Abstract
In recent years a large empirical literature has appeared on suffering at the end of life. In this literature it is recognized that suffering has existential and social dimensions in addition to physical and psychological ones. The non-physical aspects of suffering, however, are still understood as pathological symptoms, to be reduced by therapeutical interventions as much as possible. But suffering itself and the negative emotional states it consists of are intentional states of mind which, as such, make cognitive claims: they are more or less appropriate responses to the actual circumstances of the patient. These circumstances often are such that it would rather be a pathological symptom not to be sad and not to suffer. Suffering, therefore, is sometimes and to some extent a condition to be respected. Although I do not dispute that the alleviation of suffering is the main aim of palliative care, in pursuing that aim we should acknowledge a constraint of realism.
Highlights
Suffering is an all-too-common experience in human life, in all its phases
When Eric Cassell published his classical paper on the nature of suffering and the goals of medicine in 1982,1 medical literature had for a long time been almost silent about the phenomenon
In order to flesh out the realistic approach we would have to consider in detail what it means in respect to some components of suffering, described in terms of their intentional object, that on the evidence of the empirical studies seem to belong to the most important ones, both in terms of incidence and of severity
Summary
As we saw Cassell conceives of suffering as being distressed by circumstances understood as threats to one’s person. You should understand the event or it effects as endangering the core of your personhood This means that suffering is an intentional state, not merely a sensation with a certain tonality. If we understand suffering in the way Cassell proposes, it can never be a good argument, in assessing someone’s suffering from a certain disease, to say that other people who are in exactly the same physiological condition, do not suffer, or do not suffer severely For whether this condition can intelligibly be perceived by someone as endangering her integrity as a person, will depend on the person she is, her character, her life history and her values.
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