A Social Account of Suffering

50,000 cultured brain cells sit in a petri dish. Through a combination of electronic sensors, software engineering and robotic sculpture, the physiology of the cells interacts with the psychology of some patrons of an art gallery [1]. From this transaction, judgments arise - the audience might report feelings of being watched, of play, or simply of remotely observing an oblivious 'seizure machine.' One particular type of audience member, the Animal Ethicist, might even wonder if we should be worried that the culture of brain cells (as a former animal) might be in pain.

Brain cells, electrodes, and tiny Peter Singer (image from here). 

While in most cases it is fairly straightforward to determine that a human is in pain, when one starts to asks if non-humans (or even humans with severe communication problems, such as locked-in patients) are in pain, it is common to turn to neuroscience for help. The idea is that while mental states (such as pain and suffering) can only be deduced from behavior if the behaviors are 'wired up correctly,' mental states are always (or non-contingently, to borrow the language of Dr. Martha Farah [2]) related to brain states. Thus, the tools of neuroscience can give us direct access to the amount of pain an organism is experiencing, bypassing a body that might hide this information from us (which could happen because of injury, or because the body was never equipped with a human face). We are obligated to perform this scientific investigation, as we have an obligation to prevent pain and suffering.

Pain is something the brain does.  Nociception sends information about tissue damage (1) through the spinal cord, where such information can be modulated (2).  However, pain doesn't really become that nasty, unpleasant experience until it weasels its way into your limbic system (4).  Image retrieved from here.  

At this point, we are working with the following assumption:



1) “Neural systems are the substrate of private, internal 'mental' events (such as “suffering”), which can be a source of moral value”



Amusingly enough, this assumption can lead us to a mathematical formulation of suffering. The logic is as follows: the human brain, as well as perhaps other brains, has the capacity for suffering. We can be somewhat precise about this, and say that this capacity is defined as the 'natural' ability to orchestrate behaviors that have been identified as correlates of suffering (such as freezing, favoring limbs, calling for help, and 'pained' facial expressions), in response to stimuli that are 'naturally' associated with suffering (extended bouts of pain, either physical of social). The circuitry within the brain that provides this capacity, while not yet fully understood, should in principle be a physical, deterministic system. As part of a physical, deterministic system, this circuitry should be describable as a set of mathematical relationships. Furthermore, as we earlier decided that mental states are only contingently related to brain states, it is this mathematical relationship (which the 'suffering-behaviors' merely point to) that is the essence of suffering [3].

Is pain merely a mathematical construct?  Image from here. 

The implications of this are delightfully absurd: if suffering is a mathematical relationship, then any system that implements that relationship (a rat, a culture of brain cells, or a deviously engineered toaster) should qualify as being able to suffer, and under some ethical systems (here I am alluding to those of the animal ethicists Peter Singer and Richard Ryder) thus enter into the realm of morally relevant beings. That is, it becomes a moral obligation to prevent these entities from suffering, no matter how silly or alien their “suffering” might appear, simply due to the physical laws that govern part of their behavior.



Before we get too carried away (and start passing laws against posting such equations in public), let us carefully revisit that assumption number 1. This statement can be problematized from a variety of perspectives (it's Cartesian, for God's sake!), but lets stick to a neuroscientific perspective. First, we've supposed the existence of private, internal events (“qualia”) that can't be directly measured, and have to be accounted for in addition to the (public) neural events that we can measure. Secondly, we must also deal with the fact that we've given these mysterious, ghostly events control over value, effectively tying one mystery to another. Compare the above assumption then, to the one below:



2) “Neural systems are the substrate of public, embedded 'social' events (such as “suffering”), which can be a source of moral value”



This small change in wording has solved the two problems outlined with assumption 1. First, we no longer have to contend with an awkward metaphysics that describes two kinds of events (internal, unmeasurable “mental” events and our normal, measurable “physical” events)- instead, all events are now public and capable of being measured (which, as scientists, causes us a sigh of relief). Secondly, we no longer have value popping out of nowhere. Instead, suffering has moral value as it is a social event: a social, 'embedded' subject is needed to judge that suffering to has occurred, and while doing so judges this suffering to be 'bad.'

