The Nature of Suffering underscores the change that is taking place in medicine from a basic concern with disease to a greater focus on the sick person. Cassell centers his discussion on the problem of suffering because, he says, its recognition and relief are a test of the adequacy of any system of medicine. He describes what suffering is and its relationship to the sick person: bodies do not suffer, people do. An exclusive concern with scientific knowledge of the body and disease, therefore, impedes an understanding of suffering and diminishes the care of the suffering patient. The growing criticism that medicine is not sufficiently humanistic does not go deep enough to provide a basis for a new understanding of medicine. New concepts in medicine must have their basis in its history and in the development of ideas about disease and treatment. Cassell uses many stories about patients to demonstrate that, despite the current dominance of science and technology, there can be no diagnosis, search for the cause of the patient's disease, prognostication, or treatment without consideration of the individual sick person. Recent trends in medicine and society, Cassell believes, show that it is time for the sick person to be not merely an important concern for physicians but the central focus of medicine. He addresses the exciting problems involved in such a shift. In this new medicine, doctors would have to know the person as well as they know the disease. What are persons, however, and how are doctors to comprehend them? The kinds of knowledge involved are varied, including values and aesthetics as well as science. In the process of knowing the experience of patient and doctor move to center stage. He believes that the exploration of the person will engage medicine in the 21st century just as understanding the body has occupied the last hundred years.

This is a revised and expanded edtion of a classic in palliative medicine, originally published in 1991. With three added chapters and a new preface summarizing our progress in the area of pain management, this is a must-hve for those in palliative medicine and hospice care. The obligation of physicians to relieve human suffering stretches back into antiquity. But what exactly, is suffering? One patient with metastic cancer of the stomach, from which he knew he would shortly die, said he was not suffering. Another, someone who had been operated on for a mior problem--in little pain and not seemingly distressed--said that even coming into the hospital had been a source of pain and not suffering. With such varied responses to the problem of suffering, inevitable questions arise. Is it the doctor's responsibility to treat the disease or the patient? And what is the relationship between suffering and the goals of medicine? According to Dr. Eric Cassell, these are crucial questions, but unfortunately, have remained only queries void of adequate solutions. It is time for the sick person, Cassell believes, to be not merely an important concern for physicians but the central focus of medicine. With this in mind, Cassell argues for an understanding of what changes should be made in order to successfully treat the sick while alleviating suffering, and how to actually go about making these changes with the methods and training techniques firmly rooted in the doctor's relationship with the patient. Dr. Cassell offers an incisive critique of the approach of modern medicine. Drawing on a number of evocative patient narratives, he writes that the goal of medicine must be to treat an individual's suffering, and not just the disease. In addition, Cassell's thoughtful and incisive argument will appeal to psychologists and psychiatrists interested in the nature of pain and suffering.

This is a revised and expanded edtion of a classic in palliative medicine, originally published in 1991. With three added chapters and a new preface summarizing our progress in the area of pain management, this is a must-hve for those in palliative medicine and hospice care. The obligation of physicians to relieve human suffering stretches back into antiquity. But what exactly, is suffering? One patient with metastic cancer of the stomach, from which he knew he would shortly die, said he was not suffering. Another, someone who had been operated on for a mior problem--in little pain and not seemingly distressed--said that even coming into the hospital had been a source of pain and not suffering. With such varied responses to the problem of suffering, inevitable questions arise. Is it the doctor's responsibility to treat the disease or the patient? And what is the relationship between suffering and the goals of medicine? According to Dr. Eric Cassell, these are crucial questions, but unfortunately, have remained only queries void of adequate solutions. It is time for the sick person, Cassell believes, to be not merely an important concern for physicians but the central focus of medicine. With this in mind, Cassell argues for an understanding of what changes should be made in order to successfully treat the sick while alleviating suffering, and how to actually go about making these changes with the methods and training techniques firmly rooted in the doctor's relationship with the patient. Dr. Cassell offers an incisive critique of the approach of modern medicine. Drawing on a number of evocative patient narratives, he writes that the goal of medicine must be to treat an individual's suffering, and not just the disease. In addition, Cassell's thoughtful and incisive argument will appeal to psychologists and psychiatrists interested in the nature of pain and suffering.

