The Nature of Suffering and the Goals of Medicine

Front Cover
Oxford University Press, USA, Oct 3, 1991 - Medical - 272 pages
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.
 

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Contents

Ideas in Conflict The Rise and Fall of New Views of Disease
3
The Changing Concept of the Ideal Physician
16
The Nature of Suffering
29
Suffering in Chronic Illness
46
The Mysterious Relationship Between Doctor and Patient
62
How to Understand Diseases
76
The Pursuit of Disease or the Care of the Sick?
88
Treating the Disease the Body or the Patient
108
The Measure of the Person
164
The Clinicians Experience Power Versus Magic in Medicine
200
Mind and Body
221
The Illness Called Dying
243
Pain and Suffering
260
The Care of the Suffering Patient
278
Notes
293
Index
308

The Doctor and the Patient
130
Who Is This Person?
148

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About the author (1991)

Eric J. Cassell is Clinical Professor of Public Health at Cornell University Medical College, and an attending physician at The New York Hospital. He is a fellow of the Hastings Center and a member of the Institute of Medicine of The National Academy of Sciences. He is the author of The Healer's Art, The Place of Humanities in Medicine, and Talking with Patients.

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