The Nature of Suffering and the Goals of Medicine, 2nd Edition

by Eric J. Cassell

This is a revised and expanded edtion of a classic in palliative medicine, originally published in 1991. With three added chapters and a new preface summarizing our progress in the area of pain management, this is a must-hve for those in palliative medicine and hospice care.

The obligation of physicians to relieve human suffering stretches back into antiquity. But what exactly, is suffering? One patient with metastic cancer of the stomach, from which he knew he would shortly die, said he was not suffering. Another, someone who had been operated on for a mior problem--in little pain and not seemingly distressed--said that even coming into the hospital had been a source of pain and not suffering. With such varied responses to the problem of suffering, inevitable questions arise. Is it the doctor's responsibility to treat the disease or the patient? And what is the relationship between suffering and the goals of medicine?

According to Dr. Eric Cassell, these are crucial questions, but unfortunately, have remained only queries void of adequate solutions. It is time for the sick person, Cassell believes, to be not merely an important concern for physicians but the central focus of medicine. With this in mind, Cassell argues for an understanding of what changes should be made in order to successfully treat the sick while alleviating suffering, and how to actually go about making these changes with the methods and training techniques firmly rooted in the doctor's relationship with the patient.

Dr. Cassell offers an incisive critique of the approach of modern medicine. Drawing on a number of evocative patient narratives, he writes that the goal of medicine must be to treat an individual's suffering, and not just the disease. In addition, Cassell's thoughtful and incisive argument will appeal to psychologists and psychiatrists interested in the nature of pain and suffering.

Genres: Medicine, Nonfiction, Philosophy, Medical, Health Care, Health, Science

336 pages, Paperback

First published October 3, 1991

Reviews

[Kelly · Rating 4 out of 5]

This book raises some vital points about the important of physicians treating people rather than just their bodies or the diseases they have, and interesting philosophical discussions of suffering. The summary of the history of medicine and of medical philosophy is also excellent, and there are lots of patient stories that make it clear the author is a dedicated and caring physician. But not all of the author’s philosophical discussions are well explained, he seems to particularly disagree with the approaches of psychologists to making medical decisions, and he takes some little digs at people opposed to abortion and assisted suicide that didn’t really seem warranted by the rest of the discussions in which they appeared. Also, the writing — or more so, the copy editing — was surprisingly sloppy in a couple of chapters. So it was a good and thought-provoking book, with lots of good suggestions for further reading, but it wasn’t as great as the recommendation I’d gotten had suggested.

[Leslie · Rating 5 out of 5]

This book articulates important and enduring concepts for the practice of medicine. Most of all, it challenges the "either/or" paradigm in which the science of medicine roundly trumps the art of medicine by offering a robust defense of a "both/and" paradigm with the patient at the center of practice. It reminds clinicians of the noble goals with which we entered medicine, and enriches our understanding of what those goals mean.

Although Cassell illustrates his analysis with lots of stories, at times it is quite thick with abstract concepts. Nonetheless, he states them clearly and provides ample opportunity to digest them. I have read few better discussions of personhood, the threat of illness to personhood, the difference between illness and disease, and why medicine should aim above all to treat illness, promote function, and relieve suffering.

[Nelson Giraldo · Rating 5 out of 5]

The nature of suffering

A wonderful book to learn about the human suffering, how understand it and how give relieve, at least listenig.
Thanks

[Carol · Rating 5 out of 5]

The two central issues in the book that I would like to discuss and expand upon are: his view of PERSON rather than the mind/body dualism we see too often and his view of meaning which is central to how he views suffering. An outstanding book.

[G.licious · Rating 3 out of 5]

Thick reading but thorough and insightful.