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 healthcare? 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.
References
Aaltola E (2018) Philosophical narratives of suffering: Nietzsche, Levinas, Weil and their cultural roots. Suom Antropol J Finnish Anthropol Soc 43(3):22–40
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
Amato JA (1990) Victims and values: a history and a theory of suffering. Praeger, New York
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
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
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
Bain D, Brady M, Corns J (2020) Philosophy of suffering: metaphysics, value, and normativity. Routledge, London
Bakan D (1968) Disease, pain, and sacrifice: toward a psychology of suffering. University of Chicago Press, Chicago
Bastian B (2019) From suffering to satisfaction: why we need pain to feel pleasure. In: Bain D, Brady M, Corns J (eds) Philosophy of Suffering. Routledge, London, pp 194–210
Beauchamp TL (1991) Philosophical ethics: an introduction to moral philosophy, 2nd edn. McGraw Hill, New York
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
Boston P, Bruce A, Schreiber R (2011) Existential suffering in the palliative care setting: an integrated literature review. J Pain Symptom Manag 41(3):604–618
Brady MS (2018) Suffering and virtue. Oxford University Press, Oxford
Brinkmann S (2014) Languages of suffering. Theor Psychol 24:630–648
Broad CD (1930) Five types of ethical theory. Harcourt, Brace and Company, New York
Burgess MM (1993) The medicalization of dying. J Med Philos 18(3):269–279
Bustan S (2019) Diagnosing human suffering and pain: integrating phenomenology in science and medicine. In: van Rysewyk S (ed) Meanings of pain. Springer, Cham, pp 37–58. https://doi.org/10.1007/978-3-030-24154-4_3
Bustan S, Gonzalez-Roldan A, Schommer C, Kamping S, Löffler M, Brunner M et al (2018) Psychological constructs and contextual factors associated with the assessment of pain and related-suffering. PLoS One 13(7):e0199814
Byock IR (1996) The nature of suffering and the nature of opportunity at the end of life. Clin Geriatr Med 12(2):237–238
Carel HH (2014) Illness and its experience: the perspective of the patient. In: Handbook of concepts in the philosophy of medicine. Springer, Dordrecht
Carel H, Kidd IJ (2019) Suffering as transformative experience. In: Bain D, Brady M, Corns J (eds) Philosophy of suffering: metaphysics, value, and normativity philosophy of suffering. Routledge, London, pp 165–179
Cassell EJ (1982) The nature of suffering and the goals of medicine. N Engl J Med 306:639–645
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
Cassell EJ (1999) Diagnosing suffering: a perspective. Ann Intern Med 131(7):531–534
Cassell EJ (2004) The nature of suffering and the goals of medicine, 2nd edn. Oxford, New York
Cassell EJ, Rich BA (2010) Intractable end-of-life suffering and the ethics of palliative sedation. Pain Med 11:435–438
Cavanaugh TA (2006) Double-effect reasoning: doing good and avoiding evil. Clarendon, Oxford
Chapman CR, Gavrin J (1992) Suffering and its relationship to pain. J Palliat Care 9(2):5–13
Charmaz K (1983) Loss of self: a fundamental form of suffering in the chronically ill. Sociol Health Illn 5(2):168–195
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
Chomsky N (1965) Aspects of the theory of syntax. MIT Press, Cambridge, MA
Clarke BM (2011) On suffering: pathways to healing & health. Dartmouth College Press, Hanover
Clouser KD, Culver CM, Gert B (1981) Malady: a new treatment of disease. Hast Cent Rep 11(3):29–37
Clouser K, Culver C, Gert B (1997) Malady. In: Humber J, Almeder R (eds) What is disease? Humana Press, Totowa, pp 173–218
Coleman S (2019) Painfulness, suffering, and consciousness. In: Bain D, Brady M, Corns J (eds) Philosophy of suffering: metaphysics, value, and normativity philosophy of suffering. Routledge, London, pp 55–74
