In that case, you can’t even prefer one person with pain to 3^^^^3 people with the same pain.
(And if you say that you can’t add up sizes of pains, but you can add up “whether there is a pain”, the latter is all that is necessary for one of the problems to happen; exactly which problem happens depends on details such as whether you can do this for all sizes of pains or not.)
In that case, you can’t even prefer one person with pain to 3^^^^3 people with the same pain.
(And if you say that you can’t add up sizes of pains, but you can add up “whether there is a pain”, the latter is all that is necessary for one of the problems to happen; exactly which problem happens depends on details such as whether you can do this for all sizes of pains or not.)