What We Mean When We Talk About Suffering—and Why Eric Cassell Should Not Have the Last Word

Tate, Tyler; Pearlman, Robert A.

doi:10.1353/pbm.2019.0005

Cited by 34 publications

(27 citation statements)

References 28 publications

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“…Suffering can be characterized as an undesired experience that involves enduring under loss or privation of some perceived good ( VanderWeele, 2019a ). It is a negatively valenced subjective experience that threatens a person's sense of self ( Cassell, 2004 ; Fitzpatrick et al., 2016 ) by, amongst others, thwarting progress towards meaningful goal-oriented pursuits, disrupting the continuity of valued social connections, or challenging well-established views, beliefs, and assumptions about the world ( Tate & Pearlman, 2019 ). Some features of suffering (e.g., its intensity or duration) resemble those that may also accompany physical symptoms, pain, or illness ( VanderWeele, 2019a ).…”

Section: Introductionmentioning

confidence: 99%

Suffering, Mental Health, and Psychological Well-being During the COVID-19 Pandemic: A Longitudinal Study of U.S. Adults With Chronic Health Conditions

Cowden

Davis

Counted

et al. 2021

Wellbeing, Space and Society

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Suffering has been a topic of considerable discussion in the fields of medicine and palliative care, yet few studies have reported causal evidence linking the experience of suffering to health and well-being. In this three-wave prospective cohort study, we explore the potential psychological implications of suffering during the COVID-19 pandemic by examining relations among suffering, mental health, and psychological well-being in a sample of U.S. adults living with chronic health conditions. We analyzed data from n = 184 participants who completed assessments one month before the SARS-CoV-2 outbreak was declared a pandemic by the World Health Organization (February 2020) and then two months (April 2020) and four months later (May/June 2020). Analyses controlled for a range of factors, including sociodemographic characteristics, physical health, religious/spiritual factors, psychological characteristics, and prior values of the predictor and each of the outcomes assessed one month before the COVID-19 pandemic. Results of the primary analysis indicated that greater overall suffering assessed one month into the COVID-19 pandemic was associated with lower psychological well-being (β = -.17, 95% CI: -.29, -.05) and higher levels of anxiety (β = .27, 95% CI: .13, .41) and depression (β = .16, 95% CI: .03, .29) two months later. In a secondary analysis that explored anxiety, depression, and psychological well-being as candidate antecedents of suffering, depression assessed one month into the COVID-19 pandemic was most strongly associated with worse overall suffering two months later. We highlight the implications of the findings for high-risk populations who are suffering amidst the challenges of the COVID-19 pandemic. Potential benefits of both integrating assessments of suffering into screening procedures and addressing experiences of suffering in mental health service settings are discussed.

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Section: Introductionmentioning

confidence: 99%

Suffering, Mental Health, and Psychological Well-being During the COVID-19 Pandemic: A Longitudinal Study of U.S. Adults With Chronic Health Conditions

Cowden

Davis

Counted

et al. 2021

Wellbeing, Space and Society

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“…Unfortunately, there are a number of problems with Cassell's view. 6 One major problem is that it leaves no room for the suffering of infants or nonverbal children. Cassell is explicit that young children cannot suffer because they are not fully persons, 7 meaning that they do not possess language or a sense of identity or of the future and cannot attach meaning to their experiences.…”

Section: Eric Cassell and The Suffering Of Childrenmentioning

confidence: 99%

“…From the perspective of pediatric medicine, Cassell's conceptualization is incomplete. Newborns, infants, and nonverbal pediatric patients can certainly experience more than bare pain; indeed, the claim that infants and nonverbal children (and anyone with profound cognitive disability for that matter) can suffer is supported philosophically 6,8,9 and by the robust consensus of parents and pediatric clinicians, both anecdotally and in the published literature. [10][11][12] Whether due to social, spiritual, psychological, existential, or biological factors, there is a broad acknowledgment in pediatrics that all children can suffer, even those who cannot articulate their suffering experience.…”

Section: Eric Cassell and The Suffering Of Childrenmentioning

confidence: 99%

Pediatric Suffering and the Burden of Proof

Tate¹

2020

Pediatrics

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The alleviation of suffering has always been central to the care of the sick. Yet as medical technology has advanced and life-sustaining treatments multiplied, medicine's capacity to both prevent and create suffering has grown exponentially. In pediatric medicine, the ability to stave off death with life-sustaining treatments allows children to survive but also to suffer in ways that are diverse and unprecedented. However, although parents and pediatric clinicians broadly agree that all children can suffer, there is little published literature in which researchers analyze or clarify the concept of pediatric suffering. This gap is worrisome, especially in light of growing concerns that the label of suffering is used to justify end-of-life decision-making and mask quality-of-life determinations for pediatric patients with profound neurologic impairment. Moreover, the awareness that some children can experience suffering but cannot communicate whether and how they are suffering creates a problem. Does the determination of suffering in a nonverbal child lie in the judgement of clinicians or parents? In this article, I will address several important questions related to the suffering of children through an analysis of two prevalent conceptualizations of pediatric suffering and suggest a possible avenue forward for future scholarship.

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“…Deepening relationships. People suffer when they both lose their sense of self and experience their life through a negative mood . Empathic attunement responds to this suffering directly in two senses.…”

Section: The Virtue Of Empathic Attunementmentioning

confidence: 99%

Empathetic Practice: The Struggle and Virtue of Empathizing with a Patient's Suffering

Campelia¹,

Tate²

2019

Hastings Center Report

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In this article, our analysis of empathy in the clinical context hinges on the complexities of patients who are acutely suffering. Using a case concerning a heart transplant patient with Duchenne muscular dystrophy, Alex, and his nurse, Joe, we investigate how empathy’s phenomenological nebulousness can generate doubts about its virtue. Even when asking, “How are you, Alex?” Joe hates the question; it seems empty, silly. Cases like this show both that the enactment of empathy is sometimes challenging and that it can be reasonable to wonder if empathy is a virtue at all. Perhaps Alex’s suffering is simply too massive: Joe cannot possibly know how he feels, so why try? Perhaps empathy would only cause Joe to suffer along with Alex. Not only is empathy difficult to produce in the context of Alex’s suffering; it may not even be possible; and if we simply cannot muster empathy, what is the point of morally demanding it? In response, we distinguish different kinds of empathic engagements from one another and offer separate counsel. We argue that it is important to understand empathy as something that must be honed across varied contexts before it can be called a virtue. Conceptualizing and operationalizing empathy in this way helps to ground its possibility and virtue even in the most challenging and complex clinical encounters.

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What We Mean When We Talk About Suffering—and Why Eric Cassell Should Not Have the Last Word

Cited by 34 publications

References 28 publications

Suffering, Mental Health, and Psychological Well-being During the COVID-19 Pandemic: A Longitudinal Study of U.S. Adults With Chronic Health Conditions

Suffering, Mental Health, and Psychological Well-being During the COVID-19 Pandemic: A Longitudinal Study of U.S. Adults With Chronic Health Conditions

Pediatric Suffering and the Burden of Proof

Empathetic Practice: The Struggle and Virtue of Empathizing with a Patient's Suffering

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