... the duty to relieve suffering comes in two parts: a prohibition against inflicting suffering, and a requirement to prevent it. What we tend to un… - Jamie Mayerfeld

An agent who regarded [sound moral principles] as mere rules of thumb would ignore them whenever she calculated that compliance wasn’t necessary to minimize the cumulative badness of suffering. The problem is that it might also be in her own interest to violate these principles, and self-interest could distort her calculations, even when she calculated sincerely. She could thus acquire a pattern of violating the principles even when compliance with them really was necessary to prevent the worst cumulative suffering. To avoid this, we would want her to feel strongly inhibited from violating the principles. Inhibitions of this kind can insulate agents from the effect of biased calculations.

I believe that most of us tend to underrate the evilness of suffering. The reason is that it is difficult for us, when not actually suffering, to recollect what suffering really is. We employ numerous psychological mechanisms to conceal from our consciousness the true nature or meaning of suffering, to falsify and deny it. We do this without renouncing the word, however. The word comes to designate, in our minds, only a faint copy or superficial image of the real thing; but having forgotten what the original is, we mistake it in the copy. We ascribe to "suffering" a certain gravity of evil; but it is slight compared to what we would ascribe to suffering itself, if we could only recall its true meaning.

Real cases of suffering ... tend to go unheard. This is not only because people who are genuinely suffering typically lack the resources with which to publicize their condition, but also because ... many forms of suffering deprive people of the very ability to express, sometimes even think, the fact that they are suffering.