Our twenty-second meeting and open seminar was held on June 24, 2011 hosting  Dr. Michele Farisco who spoke on: The Ethical Pain: detection and management of pain and suffering in patients with disorders of consciousness.

Michele is a philosopher who specializes in ethical issues concerning the areas of transhumanism, cognitive enhancement, severe disorders of consciousness such as the persistent vegetative state, and legal aspects of neuroscience.

This seminar was informative and stimulated a very interesting debate. Beginning with the application of functional MRI to the study of severely compromised patients in the Liegi Coma Science Department, where Michele spent four months, he explained how the patient’s pain cannot be assessed by neurotechnology alone because cerebral mechanisms responsible for pain are not fully understood either in normal individuals.

The data available, however, are useful approximations and can possibly lead to a prudent approach to pain, suggesting the general use of pain medications in these very compromised patients. Michele showed how different countries in the world regard these new technologies, always in reference to pain and in these specific conditions. There is no uniformity in the use or relevance attributed to these technologies in different countries.  At the same time, professional societies in the same country have different evaluations of these new technologies. They are very sophisticated and require a dedicated team, and their high costs are prohibitive for most countries.

The difference between pain and suffering in humans was discussed and a distinction was tentatively made. However, human suffering appears to be a very difficult category given the complexity of human feelings, emotions and behaviors. As such, it requires all the support that is available, both to patients and their families. Some of the physicians present at the seminar reported touching experiences of these medical conditions and the ethical issues they continue to raise, especially after the application of expensive but fascinating new technologies.