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End-of-life ethics

Should palliative care erase all suffering?

Hartogh GD · Medicine, health care, and philosophy · 2017

Open access · cc by · source: Europe PMC

Den Hartogh says end-of-life studies cite Cassell but then measure suffering like a symptom list; dying well can require respecting some suffering, not only removing it.

Key findings

Physical symptoms of terminal illness often should be soothed because they no longer help. But not every element of suffering is like a distressing symptom it is always in the patient’s interest to eliminate. Within constraints of realism, support should help find an appropriate attitude. Paradoxically, some suffering should be respected as part of dying well.

Methodology

He samples empirical papers on suffering at the end of life, all of which cite Cassell’s definition, then shows they pay lip service: they add psychological and social items but still treat them as removable symptoms. Fatigue is his example of why ‘importance’ ratings misfire.

Limitations

This is a philosophical reading of a literature sample, not a new hospice trial. It does not say clinicians should withhold analgesia. ‘Dying well’ is a normative claim, not an outcome measure.

How this study connects

Role on claims

Each row is a claim on a concept or method page where this paper supports, challenges, or qualifies the statement. Roles are hand-checked — not a model guess.

  • SupportsEnd-of-life ethicsconcept

    Den Hartogh argues dying well can require respecting some suffering rather than only removing it as a symptom list.

    Evidence for the claim as stated.

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