Suffering in the clinical setting

This dissertation begins with the assumption that there is suffering in this world. In Chapter II I explore the notion of suffering by looking at the relationship between suffering and pain, suffering and personhood, and suffering and values.

Chapter III is about suffering and autonomy. I begin with why autonomy matters so much by exploring the three key aspects of autonomy that are freedom, responsibility, and the individual. In the next two sections of this chapter I demonstrate the close relationship autonomy has to suffering by showing that there are conditions under which suffering may diminish autonomy and conditions under which autonomy may diminish suffering. I conclude this chapter with how all this relates to the clinical setting by way of the topics of informed consent and refusal of treatment.

Chapter IV discusses suffering and justice. I begin with a look at the nature of justice. I then examine the distinction between justice and misfortune as it relates to suffering. I examine two major views concerning this distinction and develop a new way of looking at them. In the last section of this chapter I point out how this new approach can affect our thinking about justice and the social responsibility concerning the allocation of health care.

In Chapter V I look at the relationship between suffering patients and physicians. The first part of this chapter is concerned with an argument that physicians have a responsibility toward suffering patients. The responsibility I argue for concerns providing opportunities for healing to occur in the lives of suffering patients. I also explore the importance of good communication between physicians and suffering patients as it relates to this responsibility. Based on how suffering interacts with autonomy and justice, and the role it plays in the relationship between physicians and suffering patients, I believe the argument can be made that suffering is an important issue for medical ethics that needs to be reevaluated in light of current trends in medicine.