Dahl E, Falke C, Eriksen TE (eds) (2019) Phenomenology of the broken body. Routledge, London
Davies J (2012) The importance of suffering: the value and meaning of emotional discontent. Routledge, London
Davis M (2003) What can we learn by looking for the first code of professional ethics? Theor Med Bioeth 24(5):433–454
Dawkins MS (1980) Animal suffering: the science of animal welfare. Chapman and Hall, London
De Ridder D, Adhia D, Vanneste S (2021) The anatomy of pain and suffering in the brain and its clinical implications. Neurosci Biobehav Rev 130:125–146
de Vries R (2012) The music, art and ethics of suffering. In: Hinerman N, Sutton ML (eds) On suffering: an interdisciplinary dialogue on narrative and meaning. Interdisciplinary Press, Oxford, pp 1–11
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
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
Del Giglio A (2020) Suffering-based medicine: practicing scientific medicine with a humanistic approach. Med Health Care Philos 23:215–219
Edwards SD (2003) Three concepts of suffering. Med Health Care Philos 6(1):59–66
Eriksson K (2006) The suffering human being. Nordic Studies Press, Chicago
Federoff HJ, Gostin LO (2009) Evolving from reductionism to holism: is there a future for systems medicine? JAMA 302(9):994–996
Ferrell BR, Coyle N (2008) The nature of suffering and the goals of nursing. Oncol Nurs Forum 35(2):241–247
Fordyce WE (1988) Pain and suffering: a reappraisal. Am Psychol 43(4):276
Frank A (1995) The wounded storyteller: body, illness, and ethics. Chicago University Press, Chicago
Frank AW (2001) Can we research suffering? Qual Health Res 11(3):353–362
Frankl VE (1985) Man’s search for meaning. Simon and Schuster, New York
Gatherer D (2010) So what do we really mean when we say that systems biology is holistic? BMC Syst Biol 4:22
Gilbert P (1989) Human nature and suffering. Psychology Press, Hove
Green R, Palpant N (eds) (2014) Bioethics and suffering. Oxford University Press, New York
Gutiérrez-Sánchez D, Gómez-García R, Cuesta-Vargas AI, Pérez-Cruzado D (2020) The suffering measurement instruments in palliative care: a systematic review of psychometric properties. Int J Nurs Stud 110:103704. https://doi.org/10.1016/j.ijnurstu.2020.103704
Halpern C (2002) Suffering, politics, power: a genealogy in modern political theory. State University of New York Press, Albany
Hanson MJ, Callahan D (2000) The goals of medicine: the forgotten issues in health care reform. Georgetown University Press, Washington, DC
Hoffmaster B (2014) Understanding suffering. In: Green R, Palpant N (eds) Bioethics and suffering. Oxford University Press, New York, pp 31–53
Hofmann B (2001) Complexity of the concept of disease as shown through rival theoretical frameworks. Theor Med Bioeth 22(3):211–236
Hofmann B (2002) On the triad disease, illness and sickness. J Med Philos 27(6):651–674
Hofmann B (2014) [What is disease? In Norwegian] Hva er sykdom? Gyldendal Akademisk, Oslo
Hofmann B (2019) Expanding disease and undermining the ethos of medicine. Eur J Epidemiol 34(7):613–619. https://doi.org/10.1007/s10654-019-00496-4
Hofmann B (2021) How to draw the line between health and disease? Start with suffering. Health Care Anal 29(2):127–143. https://doi.org/10.1007/s10728-021-00434-0
Hofmann BM (2022) Managing the moral expansion of medicine. BMC Med Ethics 23(1):13. https://doi.org/10.1186/s12910-022-00836-2
Hofmann BM (2024a) Undermining autonomy and consent: the transformative experience of disease. J Med Ethics 50:195–200
Hofmann BM (2024b) Moral obligations towards human persons’ wellbeing versus their suffering: an analysis of perspectives of moral philosophy. Health Policy 142:105031. https://doi.org/10.1016/j.healthpol.2024.105031
Hofmann B (2023) Addressing the paradox: health expansion threatening sustainable healthcare. Eur J Intern Med 117:3–7. https://doi.org/10.1016/j.ejim.2023.09.012
