Rethinking Suffering: Allowing for Suffering that is Intrinsic at End of Life

Area of Science:

• Palliative Care
• End-of-Life Care
• Medical Ethics

Background:

• Palliative care providers aim to relieve suffering, but face limitations in doing so.
• The ethical duty to relieve suffering can conflict with the reality of unrelievable suffering.
• Clinicians experiencing unrelievable suffering may face moral distress and compassion fatigue.

Purpose of the Study:

• To explore the concept of "sitting with suffering" in palliative care.
• To examine the implications of unrelievable suffering for clinicians and patients.
• To propose a paradigm shift in how palliative care addresses psychosocial suffering.

Main Methods:

• Qualitative analysis of clinical experiences and ethical considerations.
• Exploration of the concept of "bearing suffering" as a therapeutic approach.
• Discourse analysis of the role of clinicians in validating patient suffering.

Main Results:

• Acknowledging and validating "unrelievable" suffering can help patients and families cope.
• The concept of "sitting with suffering" challenges the traditional focus on symptom relief.
• Clinicians' capacity to tolerate suffering can model resilience for patients and families.

Conclusions:

• "Sitting with suffering" represents a significant paradigm shift in palliative care.
• Validating suffering, rather than solely relieving it, can be a crucial aspect of end-of-life care.
• Rethinking the clinician's role is essential for addressing psychosocial suffering in dying patients.