The Nature of Suffering and the Goals of Medicine

Second Edition

Eric J. Cassell

The Nature of Suffering and the Goals of Medicine

Second Edition

Eric J. Cassell






1 Dec 2003


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  • 'Cassell's arguments and discussions are clear and logical and his style makes it a pleasure to read. It is also clinically practical, with many case histories used to introduce and illustrate the discussion. Highly recommended.' -IAHPC Website

This is a revised and expanded edition of a classic in palliative medicine, originally pulished in 1991. With three new chapters and a new preface summarizing the progress in the area of pain management, this is a must-have 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 metastatic 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 minor problem – in little pain and not seemingly distressed, said that even coming into the hospital had been a source of pain and suffering. With such varied responses to the problem of suffering, inevitable questions arise. Is it the doctor's responsbility to treat the disease or the patient? What is the relationship between suffering and the goals of medicine?

According to Dr Eric Cassell these are cruical 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.


1: Ideas in Conflict: The Rise and Fall of New Views of Disease
2: The Changing Concept of the Ideal Physician
3: The Nature of Suffering
4: Suffering in Chronic Illness
5: The Mysterious Relationship Between Doctor and Patient
6: How to Understand Diseases
7: The Pursuit of Disease or the Care of the Sick?
8: Treating the Disease, the Body, or the Patient
9: The Doctor and the Patient
10: Who is This Person?
11: The Measure of the Person
12: The Clinician's Experience: Power Versus Magic in Medicine
13: Mind and Body
14: The Illness Called Dying
15: Pain and Suffering
Epilogue: The Care of the Suffering Patient


Eric J. Cassell , Clinical Professor of Public Health, Cornell University Medical College, USA

Eric J Cassell is Clinical Professor of Public Health at Weill Medical College of Cornell University and an attending physician at The New York-Presbyterian Hospital. He is a Fellow and a member of the Board of Directors of the Hastings Center, as well as a member of the Institute of Medicine of the National Academy of Sciences and a Master of the American College of Physicians. His recent books include Changing Values in Medicine, Talking with Patients, and Doctoring.


From reviews of the First Edition:

`Well written... should be read by everyone in medical practice or considering a career in medicine.' JAMA

`Memorable passages, important ideas, and critical analysis. This is a book that clinicians and educators should read.' New England Journalf of Medicine