This is a revised and expanded edtion of a classic in palliative medicine, originally published in 1991. With three added chapters and a new preface summarizing our progress in the area of pain management, this is a must-have for those in palliative medicine and hospice care.

The essence of nursing care continually exposes nurses to suffering. Although they bear witness to the suffering of others, their own suffering is less frequently exposed. This slim volume attempts to give voice to the suffering that nurses witness in patients, families, colleagues, and themselves. By making this suffering visible, the authors wish to honor it and to learn from it. The audience includes nurses in all phases of training and practice - from students to educators to clinicians - in the wide array of settings and specialties in which nurses care for patients. The book offers nurses' colleagues in other professions - social workers, psychologists, chaplains, ethicists, and physicians - a rare window onto what it means to practice nursing. Drs. Ferrell and Coyle are also the editors of Textbook of Palliative Nursing, 2nd ed (Oxford, 2006). Independently, they have worked more than 50 years in oncology nursing, caring for patients and working to improve the quality of care that patients receive.

Currently and for centuries past, sickness has been understood to be primarily the physical result of bodily disease. Yet this definition of illness is out-of-date and untrue to life at a time when chronic illness and the problems of disability and aging are increasingly common. When persons are sick, it pervades their whole being. The Nature of Healing is based on a different definition of sickness, one that recognizes persons as sick when they cannot achieve their goals and purposes because of impairments of function, ranging from the molecular to the spiritual, which they believe to fall under the scope of medicine. Such impairments may result from disease, but certainly not all. As the sick person has increasingly become the focus of medicine, there have been repeated but mostly failed attempts to achieve both technological and humanistic goals in caring for patients. This approach is flawed because there is only one ultimate goal -- the well-being of the patient. Whether it involves the personal action of the clinician or the use of technology, everything done toward the goal of well-being is part of the healing enterprise. In this book, Eric Cassell explores what sickness is, what persons are, and how to understand function and its impairments. He explains healing skills and actions, as well as the nature of healing for sick and suffering patients. This book concludes with a discussion of the moral basis of the relationship between patient and healer, as well as the goals of healing.

"Humans have long tried to understand - and explain - this fact of the human condition. The ancient Greek playwright, Aeschylus, tells us in a tragedy he wrote in the 5th century BCE, Prometheus Bound, that Zeus punished the Titan, Prometheus, with lifelong suffering for having stolen fire and given it to humans.2 Before Prometheus's intervention, fire had only belonged to the gods. Zeus punished Prometheus by chaining him to a rock and sending an eagle to pluck out his liver during the day. At night, his liver regenerated, only for the eagle to return the next day to pluck it away again. Because Prometheus was half human, he felt the pain of the mortal wound inflicted by the eagle, but because he was half divine, he did not die from the wound"--

This textbook offers an introduction to the field of bioethics, specifically from a practicing physician standpoint. It engages a wide range of recent scholarship and emerging research covering many crucial topics in clinical ethics. While there has been increasing attention to the role of bioethics in medicine, the gap between theory and practice still exists, and it continues to impede the dialogue between health care professionals from one side and bioethicists and philosophers of medicine from the other side. This book builds bridges and open channels of connection between different parties in these conversations. It does so from a physician’s practical perspective, engaging recent scholarship and emerging research, to shed light on pivotal ethical dilemmas in contemporary clinical practice.

Debates over health care have focused for so long on economics that the proper goals for medicine seem to be taken for granted; yet problems in health care stem as much from a lack of agreement about the goals and priorities of medicine as from the way systems function. This book asks basic questions about the purposes and ends of medicine and shows that the answers have practical implications for future health care delivery, medical research, and the education of medical students.The Hastings Center coordinated teams of physicians, nurses, public health experts, philosophers, theologians, politicians, health care administrators, social workers, and lawyers in fourteen countries to explore these issues. In this volume, they articulate four basic goals of medicine -- prevention of disease, relief of suffering, care of the ill, and avoidance of premature death -- and examine them in light of the cultural, political, and economic pressures under which medicine functions. In reporting these findings, the contributors touch on a wide range of diverse issues such as genetic technology, Chinese medicine, care of the elderly, and prevention and public health."The Goals Of Medicine" clearly demonstrates the importance of clarifying the purposes of medicine before attempting to change the economic and organizational systems. It warns that without such examination, any reform efforts may be fruitless.