Life, Pain, and Revealed Preference

Everyone alive suffers, yet most living people seem to be glad to be alive. Few commit suicide, and death is feared by most.

How do we know if the pain of life is made up for by other factors? Introspection is a popular method (especially what I call the "imaginary survey," in which one imagines people's responses to being asked whether they are glad to be born). But introspection is also flawed in terms of accuracy even as to how well one's own life has gone, and introspection does not help us compare the suffering of one person to the happiness of another.

I have proposed that we look at sources of data other than introspection to figure out how much people really value or lament life and its pains and pleasures (see Mathematics of Misery, Born Obligated, What Kind of Evidence for Effective Suicidality? and Blind to the Downside). We could, I argue, look at how people act, what they buy, eat, smoke, and do. Rather than asking them about their preferences, their preferences might be revealed to us through their behavior.

A recent episode of the Radiolab podcast examined the pain scale used by doctors - a scale to measure a person's pain, from "no pain" to "worst pain imaginable." The podcast reveals the subjectivity of the scale and its inadequacy for making medical judgments; an interviewee imagines the "worst pain imaginable" to be the pain of being dragged behind a pickup truck to one's death, and imagines her pain to be about a third of that; a "3" on the pain scale, subjectively severe and interfering with her life, but dismissed by her doctor.

Her father, a doctor, recommends she report her pain as an "8" in order to be taken seriously. More interestingly, he suggests a more revealing pain scale: one that asked what sufferers would be willing to do to get rid of their pain. Get a really bad haircut, perhaps? Accept a reduced lifespan?

When I was younger, I suffered from severe migraines. In the early days of the internet, I read about trepanation and it seemed like a live option for at least two years; it was my beloved fantasy. A few days into a bad migraine when I was 19, I took the train to Rites of Passage and had a large needle, and then a ring, inserted into the flesh of my navel, hoping it might relieve the pain. (It didn't, though it did take my mind off of it.) Clearly, the revealed preference of a trade-off for pain reflects the subjective value for the person at both ends: I might have been experiencing extremely severe pain to consider piercing my skull and my body, or I might just not disvalue bodily envelope violations very much. However, data about the actual choices of thousands of people would give us evidence of the relative value of different choices for large numbers of people; while not perfect, it would be better than mere introspection.

So is life a burden, or a blessing? What are people willing to do for a longer lifespan, compared to what they're willing to do in order to die?

In the United States, around 36,000 people successfully commit suicide every year, despite the fact that suicide is illegal (on pain of resuscitation and incarceration in a mental hospital), risky, difficult, and painful, and despite the additional fact that it is illegal for others to help in any way. Worldwide, over a million people successfully commit suicide every year.

Cryonic preservation represents a chance to be reborn; one must still die, but one's brain and perhaps body are preserved in the hope of one day being reanimated. Cryonics is legal and (since it takes place after death) painless, and it is legal for others to help one achieve cryonic preservation. Cryonic preservation costs around $150,000, considerably less than the cost to raise an average American child to age 18 (not including college). In spite of this, only about a thousand people have ever signed up for cryonic preservation. The number of people who have ever signed up for cryonics in the history of the world is the same as the number who die from suicide in the United States every ten days.

While people may go to great lengths to postpone death, they do not seem to reveal a particular preference for a chance to be born again. Indeed, while life in the abstract seems to be of supreme importance, other factors can be shown to drastically outweigh the supposedly sacred value of life. For instance, studies suggest that castration may extend male lifetimes by decades, yet castrating oneself or one's son seems unthinkable, even with the lifespan enhancement effects in mind. While life may be valuable, it seems that sexual capacity, gender expression, and reproductive capacity are revealed as much more important than life simpliciter.

The fact that so many people are willing to take great risks to end their lives in order to escape the bad parts of life, and so few are willing to make serious sacrifices to be born again or drastically extend life, is evidence that life is not always a blessing, and is frequently, observably, a burden. We should continue to investigate data to determine the lived reality of the value of life and pain, and should incorporate this knowledge into our reproductive ethics. Reproduction can no longer be seen as a purely innocent endeavor, but must be recognized as a very serious gamble with the life of an innocent being.