Skip to main content

Suffering: Harm to Bodies, Minds, and Persons

Handbook of the Philosophy of Medicine
  • 637 Accesses

Abstract

Suffering is a basic human experience, and the concept of suffering can be defined in several ways. Typically, it is defined in terms of threats to human agency, loss or threat to an individual’s value system, or as an experienced negative feeling. There are several types of (human) suffering. Suffering has been studied as a bodily, a mental, a social, and as an existential or spiritual experience. Suffering is frequently considered to be personal and subjective, though not necessarily incomprehensible to others. Philosophy of language and phenomenology provide frameworks to understand other persons’ suffering. While there is some agreement that suffering is something bad (an evil) toward which we have moral obligations to alleviate, there is less agreement on how this should be done and how far we should go. This is because there are several conceptual and ethical challenges with suffering, such as how to define it and where to set the limits to our duties and aspirations to alleviate suffering. What kind of suffering should be alleviated and by whom. For example, should social or existential suffering be alleviated by health care? What measures are acceptable in alleviating suffering, e.g., are modifications of personality, reduction of autonomy, or killing acceptable measures to alleviate suffering? Another basic question is who can suffer, e.g., whether animals, embryos, fetuses, or severely demented humans can suffer.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

References

  • Adams F (1891) The genuine works of hippocrates. William Wood and Company, New York. Here cited from http://www.thefullwiki.org/Hippocratic_Oath#cite_note-9. Accessed Oct 2014

    Google Scholar 

  • Amato JA (1990) Victims and values: a history and a theory of suffering. Praeger, New York

    Google Scholar 

  • Amato JA (2014) Suffering, and the promise of a world without pain. In: Green R, Palpant N (eds) Bioethics and suffering. Oxford University Press, New York, pp 61–87

    Chapter  Google Scholar 

  • Andorno R, Baffone A (2014) Human rights and the moral obligation to alleviate suffering. In: Green R, Palpant N (eds) Suffering and bioethics. Oxford University Press, New York, pp 182–200

    Chapter  Google Scholar 

  • Arman M, Rehnsfeldt A, Lindholm L, Hamrin E (2002) The face of suffering among women with breast cancer-being in a field of forces. Cancer Nurs 25(2):96–103

    Article  Google Scholar 

  • Bakan D (1968) Disease, pain, and sacrifice: toward a psychology of suffering. University of Chicago Press, Chicago

    Google Scholar 

  • Beauchamp TL (1991) Philosophical ethics: an introduction to moral philosophy, 2nd edn. McGraw Hill, New York

    Google Scholar 

  • Best M, Aldridge L, Butow P, Olver I, Price M, Webster F (2014) Assessment of spiritual suffering in the cancer context: a systematic literature review. Palliat Support Care 11:1–27

    Google Scholar 

  • Boston P, Bruce A, Schreiber R (2011) Existential suffering in the palliative care setting: an integrated literature review. J Pain Symptom Manage 41(3):604–618

    Article  Google Scholar 

  • Brinkmann S (2014) Languages of suffering. Theor Psychol 24:630–648

    Article  Google Scholar 

  • Broad CD (1930) Five types of ethical theory. Harcourt, Brace and Company, New York

    Google Scholar 

  • Burgess MM (1993) The medicalization of dying. J Med Philos 18(3):269–279

    Article  Google Scholar 

  • Byock IR (1996) The nature of suffering and the nature of opportunity at the end of life. Clin Geriatr Med 12(2):237–238

    Google Scholar 

  • Carel HH (2014) Illness and its experience: the perspective of the patient. In: Handbook of concepts in the philosophy of medicine. Springer, Dordecht

    Google Scholar 

  • Cassell EJ (1982) The nature of suffering and the goals of medicine. N Engl J Med 306:639–645

    Article  Google Scholar 

  • Cassell EJ (1992) The nature of suffering: physical, psychological, social and spiritual aspects. In: Starck P, McGovern J (eds) The hidden dimension of illness: human suffering. National League for Nursing Press, New York, pp 1–10

    Google Scholar 

  • Cassell EJ (1999) Diagnosing suffering: a perspective. Ann Intern Med 131(7):531–534

    Article  Google Scholar 

  • Cassell EJ (2004) The nature of suffering and the goals of medicine, 2nd edn. Oxford, New York

    Book  Google Scholar 

  • Cavanaugh TA (2006) Double-effect reasoning: doing good and avoiding evil. Clarendon, Oxford