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
Hudson W (2012) Historicizing suffering. In: Malpas J, Lickiss N (eds) Perspectives on human suffering. Springer, Dordrecht, pp 171–180
Husserl E (1963) Ideas: a general introduction to pure phenomenology (trans: Boyce Gibson WR). Collier Books, New York
Jølstad B (2023) Adaptation and illness severity: the significance of suffering. Med Health Care Philos 26:413–423. https://doi.org/10.1007/s11019-023-10155-x
Kaftanski W, Hanson J (2022) Suffering, authenticity, and meaning in life: toward an integrated conceptualization of well-being. Front Psychol 13:1079032. https://doi.org/10.3389/fpsyg.2022.1079032
Kant I (1780/1998) The metaphysical elements of ethics (trans: Abbott TK). Floating Press, Auckland
Kauppinen A (2020) The world according to suffering. In: Brady MS, Bain D, Corns J (eds) The philosophy of suffering. Routledge, London, pp 19–36
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]
Kissane DW (2012) The relief of existential suffering. Arch Intern Med 172(19):1501–1505
Kleinman A (1988) The illness narratives: suffering, healing, and the human condition. Basic Books, New York
Kleinman A, Kleinman J (1996) The appeal of experience; the dismay of images: cultural appropriations of suffering in our times. Daedalus 125:1–23
Kleinman A, Das V, Lock MM (eds) (1997) Social suffering. University of California Press, Berkeley
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]
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
Krikorian A, Limonero JT, Corey MT (2013) Suffering assessment: a review of available instruments for use in palliative care. J Palliat Med 16(2):130–142
Krikorian A, Limonero JT, Román JP, Vargas JJ, Palacio C (2014) Predictors of suffering in advanced cancer. Am J Hosp Palliat Med 31(5):534–542. https://doi.org/10.1177/1049909113494092
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
Leder D (1985) Toward a phenomenology of pain. Rev Existent Psychol Psychiatry 19:255–266
Levinas E (1988) Useless suffering. In: Bernasconi R, Wood D (eds) The provocation of Levinas: rethinking the other. Routledge, London
Lowe W (2020) Medical humanities, sociology and the suffering self: surviving health. Routledge, London
MacIntyre A (1981) After virtue: a study in the moral theory. Duckworth, London
Malpas J, Lickiss N (eds) (2012) Perspectives on human suffering. Springer, Dordrecht
Marinker M (1975) Why make people patients? J Med Ethics 1(2):81–84
Massin O (2019) Suffering pains. Philosophy of suffering. In: Bain D, Brady M, Corns J (eds) Philosophy of suffering: metaphysics, value, and normativity philosophy of suffering. Routledge, London, pp 74–100
Mayerfeld J (2005) Suffering and moral responsibility. Oxford University Press, New York
McClelland T (2019) The disruption model of suffering. In: Bain D, Brady M, Corns J (eds) Philosophy of suffering: metaphysics, value, and normativity philosophy of suffering. Routledge, London, pp 37–54
Merleau-Ponty M (1962 [1945]) Phenomenology of perception (trans: Smith C). Routledge, New York
Morris DB (2002) The culture of pain. University of California, Berkley
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
Morse JM, Johnson JL (1991) The illness experience: dimensions of suffering. Sage, Newbury Park
Nortvedt P, Nordhaug M (2008) The principle and problem of proximity in ethics. J Med Ethics 34(3):156–161
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
Nussbaum M (1994) The therapy of desire: theory and practice in Hellenistic ethics. Princeton University Press, Princeton
Ratcliffe M (2008) Feelings of being: phenomenology, psychiatry and the sense of reality. Oxford University Press, Oxford
Rawlinson MC (1986) The sense of suffering. J Med Philos 11(1):39–62
Rodgers BL, Cowles KV (1997) A conceptual foundation for human suffering in nursing care and research. J Adv Nurs 25(5):1048–1053