This can be seen as emphasizing (after Dr. Grant Gillett[4] and Dr. Daniel Goldberg[5]) the social components of subjectivity (specifically, handing the definitions of subjective experiences to the social realm), while denying that subjectivity exists outside of the social realm (after Dr. Daniel Dennett[6]).

Is "do cockroaches feel pain?" a question for neuroscientists studying cockroaches, or for social scientists studying humans?  Animated version here!

One disadvantage of this perspective is that it limits what we can expect to learn about pain if neuroscience focuses exclusively on "pain-pathways," while ignoring empathy.  This social perspective on suffering suggests that multiple entities (or at least multiple systems in the same entity) must be interacting before we can talk about suffering, or subjective states at all[7].  Instead, whatever abstractions or circuits that we come across within a single brain must be considered as the building blocks of subjectivity and morality, and not equivalent to such.  This implies an obligation to use value-neutral descriptions of neural states and circuits, or risk confusing “the substrate for the reality,” in the words of Dr. Gillett[4].  Thus, we can't look at a culture of rat neurons sitting in a dish and evaluate their subjective state by using the techniques of neuroscience- the question is one for the audience.



Lastly, one advantage of this conception of suffering:  by not rejecting the social component of suffering, we are forced to accept suffering as being a thick, value-laden concept that escapes reduction to a sterile set of equations, or carnal set of 'brain states.'  Suffering instead is seen as a function of not just the individual, but also the ever-changing culture the individual exists within.

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[1] Zeller-Townson, RT. (2012). Why use Brain Cells in Art? The Neuroethics Blog. Retrieved on April 29, 2013, from http://www.theneuroethicsblog.com/2012/09/why-use-brain-cells-in-art.html

[2] Farah, Martha J. "Neuroethics and the problem of other minds: implications of neuroscience for the moral status of brain-damaged patients and nonhuman animals." Neuroethics 1.1 (2008): 9-18.

[3] Unless you hold that the fact that these equations are being expressed through neurons, rather than other physical systems, is morally salient- but that is another blog post.  I'm adopting a functionalist stance in this post.

[4] Gillett, Grant R. "The subjective brain, identity, and neuroethics." The American Journal of Bioethics 9.9 (2009): 5-13.

[5] I'd like to thank Dr. Daniel Goldberg for pointing out these particular accounts of pain (via twitter, of all places!) Goldberg, Daniel. "Subjectivity, consciousness, and pain: The importance of thinking phenomenologically." The American Journal of Bioethics 9.9 (2009): 14-16.

[6] Dennett, Daniel C. Consciousness explained. ePenguin, 1993.

[7]This isn't to say that someone can't suffer (or experience other, more pleasant qualia) in isolation.  I am merely suggesting that the judgment that this subject makes, "I am suffering," is as much a function of the subject's brain state, as it is the social environment that shaped the subject's operational definition of 'suffering.'  However, I am saying that if no one applies the label "suffering" to a state (say, the struggles of a virion as it battles your immune system), ever, then it hasn't suffered.





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Zeller-Townson, R. (2013). A Social Account of Suffering. The Neuroethics Blog. Retrieved on
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Uncovering the Neurocognitive Systems for 'Help This Child'

In their article, “Socioeconomic status and the brain: mechanistic insights from human and animal research,” Daniel A. Hackman, Martha J. Farah, and Michael J. Meaney explore how low socioeconomic status (SES) affects underlying cognitive and affective neural systems. They identify and focus on two sets of factors that determine the relationship between SES and cognitive development: (1) the environmental factors or ‘mechanisms’ that demonstrably mediate SES and brain development; and (2) those neurocognitive systems that are most strongly affected by low SES, including language processing and executive function.  They argue that “these findings provide a unique opportunity for understanding how environmental factors can lead to individual differences in brain development, and for improving the programmes and policies that are designed to alleviate SES-related disparities in mental health and academic achievement” [1].

