This thought-provoking paper by John O’Brien dives into the ethical debate surrounding the use of pain as a professional tool in working with people with severe disabilities. O’Brien firmly argues against the intentional infliction of pain, emphasizing that it undermines positive human relationships and creates a power imbalance between professionals and vulnerable individuals. The document critiques euphemisms like “aversive treatment” and explores the historical, ethical, and procedural aspects of using pain in therapeutic settings. It highlights the dangers of bureaucratizing pain, the inefficiency of such methods, and the need for alternatives rooted in respect, mutual vulnerability, and personal knowledge.
O’Brien advocates for non-aversive strategies that foster dignity, meaningful activity, and enduring relationships. He challenges professionals to reject pain-based interventions, not just because they may be ineffective, but because they are fundamentally wrong. The paper also explores broader societal implications, urging communities to create conditions that reduce the occurrence of pain and support reconciliation and shared suffering.
Packed with references to research, historical practices, and expert opinions, this paper is a call to action for professionals, caregivers, and advocates to rethink their approaches and prioritize compassion over control. It’s a must-read for anyone interested in ethical practices, disability rights, and building inclusive communities.