    Book  Google Scholar 

  • Chapman CR, Gavrin J (1992) Suffering and its relationship to pain. J Palliat Care 9(2):5–13

    Google Scholar 

  • Charmaz K (1983) Loss of self: a fundamental form of suffering in the chronically ill. Sociol Health Illn 5(2):168–195

    Article  Google Scholar 

  • Cherry MJ (2014) Human suffering and the limits of secular bioethics. In: Green R, Palpant N (eds) Bioethics and suffering. Oxford University Press, New York, pp 337–355

    Chapter  Google Scholar 

  • Chomsky N (1965) Aspects of the theory of syntax. MIT Press, Cambridge, MA

    Google Scholar 

  • Clarke BM (2011) On suffering: pathways to healing & health. Dartmouth College Press, Hanover

    Google Scholar 

  • Clouser KD, Culver CM, Gert B (1981) Malady: a new treatment of disease. Hastings Cent Rep 11(3):29–37

    Article  Google Scholar 

  • Clouser K, Culver C, Gert B (1997) Malady. In: Humber J, Almeder R (eds) What is disease? Humana Press, Totowa, pp 173–218

    Chapter  Google Scholar 

  • Davies J (2012) The importance of suffering: the value and meaning of emotional discontent. Routledge, London

    Google Scholar 

  • Davis M (2003) What can we learn by looking for the first code of professional ethics? Theor Med Bioeth 24(5):433–454

    Article  Google Scholar 

  • Dawkins MS (1980) Animal suffering: the science of animal welfare. Chapman and Hall, London

    Book  Google Scholar 

  • Decety J (2014) Social neuroscience meets philosophy: suffering, empathy, and moral cognition. In: Green R, Palpant N (eds) Bioethics and suffering. Oxford University Press, New York, pp 89–104

    Chapter  Google Scholar 

  • DeGrazia D (2014) What is suffering, and what kind of beings can suffer? In: Green R, Palpant N (eds) Bioethics and suffering. Oxford University Press, New York, p 138

    Google Scholar 

  • Edwards SD (2003) Three concepts of suffering. Med Health Care Philos 6(1):59–66

    Article  Google Scholar 

  • Eriksson K (2006) The suffering human being. Nordic Studies Press, Chicago

    Google Scholar 

  • Federoff HJ, Gostin LO (2009) Evolving from reductionism to holism: is there a future for systems medicine? JAMA 302(9):994–996

    Article  Google Scholar 

  • Ferrell BR, Coyle N (2008) The nature of suffering and the goals of nursing. Oncol Nurs Forum 35(2):241–247

    Article  Google Scholar 

  • Fordyce WE (1988) Pain and suffering: a reappraisal. Am Psychol 43(4):276

    Article  Google Scholar 

  • Frank AW (2001) Can we research suffering? Qual Health Res 11(3):353–362

    Article  Google Scholar 

  • Gatherer D (2010) So what do we really mean when we say that systems biology is holistic? BMC Syst Biol 4:22

    Article  Google Scholar 

  • Gilbert P (1989) Human nature and suffering. Psychology Press, Hove

    Google Scholar 

  • Green R, Palpant N (eds) (2014) Bioethics and suffering. Oxford University Press, New York

    Google Scholar 

  • Halpern C (2002) Suffering, politics, power: a genealogy in modern political theory. State University of New York Press, Albany

    Google Scholar 

  • Hanson MJ, Callahan D (2000) The goals of medicine: the forgotten issues in health care reform. Georgetown University Press, Washington

    Google Scholar 

  • Hoffmaster B (2014) Understanding suffering. In: Green R, Palpant N (eds) Bioethics and suffering. Oxford University Press, New York, pp 31–53

    Chapter  Google Scholar 

  • Hofmann B (2001) Complexity of the concept of disease as shown through rival theoretical frameworks. Theor Med Bioeth 22(3):211–236

    Article  Google Scholar 

  • Hofmann B (2002) On the triad disease, illness and sickness. J Med Philos 27(6):651–674

    Article  Google Scholar 

  • Hofmann B (2014) [What is disease? In Norwegian] Hva er sykdom? Gyldendal Akademisk, Oslo

    Google Scholar 

  • Holm AL, Severinsson E (2008) The emotional pain and distress of borderline personality disorder: a review of the literature. Int J Ment Health Nurs 17(1):27–35

    Article  Google Scholar 

  • Hudson W (2012) Historicizing Suffering. In J. Malpas & N. Lickiss (Eds.), Perspectives on Human Suffering. Dortrecht: Springer, pp. 171–180.

