 While Helm’s view of pleasure and pain accommodates Anscombe’s constraint that pleasure provide holistically intelligible reasons for action and also fits his larger agenda, it implausibly makes a kitten’s or an infant’s hurting from a bruised limb or deriving pleasure from nursing depend on their having appropriate large patterns of background concerns including, as he tells us, in cases of bodily pain, background concerns for the integrity of their bodies (2002, pp. 24–27). If such a larger pattern of concern for one’s body is necessary for the affective component of pain, both should together fade away in, for example, a terminally ill patient who now wants mainly a speedy natural death, rather than the continuance of whatever bodily integrity remains. To the extent that someone has predominantly such a pattern of desire and emotion, it would seem, on this view, that sensory pain (or, as Helm has it, the stimulation that would otherwise have been painful) must, as signaling the approach of the desired end, be if not purely then at least on balance pleasant. And in the unconflicted limiting case, we need not offer palliative analgesia for relief of pain, since experiencing pain is supposedly unintelligible lacking an appropriate larger pattern of desires and emotions. Lacking this, as Helm claims in renewing the ancient Stoic claim about the sage under torture, one’s writhing and screaming fail to signify that one is suffering pain (2002, p. 24). No need for morphine to palliate any such seeming pain of our patient, it seems. And Richard Moran would add that morphine should be equally useless for providing the solace of pleasure, as this similarly always depends on appropriately connecting with a patient’s cognitively complex normative space of skills and reasons (Moran 2002, pp. 209–14). Such views may have testable consequences. They may predict that broad attitude changes accompany effective antidepresssant therapy and, less plausibly, all transient enjoyments and lightening of mood. 