“Jobseeker! Can of Strongbow, I’m a mess/ Desperately clutching onto a leaflet on depression/ Supplied to me by the NHS/ It’s anyone’s guess how I got here.” – Sleaford Mods, Jobseeker
In the run up to the 1968 US presidential election- and amidst all the political upheaval, civil rights protests and race riots of the late 1960s- Nixon created a winning campaign focusing on “law and order”, with a promise to be “tough on crime.” (Click here for his iconic ‘The First Civil Right’ advert.)
He argued, against the democratic nominee Hubert Humphrey, that “doubling the conviction rate in this country would do more to cure crime in America than quadrupling the funds for Humphrey’s war on poverty.” And hence the beginnings of the modern american “’Tough on Crime’ movement; .. a set of policies that emphasize[d] punishment as a primary, and often sole, response to crime.”* This continued partly through the efforts of Clinton, who diverted funds from projects investing in deprived communities into increasing policing and prison capacities; the modern legacy of which is the second highest incarceration rate globally, and huge racial and class-based disparities in sentencing (black men are statistically more likely to go to prison than complete high-school**). It’s also made police forces in impoverished, inner-city areas (such as the parts of Baltimore currently rioting over the murder of Freddie Gray) more akin to an “army of occupation”, than anything aimed at protecting citizens from the negative effects of crime.***
[For Part One click here]
Perhaps more than any of the bad pictures of “pain” Wittgenstein attempts to disentangle people from in the Philosophical Investigations, the above picture assimilates our knowledge of other’s pain to our knowledge of stuff, of features of the external world. Here “pain” is a feature of the world (albeit of that part of the world taken up by someone’s body), one which we can know about with a high degree of certainty, or if we are uncertain about it is simply because we do not yet have enough factual information to hand. (“I’m unsure if she is in pain, I’m still waiting on the results of the scan.”)
Yet it stems from the same kind of unease also leading to those pictures which Wittgenstein does address: the thought that if the question “Are they in pain?” is to have any kind of bite there must be something called “a pain” to exist “somewhere” (whether physically or mentally). The “medical” solution (the one I have discussed above) is a picture which does enable us to know someone elses pain, and yet in doing so robs pain of its phenomenological content (and many of the instances we would refer to as pain.) On the other hand attempts to situate this strange object called a “pain” in the realms of “the mental”, have the unfortunate effect of meaning that we can never know if someone is ever in pain at all. Both pictures, however, “yoke” knowledge (of another’s pain) to “certainty”: knowing something is being able to gather the appropriate evidence for it, to be “sure” about it. Continue reading
It seems like a weird question to ask how you can know if someone is in pain or not.
Not that this has really stopped philosophers from continuously asking it, and many of them answering along sceptical lines; you cannot ever know another’s pain, you can only guess at or surmise it. (PI 246) But this is not what I’m talking about. As my philosophy tutor, Bob Hargrave, used to say, the only possible response to a philosopher who claims they can seriously entertain the possibility that someone screaming and writhing under a torturer’s implements isn’t actually “in pain”, is to back away from them slowly. (This goes along with a certain, and largely justified, fashion of seeing most philosophical problems as being abstract and irrelevant to our lives: of course we constantly treat other people’s pain as something obvious and indisputable, whatever the philosophers decide between them is hardly going to have much bearing on that.)
What I’m talking about, though, are the kinds of situations I now encounter all the time. Where a patient on the ward is doubled up, clutching their stomach and the response of the nurses and doctors is simply to label it as “behavioural”- the polite, medicalized way of saying “they’re just faking it to get attention.” Instead of responding to their pain, instead of comforting them (or offering some other kind of relief), we simply have to work out how to manage their problematic behaviour. They very much look like they’re in excruciating pain, but we know that they’re not, so treating them as if they are is inappropriate. Continue reading
Last week Dr Peter Carter (general secretary of the Royal College of Nursing) angered a large proportion of the nurses and support workers he is supposed to represent by urging them not to strike, since doing so would involve “abandoning their patients.”
One of the things he said in his speech to the RCN’s annual congress is less controversial; not giving NHS workers their 1% pay rise in line with the cost of living is obviously “insulting”, and as someone on the lowest rung of their pay scale, I can attest to the fact that what I earn is enough for a young, childless person to just about subsist on but not a lot more. And whilst striking is clearly at its most effective (and ethically defensible) when the individuals setting working conditions and wages are the ones directly harmed by the strike (i.e. corporation owners), public sector strikes do often work, and can do so in a way which either does not harm, or only negligibly harms, the public (and may even help them.)
Before I started taking psychiatric patients on ‘escorted leave’, I’d never felt like I was being looked at so much by strangers.
(That’s not to say I was never looked at. Sadly I’ve had my fair share of everything from odd looks to homophobic abuse for being physically affectionate to members of the same sex in public. But for me it was nothing as isolating or pervasive as this.)