Svenaeus (2020) holds that doctors should attempt to understand the suffering of their patients not only as caused by some bodily dysfunction but as a subjective experience. The latter can only be accomplished through empathy, narrative and dialogue. This is especially important in end-of-life care. Though palliative care has achieved improved treatment of suffering narrowly understood, as caused by all kinds of bodily dysfunctions, medicine as a whole has not made great strides in addressing suffering properly understood, i.e. from a broad phenomenologically informed perspective.
Streeck (2020) maintains that the strong focus on prevention and relief of suffering within palliative care might have unintended but seriously negative consequences. In particular, she sketches two different pathways in which this might play out. First, if attempts at thwarting or alleviating suffering happen to be unsuccessful, there are only two options left: terminal sedation or just continuing the attempts already started. Terminal sedation renders patients in an unconscious state, it triggers fierce discussions about the precise demarcation with euthanasia, and its increased practise might lead to a greater acceptance of physician assisted suicide and euthanasia, as these are also motivated by the elimination of suffering. Continuing attempts at mitigating suffering that have thus far been unsuccessful, on the other hand, might prove to be futile. In addition, it could put mounting pressure on patients to match the caregivers’ expectations, thus increasing the suffering. Second, if patients—for whatever reasons, e.g. not wanting to be sedated or wishing to make practical arrangements for imminent death—wish to tolerate a certain kind of suffering instead of having it treated, continued efforts to suppress this suffering might in truth counteract patients’ aims and desires. After all, patients being in a vulnerable position might feel pressure to accept the palliative care treatment offered, which might thus actually lower their quality of life as perceived from the patients’ point of view.
Ahlzen (2020) endorses the common-sense view that medicine should attempt to alleviate suffering. In addition, he acknowledges that medicine in general and palliative care in particular have gained progress in tackling suffering. Yet, all suffering at the end of life has obviously not been eradicated.