one to suffer, since the S2 of my loved one, if exists, implies a new suffering on my part (S3) that is originated by my own assessment of the existence of S2. I choose to suffer (S1) and in doing so, I suffer less, seen globally (because S1 < S2 + S3). This way I’m avoiding what is for me the worst of situations (S2 + S3), that is, my loved one suffering (S2) plus my assessment of the importance of that suffering (S3), and ignoring the valuation of my loved one, who curiously could be the symmetrical.

As can be seen, everything is a matter of preferences and interests. I could use the word interest when I write, but interest sounds like “interesting movie”. And preferences sounds like “ordering at a restaurant”. “Pain” reflects much better what is happening. Of course, the morally relevant is the satisfaction of preferences, or interests, which is the same idea. Perhaps all that has been explained is only a lexical problem of definitions, if it exists. The next interesting topic to consider is to assess which are the most relevant interests or preferences. The axiology is the branch of philosophy that deals with the valuations of what is valuable, and tries to answer the question: “What is important?”

We negative utilitarians ask the question, and to answer it, we do an exercise of imagination and empathy to suppose how it can be to experience all kinds of situations, the greatest physical and psychological pleasures, such as greater orgasms, to receive a Nobel Prize, to fall in love and to be reciprocated, to triumph in karaoke or to be the director of that film you always wanted to do… whatever… And also the greatest pains and sufferings… and we came to the conclusion that avoiding suffering (and especially, in my opinion, to avoid intense suffering) is the highest moral priority. That is, avoiding intense suffering is the most valuable thing.

I believe that gathering testimony from those who have suffered horrible things like tortured or large burned can be very useful. These people possibly also knew the happiness of love or at least the pleasure of the orgasm. They know both worlds. What are the priorities for them? We could ask them about if they’d accept to go through that experience again to enjoy certain things; or on the contrary, if they would prefer not to enjoy certain things, in order to avoid such experience. This can help us understand what is more valuable. Just as people who have never experienced an orgasm should have difficulty in appreciating its positive value, it is reasonable to consider that people who have never been tortured (most) or who have never suffered the agony of pre-death instants (all) can’t correctly appreciate its negative value. If the reflection on the very negative and terrible things produces on us restlessness and rejection, which is understandable, we run the risk of ignoring or underestimating the highest of moral priorities: to alleviate and to prevent the extreme suffering.

The privileged who belong to social groups that have managed to keep away from physical pain should pay more attention to those who suffer it, especially in cases where it is more difficult to understand, as in the case of nonhuman animals, or terminally ill patients who die without adequate palliative care. In particular, there is a terrible risk that numerous human deaths are occurring systematically in the form of extreme suffering, while physicians are more concerned about avoiding potential legal problems than providing pain-relieving analgesics, and relatives, if they exist, often make the mistake of staying on the sidelines, cowed in front of doctors for their own lack of knowledge, vulnerable to the arbitrariness of the criteria of different religions, and impressed by the philosophical aspect that a loved one is going to die and stop living.