The Nature of Suffering and the Goals of Medicine / Edition 2

by Eric J. Cassell

Overview

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.

Product Details

ISBN-13:	9780195156164
Publisher:	Oxford University Press
Publication date:	03/25/2004
Edition description:	REVISED
Pages:	336
Product dimensions:	9.42(w) x 6.16(h) x 0.88(d)
Lexile:	1330L (what's this?)

About the Author

About the Author:
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.

Table of Contents

Preface to the Second edition1. Ideas in Conflict: The Rise and Fall of New Views of Disease2. The Changing Concept of the Ideal Physician3. The Nature of Suffering4. Suffering in Chronic Illness5. The Mysterious Relationship Between Doctor and Patient6. How to Understand Diseases7. The Pursuit of Disease or the Care of the Sick? 8. Treating the Disease, the Body, or the Patient9. The Doctor and the Patient10. Who is This Person? 11. The Measure of the Person12. The Clinician's Experience: Power Versus Magic in Medicine13. Mind and Body14. The Illness Called Dying15. Pain and SufferingEpilogueThe Care of the Suffering Patient

Editorial Reviews

Reviewer: Patricia Wong, MD (Private Practice)
Description: Eric Cassell presents a perceptive, insightful discussion on what it means to be ill from a humanity viewpoint. This book should be on the required reading list in psychiatry for medical students. You will discover why your patient will continue to be unwell even though you have made the proper diagnosis and instituted the proper treatment course and the laboratory studies have improved. Learn how to treat the soul and mind, not only the body. Unfortunately, this is not taught in medical school or is taught poorly. Experienced physicians would benefit from reading this book. It explains the difference between being a technician and a really fine doctor.
Purpose: The author's purpose is to educate physicians on alleviating patient suffering through the patient-doctor relationship. The ethical dilemmas physicians are faced with are explored in a soul searching manner. How do you decide to treat a patient when you feel it is "a waste of resources" and "wouldn't make a difference anyway" (i.e,. the patient is going to die irrespective of what will be done). How do you handle and feel about patients refusing your therapy when you are certain they may die if they don't follow your advice? Cassell points out that as technology advances in the medical arena, our ability to treat these kinds of problems is rapidly dwindling.
Audience: The audience is all medical care providers and students.
Features: The doctor-patient relationship is explored, promoting an understanding of disease in the context of how one experiences personal loss and control, framing it in terms of the conflict between the self and the body. Trying to present the patient with choices on sickness, disability, and death that will lead to harmony is as difficult as it sounds. A therapist should accompany every book sold. The history of the evolution of our thinking that saving someone from death and prolonging survival are the most important goals of a caregiver is presented. In the 19th century people commonly died in their 30s or 60s, but when CPR was discovered and antibiotics were developed, a debate emerged whether it was better to let someone go to heaven or stay on earth. This is very interesting stuff. You have to read it!
Assessment: This is one of the best written books of this genre.

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