Rousseau P (2001) Ethical and legal issues in palliative care. Prim Care 28(2):391–400
Sartre JP (2003 [1943]) Being and nothingness (trans: Eyre R). Routledge, London
Scarry E (1987) The body in pain: the making and unmaking of the world. Oxford University Press, New York
Scheler M (1974) The meaning of suffering. In: Max Scheler (1874–1928) Centennial Essays. Springer Netherlands, Dordrecht, pp 121–163
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
Schopenhauer A (2008) The world as will and presentation (trans: Richard E). Aquila in collaboration with David Carus. Longman, New York
Schulz R, Monin JK, Czaja SJ, Lingler JH, Beach SR, Martire LM, Dodds A, Hebert RS, Zdaniuk B, Cook TB (2010) Measuring the experience and perception of suffering. Gerontologist 50(6):774–784. https://doi.org/10.1093/geront/gnq033
Seneca (2004) On the shortness of life (trans: Costa CDN). Penguin, London
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
Singer P (1990 [1975]) Animal liberation. New York Review Books, New York
Singer P (2011 [1979]) Practical ethics. Cambridge University Press, New York
Smith DT (2011) A sociological alternative to the psychiatric conceptualization of mental suffering. Sociol Compass 5(5):351–363
Spelman EV (1997) Fruits of sorrow: framing our attention to suffering. Beacon, Boston
Strang P, Strang S, Hultborn R, Arnér S (2004) Existential pain – an entity, a provocation, or a challenge? J Pain Symptom Manag 27(3):241–250
Streeck N (2020) Death without distress? The taboo of suffering in palliative care. Med Health Care Philos 23:343–351
Svenaeus F (2014) The phenomenology of suffering in medicine and bioethics. Theor Med Bioeth 35(6):407–420
Svenaeus F (2017) Phenomenological bioethics: medical technologies, human suffering, and the meaning of being alive. Routledge, London
Taylor RL, Watson J (eds) (1989) They shall not hurt: human suffering and human caring. Colorado Associated University Press, Boulder
Toombs KS (1999) The meaning of illness: a phenomenological account of the different perspectives of physician and patient. Kluwer, Amsterdam
Ulvestad E (2012) Psychoneuroimmunology: the experiential dimension. Methods Mol Biol 934:21–37
Usherwood TP (1990) Responses to illness – implications for the clinician. J R Soc Med 83(4):205–207
van Hooft S (1998a) The meanings of suffering. Hast Cent Rep 28(5):13–19
Van Hooft S (1998b) Suffering and the goals of medicine. Med Health Care Philos 1:125–131
van Hooft S (2012) Ethics of suffering: modern law, philosophy and medicine/Marinos Diamantides. Monash Bioeth Rev 20(4):50–52
Wakefield JC (2013) DSM-5 grief scorecard: assessment and outcomes of proposals to pathologize grief. World Psychiatry 12(2):171–173
Wall PD (2000) Pain: the science of suffering. Columbia University Press, New York
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
Wierzbicka A (1996) Semantics: primes and universals: primes and universals. Oxford University Press, Oxford, UK. https://books.google.com/books?hl=no&lr=&id=ZN029Pmbnu4C&oi=fnd&pg=PA3&dq=%E2%80%A2%09Wierzbicka,+A.+(1996).+Semantics:+Primes+and+universals:+Primes+and+universals.+Oxford,+UK:+Oxford+University+Press&ots=u266Ba2fwE&sig=6KC6rrf2BQYwAwnK2bjD7vXAytY
Wilson RA, Brown RD (2009) Humanitarianism and suffering: the mobilization of empathy. Cambridge University Press, Cambridge
Wittgenstein L (2001 [1953]) Philosophical investigations. Blackwell, Oxford
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Hofmann, B. (2024). Suffering: Harm to Bodies, Minds, and Persons. In: Schramme, T., Walker, M. (eds) Handbook of the Philosophy of Medicine. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-8706-2_63-2
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Suffering: Harm to Bodies, Minds, and Persons- Published:
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