    Chapter  Google Scholar 

  • Husserl E (1963) Ideas: a general introduction to pure phenomenology (trans: Boyce Gibson WR). Collier Books, New York

    Google Scholar 

  • Kant I (1780/1998) The Metaphysical Elements of Ethics (T. K. Abbott, Trans.). Auckland: Floating Press

    Google Scholar 

  • Kirkengen AL, Ekeland TJ, Getz L, Hetlevik I, Schei E, Ulvestad E, Vetlesen AJ (2015) Medicine’s perception of reality – a split picture: critical reflections on apparent anomalies within the biomedical theory of science. J Eval Clin Pract. [Epub ahead of print]

    Google Scholar 

  • Kissane DW (2012) The relief of existential suffering. Arch Intern Med 172(19):1501–1505

    Article  Google Scholar 

  • Kleinman A (1988) The illness narratives: suffering, healing, and the human condition. Basic Books, New York

    Google Scholar 

  • Kleinman A, Kleinman J (1996) The appeal of experience; the dismay of images: cultural appropriations of suffering in our times. Daedalus 125:1–23

    Google Scholar 

  • Kleinman A, Das V, Lock MM (eds) (1997) Social suffering. University of California Press, Berkeley

    Google Scholar 

  • Kornelsen J, Atkins C, Brownell K, Woollard R (2015) The meaning of patient experiences of medically unexplained physical symptoms. Qual Health Res. [Epub ahead of print]

    Google Scholar 

  • Krashin D, Murinova N, Howe C, Ballantyne J (2014) Biology and suffering. In: Green R, Palpant N (eds) Bioethics and suffering. Oxford University Press, New York, pp 106–131

    Chapter  Google Scholar 

  • Lauritzen P (2014) Reproductive technology in suffering’s shadow. In: Green R, Palpant N (eds) Bioethics and suffering. Oxford University Press, New York, pp 357–373

    Chapter  Google Scholar 

  • Leder D (1985) Toward a phenomenology of pain. Rev Existent Psychol Psychiatry 19:255–266

    Google Scholar 

  • Levinas E (1988) Useless suffering. In: Bernasconi R, Wood D (eds) The provocation of Levinas: rethinking the other. Routledge, London

    Google Scholar 

  • MacIntyre A (1981) After virtue: a study in the moral theory. Duckworth, London

    Google Scholar 

  • Malpas J, Lickiss N (eds) (2012) Perspectives on human suffering. Springer, Dordrecht

    Google Scholar 

  • Marinker M (1975) Why make people patients? J Med Ethics 1(2):81–84

    Article  Google Scholar 

  • Mayerfeld J (2005) Suffering and moral responsibility. Oxford University Press, New York

    Google Scholar 

  • Merleau-Ponty M (1962 [1945]) Phenomenology of perception (trans: Smith C). Routledge, New York

    Google Scholar 

  • Morris DB (2002) The culture of pain. University of California, Berkley

    Google Scholar 

  • Morrissey MB (2011) Phenomenology of pain and suffering at the end of life: a humanistic perspective in gerontological health and social work. J Soc Work End Life Palliat Care 7(1):14–38

    Article  Google Scholar 

  • Morse JM, Johnson JL (1991) The illness experience: dimensions of suffering. Sage, Newbury Park

    Google Scholar 

  • Nortvedt P, Nordhaug M (2008) The principle and problem of proximity in ethics. J Med Ethics 34(3):156–161

    Article  Google Scholar 

  • Nunes J, Ventura T, Encarnacao R, Pinto PR, Santos I (2013) What do patients with medically unexplained physical symptoms (MUPS) think? A qualitative study. Ment Health Fam Med 10(2):67–79

    Google Scholar 

  • Nussbaum M (1994) The therapy of desire: theory and practice in Hellenistic ethics. Princeton University Press, Princeton

    Google Scholar 

  • Ratcliffe M (2008) Feelings of being: phenomenology, psychiatry and the sense of reality. Oxford University Press, Oxford

    Book  Google Scholar 

  • Rawlinson MC (1986) The sense of suffering. J Med Philos 11(1):39–62

    Article  Google Scholar 

  • Rousseau P (2001) Ethical and legal issues in palliative care. Prim Care 28(2):391–400

    Article  Google Scholar 

  • Sartre JP (2003 [1943]) Being and nothingness (trans: Eyre R). Routledge, London