Neuroscience can tell us how SES may affect her brain.

Can it move us to do something about it?

Theoretically, I have no doubt that neuroscience can make a powerful contribution to early childhood development by determining whether and which neurocognitive systems appear to be more extensively affected by low socioeconomic status.

This is, as the authors themselves point out, important work, because understanding which systems are affected can help educators and policy-makers develop programs to target them more directly and successfully. For example, the work of D’Anguilli et. al. demonstrates that low-SES children pay more attention to unattended  stimuli, and are thereby more susceptible to becoming distracted and having a harder time focusing on a given task. [2] A corresponding, corrective strategy would consist in introducing games, lessons and computer-based strategies which explicitly target executive functions – and indeed, just such a set of measures is being used by the Tools of the Mind curriculum, which as of this year is being implemented in 18,000 pre-kindergarten and kindergarten classrooms, in Head Start programs, public schools, and childcare centers across the nation.

Fig. 1: The yellow 'brain development' box represents those neurocognitive systems that are most affected by low SES, and could include 'language processing' and 'executive function'

So far, so good. So what am I worried about?



What do you think? 



I’m not ‘worried’ so much as left wondering about one issue in Hackman et. al.’s review that I would now like to explore, and that I would welcome further discussion about.



My concern relates to the broader relationship between scientific knowledge and our individual and collective moral motivation to do something about an ongoing injustice. Allow me illustrate what I mean using two diagrams adapted from the Hackman et. al. article. The first represents the state of our knowledge regarding the relationship between SES and development, without any concrete neuroscientific understanding of the neurocognitive systems that mediate between them:

Fig. 2: We know that SES affects developmental outcomes,

even if we don't understand the neurocognitive systems that mediate the relationship

The second represents the state of our knowledge regarding the relationship between SES and development, now including our emerging neuroscientific understanding of the neurocognitive systems that mediate between them, outlined in the paper:

Fig. 3: Neuroscience is beginning to elucidate which neurocognitive systems are

most strongly affected by SES, and thereby influence children's developmental outcomes

My question is this: if sociologists and psychologists have already firmly established the relationship between SES, specific environmental mediators, and resulting developmental outcomes, as in Figure 1, (and they have, as the evidence cited by Hackman’s et. al. attests to), then can the addition of a scientific understanding of the intermediary mechanisms in any way enhance or strengthen our practical commitment to improving children’s SES and the corresponding environmental mediators that affect their development?  In other words, if I already know that SES, and specifically prenatal influences, directly affect elements of children’s cognitive and emotional development, do I need to know anything before doing something about it? And will knowing more about it, including understanding the causal sequence mediating the relationship, prompt me to do anything more about it than I was doing before?



Again, as mentioned, I fully recognize and appreciate the potential of neuroscientists and their collaborators to “design of more specific and powerful interventions to prevent and remediate the effects of low childhood SES.” [1] A second, equally essential neuroscientific question to explore is whether certain brain propensities increase the likelihood of individuals' living in low-SES circumstances. Could we say that certain brain propensities correspond to developmental diseases, or to a kind of physical handicap - one that traps people in poverty and decreases their likelihood of attaining a better quality of life?  If so, would this oblige us to take action? These are fundamental questions that need to be explored further. For my part, I'm not sure I agree with the statement that neuroscience can “highlight the importance of policies that shape the broader environments to which families are exposed” with any more clarity or motivational force than our existing knowledge already does. [1]



I am a neurophile, but…

Here’s why I’m slightly skeptical.  To borrow an example from the philosopher Peter Singer, imagine that you’re driving down the street and see a person bleeding profusely from his leg. [3] You could rush in and help this man, but you’re wearing your brand new, $375 J.Crew Ludlow suit jacket, so you think to yourself, ‘Ok, do I leave him there? I mean, it’s terrible, but I guess so, because I don’t want to get blood all over my beautiful jacket.’ If you responded to the situation in this way, we would probably call you a moral monster.

