Can You Feel My Pain Tonight? – Automated Pain Assessment and Epistemic Injustice

Automated pain assessment systems (APAS) are currently being developed to facilitate third-party pain assessments in patients with limited verbal communication abilities. They come with the danger, however, of disregarding patients in their capacity as competent knowers of their own pain experiences. Favoring the predictions of APAS over the self-reports of pain experiences may constitute a particular severe form of testimonial injustice, as we seem to have a special epistemic authority with regard to them. By investigating these potential dangers, the paper a) points to implications for pain management in the face of an emerging technology and thereby b) initiates new debates within the realm of ethics of technology. This discussion touches c) on fundamental questions with regard to the epistemology of pain and the epistemic status of a (competent) knower. The paper seeks to better understand testimonial injustice as a concept by transferring it to the epistemically challenging topic of pain knowledge.