    Google Scholar 

  • Scarry E (1987) The body in pain: the making and unmaking of the world. Oxford University Press, New York

    Google Scholar 

  • Schlieter J (2014) Adapt, endure, or overcome? The concept of “suffering” in Buddhist bioethics. In: Green R, Palpant N (eds) Bioethics and suffering. Oxford University Press, New York, pp 309–336

    Chapter  Google Scholar 

  • Schopenhauer A (2008). The World as Will and resentation, trans. Richard E. Aquila in collaboration with David Carus. Longman, New York

    Google Scholar 

  • Seneca (2004) On the shortness of life (trans: Costa CDN). Penguin, London

    Google Scholar 

  • Shweder RA, Much N, Mahapatra M, Park L (1997) The “big three” of morality (autonomy, community, divinity) and the “big three” explanations of suffering. In: Brandt AM, Rozin P (eds) Morality and health. Routledge, London, pp 119–169

    Google Scholar 

  • Singer P (1990 [1975]) Animal liberation. New York Review Books, New York

    Google Scholar 

  • Singer P (2011 [1979]) Practical ethics. Cambridge University Press, New York

    Google Scholar 

  • Spelman EV (1997) Fruits of sorrow: framing our attention to suffering. Beacon, Boston

    Google Scholar 

  • Strang P, Strang S, Hultborn R, Arnér S (2004) Existential pain – an entity, a provocation, or a challenge? J Pain Symptom Manage 27(3):241–250

    Article  Google Scholar 

  • Svenaeus F (2014) The phenomenology of suffering in medicine and bioethics. Theor Med Bioeth 35(6):407–420

    Article  Google Scholar 

  • Taylor RL, Watson J (eds) (1989) They shall not hurt: human suffering and human caring. Colorado Associated University Press, Boulder

    Google Scholar 

  • Toombs KS (1999) The meaning of illness: a phenomenological account of the different perspectives of physician and patient. Kluwer, Amsterdam

    Google Scholar 

  • Ulvestad E (2012) Psychoneuroimmunology: the experiential dimension. Methods Mol Biol 934:21–37

    Article  Google Scholar 

  • Usherwood TP (1990) Responses to illness – implications for the clinician. J R Soc Med 83(4):205–207

    Google Scholar 

  • van Hooft S (1998a) The meanings of suffering. Hastings Cent Rep 28(5):13–19

    Article  Google Scholar 

  • Van Hooft S (1998b) Suffering and the goals of medicine. Med Health Care Philos 1:125–131

    Article  Google Scholar 

  • van Hooft S (2012) Ethics of suffering: modern law, philosophy and medicine/Marinos Diamantides. Monash Bioeth Rev 20(4):50–52

    Google Scholar 

  • Wakefield JC (2013) DSM-5 grief scorecard: assessment and outcomes of proposals to pathologize grief. World Psychiatry 12(2):171–173

    Article  Google Scholar 

  • Wall PD (2000) Pain: the science of suffering. Columbia University Press, New York

    Google Scholar 

  • Ware NC (1992) Suffering and the social construction of illness: the delegitimation of illness experience in chronic fatigue syndrome. Med Anthropol Q 6(4):347–361

    Article  Google Scholar 

  • Wilson RA, Brown RD (2009) Humanitarianism and suffering: the mobilization of empathy. Cambridge University Press, Cambridge

    Google Scholar 

  • Wittgenstein L (2001 [1953]) Philosophical investigations. Blackwell, Oxford

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Bjørn Hofmann .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer Science+Business Media Dordrecht

About this entry

Cite this entry

Hofmann, B. (2015). Suffering: Harm to Bodies, Minds, and Persons. In: Schramme, T., Edwards, S. (eds) Handbook of the Philosophy of Medicine. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-8706-2_63-1

Download citation

  • DOI: https://doi.org/10.1007/978-94-017-8706-2_63-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Dordrecht

  • Online ISBN: 978-94-017-8706-2

  • eBook Packages: Springer Reference Religion and PhilosophyReference Module Humanities and Social SciencesReference Module Humanities

Publish with us

Policies and ethics

Chapter history

  1. Latest

    Suffering: Harm to Bodies, Minds, and Persons
    Published:
    21 March 2024

    DOI: https://doi.org/10.1007/978-94-017-8706-2_63-2

  2. Original

    Suffering: Harm to Bodies, Minds, and Persons
    Published:
    08 September 2015

    DOI: https://doi.org/10.1007/978-94-017-8706-2_63-1