One of these is not like the other. Or...?

Now consider a different case. Imagine that you’re watching your favorite episode of the Walking Dead when a commercial from Care comes on and reminds you that for $375, you could pay for and facilitate 8 healthy births, and thereby help save the lives of several mothers and their babies. Now you think to yourself "Well, I guess it would be good to save those people, but I really just want that jacket." In this case, our general consensus would be that while you're no Mother Theresa, we probably wouldn't want to condemn for being a moral monster. (After all, that jacket is made from 'world class wool'!) So what gives? As Singer pointed out in a series of influential articles, our rational obligation towards the mothers and their newborns should be the same as towards the bleeding man. [3] So how and why do our intuitions differ?

In his article, “From neural ‘is’ to moral ‘ought’: what are the moral implications of neuroscientific moral psychology?,” the philosopher Joshua Greene suggests that an evolutionary perspective may help explain the differences in our responses. He proposes, “consider that our ancestors did not evolve in an environment in which total strangers on opposite sides of the world could save each others’ lives by making relatively modest material sacrifices. Consider also that our ancestors did evolve in an environment in which individuals standing face-to-face could save each others’ lives, sometimes only through considerable personal sacrifice. Given all of this, it makes sense that we would have evolved altruistic instincts that direct us to help others in dire need, but mostly when the ones in need are presented in an ‘up-close-and-personal’ way.” [4] According to Greene, this makes a sense of why human beings can be extraordinarily altruistic in their immediate, interpersonal interactions, but still gobsmackingly selfish in their transnational relations.



Unfortunately, our relationship to children in lower-SES environments is closer to the distant pregnant mothers in Singer's analogy than it is to the bleeding stranger right in front us. Few of us interact with low-SES children on a daily basis, and so many of us worry about how they get on in more abstract, theoretical terms. But if this is right, then more information, or even more scientific understanding, will not be enough to move us toward addressing their developmental issues. Rather, we will need to use other kinds of knowledge, such as our emerging understanding of biased moral motivation, to reflectively increase the probability of translating our moral principles into actions. That is, examples like Singer's bleeding stranger tell us something about how our moral motivation works, and we need to use this type of knowledge to try and make low-SES children seem more like the man with the leg wound in our moral imaginations. This would increase the likelihood of our doing something to improve low-SES children's circumstances. One way of achieving this would be to ensure that we interact with low-SES parents and their children on a more regular basis, e.g., by doing something as simple as taking public transportation. This would make us more likely to put our hard-won neuroscience research to use.

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[1] Hackman, D. A., Farah, M.J., Meaney, M. J., 2010, 'Socioeconomic status and the brain: mechanistic insights from human and animal research,' in Nature 11, Available at https://mail-attachment.googleusercontent.com/attachment/u/0/?ui=2&ik=bb31177d51&view=att&th=13ad223ce6979971&attid=0.4&disp=inline&safe=1&zw&saduie=AG9B_P9-g3MEKF3MHUpOaKNL2td1&sadet=1355272405884&sads=-iGOQ0R2Qyb4_aHrUapR1YuvG1g



[2] D’Angiulli A, Herdman A, Stapells D, Hertzman C. 2002, 'Children’s event-related potentials of auditory selective attention vary with their socioeconomic status.' Neuropsychology 22:293–300.



[3] Singer, P., 1972. 'Famine, affluence, and morality.' Philosophy and Public Affairs 1, 229–243.



[4] Greene, J. 2003. ''From neural 'is' to moral 'ought': what are the moral implications of neuroscientific moral psychology?' Nature. Available at: http://www.overcominghateportal.org/uploads/5/4/1/5/5415260/from_neural_is_to_moral_ought.pdf







Want to cite this post? 

Haas, J. Uncovering the Neurocognitive Systems for 'Help This Child'. The Neuroethics Blog. Retrieved on
, from http://www.theneuroethicsblog.com/2012/12/uncovering-neurocognitive-systems-for.html