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On Suffering: Pathways to Healing & Health PDF

321 Pages·2011·2.241 MB·English
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Preview On Suffering: Pathways to Healing & Health

medicine & health / psychology C l a The first book to address issues of suffering r k e as separate from pain that require psychologically Beverley M. o and culturally sensitive interventions n Clarke Currently in medicine, theories of pain regard pain and suffering as one s and the same. It is assumed that if pain ceases, suffering stops. These theories are not substantiated in clinical practice, where some patients report little pain u and extreme suffering and other individuals have a lot of pain and virtually no suffering. f Based on the results of a scientific questionnaire, as well as evidence from and conversations with hundreds of patients, Beverley M. Clarke argues f convincingly that suffering is often separate from pain, has universal measurable characteristics, and requires suffering-specific treatments that are sensitive to the e patient’s individual psychology and cultural background. According to Clarke, r suffering occurs when individuals who have experienced a life change because of medical issues perceive a threat to their idea of self and personhood. This kind ı of suffering, based on a lost “dream of self,” affects every aspect of an individual’s n life. Treating the patient as a whole person — an approach that Clarke strongly advocates — is an issue overlooked in the majority of chronic care and traumatic injury treatments, focused as they are on pain reduction. g Clarke believes passionately that the management of suffering in medicine is the responsibility of all health care practitioners. Until they come to identify and understand suffering as distinct from pain, the entire health care system hp ea will continue to carry the financial and moral burden of incomplete diagnoses, at h l inappropriate referrals for care, ineffective treatment interventions, and lost iw n On human potential. a g y beverley m. clarke is an associate professor, School of Rehabilitation &s Science, and a neurology associate, Division of Neurology, at McMaster t h o Sufferıng University, Hamilton, Ontario, Canada. e a l t h dartmouth college press Hanover, New Hampshire pathways to healing D a Published by University Press of New England r t m and health Hanover and London Cover illustration: o u www.upne.com ©iStockphoto.com / Matthias Straka th On Suffering Beverley M. Clarke (cid:16) On Suffering �������� �� � ������ & ������ Dartmouth College Press Hanover, New Hampshire dartmouth college press An imprint of University Press of New England www.upne.com © 2011 Trustees of Dartmouth College All rights reserved Manufactured in the United States of America Designed by Eric M. Brooks Typeset in Quadraat and Quadraat Sans by Passumpsic Publishing University Press of New England is a member of the Green Press Initiative. The paper used in this book meets their minimum requirement for recycled paper. For permission to reproduce any of the material in this book, contact Permissions, University Press of New England, One Court Street, Suite 250, Lebanon NH 03766; or visit www.upne.com Library of Congress Cataloging-in-Publication Data appear on the last printed page of this book. 5 4 3 2 1 * This book is dedicated to my son, robin blair fraser clarke, With love and admiration contents Foreword ix Preface xi Acknowledgments xiii Introduction 1 part i · suffering What Man Has Made of Man 1 · Suffering in Medicine A New Aspect of an Old Problem 13 2 · Suffering Is Not Pain The Evidence 25 3 · The Power of Religious and Spiritual Beliefs 39 4 · Suffering and Culture 51 5 · Crises of Suffering across the Life Span 65 6 · The Language of Suffering 77 7 · Medical-Legal Disclosure of Suffering 89 part ii · identifying those who suffer Now Is the Time to Know 8 · Power Differentials and Suffering 109 9 · How to Assess Suffering 128 10 · Standards of Care 148 11 · Key Components of Suffering in Chronic Illness 164 part iii. caring for those who suffer When the World Is Too Much with Us 12 · The Resolution of Suffering 183 13 · The Roles of Health Care Professionals 197 14 · Habilitation and Rehabilitation 216 15 · The Wounded Spirit Reclaiming Personhood 231 16 · Surviving and Thriving 243 Epilogue 255 Appendixes a–d 259 References 273 Index 293 foreword Professor Beverley Clarke is a pioneer in the investigation and understanding of the concept of suffering. She has collected large amounts of clinical data on epilepsy, rheumatoid arthritis, migraine, and spinal cord injury. Professor Clarke has demonstrated that suffering should be considered distinct from pain. She has combined information from clinical, research, philosophical, and legal areas in showing the importance of suffering in all these areas. This book is the product of a comprehensive and thoughtful analysis of available literature and information from many sources. In my opinion this book provides an assembled text on many complex issues, and it represents many years of work on such an important subject. dr. adrian r. m. upton, M.A., M.B., B.Chir., lrcp, mrcs, frcp(c), frcp(e), frcp(g), Professor of Medicine—Neurology, Director of Neurology and Epilepsy Clinics, and Director of Diagnostic Neurophysiology, McMaster University Medical Centre, Hamilton, Ontario, Canada

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