Exploring the Brain in Pain: An Applied Neuroscience & Law Initiative

Amanda C. Pustilnik

I am excited to join the Petrie-Flom Center as the first Senior Fellow in Law & Applied Neuroscience. This fellowship is the product of an innovative partnership between the Petrie-Flom Center and the Center for Law, Brain and Behavior (CLBB) at Massachusetts General Hospital. This partnership aims to translate developments in neuroscience into legal applications, remaining sensitive to the normative dimensions of many – if not all – legal questions. The field of law & neuroscience is large and growing, addressing questions that intersect with nearly every area of law and a huge range of social and human concerns. CLBB is bringing together scientists, bioethicists, and legal scholars to look at questions ranging from criminal responsibility and addiction, to mind-reading and brain-based lie detection, to how the brain’s changes over our lifecourse affect our capacities to make decisions.

In the first year of this joint venture, we will be focusing on a set of issues with potentially huge implications for the law: The problem of pain. Pain is pervasive in law, from tort to torture, from ERISA to expert evidence. Pain and suffering damages in tort add up to billions of dollars per year; disability benefits, often awarded to people who suffer or claim to have chronic pain, amount to over one hundred billion annually. Yet legal doctrines and decision-makers often understand pain poorly, relying on concepts that are out of date and that can cast suspicion on pain sufferers as having a problem that is “all in their heads.”

Now, brain imaging technologies are allowing scientists to see the brain in pain – and to reconceive of many types of pain as diseases of the central nervous system. Brain imaging shows that, in many cases, the problem is literally in sufferers’ heads: Long-term pain changes the structure and function of the brain, perpetuating non-adaptive pain and interfering with cognitive and emotional function.The goal of my work this year with Petrie-Flom and CLBB will be to explore the ways in which this new science may have practical and theoretical applications for the law. How should pain neuroimaging be handled as a matter of expert evidence in state, federal, and administrative proceedings? What doctrinal changes, if any, should occur in disability law to account for the ways in which chronic pain can become a central nervous system disorder? Tort law currently compensates physical and psychiatric or emotional injuries differently; if chronic pain is a subjective experience rooted in brain dysfunction, is the ongoing pain of an injury meaningfully different from a psychiatric harm?

In opening a window into how the brain generates subjective experiences, neuroimaging should lead to doctrinal and practice-based revisions that increase law’s accuracy and fairness. So doing, brain imaging should change the law’s mind about the nature of pain, and may require the law to rethink its dualism between body and mind.  I am honored to be joined in this work by eminent CLBB faculty, including Dr. David Borsook, Professor of Anesthesiology at Boston Children’s Hospital and the Director of the Pain and Imaging Neuroscience (P.A.I.N.) Group at Boston Children’s, MGH and McLean Hospitals, and Dr. Lisa Feldman Barrett, a preeminent neuroscientist in the field of emotion and Director of the Interdisciplinary Affective Science Laboratory at Northeastern University, who also holds research and teaching appointments at Massachusetts General Hospital and Harvard Medical School.

In addition to the project on pain, I also will be blogging from time to time on issues in law & neuroscience generally. We look forward to engaging you in blogging and a series of public and university events, which will be announced here.