End-of-life ethics
Should palliative care erase all suffering?
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.
How this study connects
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Should palliative care erase all suffering?
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Paper’s question?
proper aim of palliative care Hartogh Govert den 0031 235321273 g.a.denhartogh@uva.nl medical literature had for a long time been almost silent about the p
What do almost all studies cite?
Almost all these studies refer to Cassell, and in particular to his ‘definition’ of suffering. So it seems fitting to start (“” section) by considering Cas
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.
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