A book on the problem of evil, focusing on alleged gratuitous suffering.

Distant Suffering examines the moral and political implications for a spectator of the distant suffering of others as presented through the media. What are the morally acceptable responses to the sight of suffering on television, for example, when the viewer cannot act directly to affect the circumstances in which the suffering takes place? Luc Boltanski argues that spectators can actively involve themselves and others by speaking about what they have seen and how they were affected by (...) it. Developing ideas in Adam Smith's moral theory, he examines three rhetorical 'topics' available for the expression of the spectator's response to suffering: the topics of denunciation and of sentiment and the aesthetic topic. The book concludes with a discussion of a 'crisis of pity' in relation to modern forms of humanitarianism. A possible way out of this crisis is suggested which involves an emphasis and focus on present suffering. (shrink)

Suffering, in one form or another, is present in all of our lives. But why do we suffer? On one reading, this is a question about the causes of physical and emotional suffering. But on another, it is a question about whether suffering has a point or purpose or value. In this ground-breaking book, Michael Brady argues that suffering is vital for the development of virtue, and hence for us to live happy or flourishing lives. After (...) presenting a distinctive account of suffering, and a novel account of its core element, unpleasantness, Brady proceeds to focus on three claims that are central to his picture. The first is that forms of suffering, like pain and remorse, can themselves constitute virtuous responses. The second is that suffering is essential for four important classes of virtue - virtues of strength, such as fortitude and courage; virtues of vulnerability, such as adaptability and humility; moral virtues, such as compassion; and the practical and epistemic excellences that make up wisdom. His final claim third is that suffering is vital for the social virtues of justice, love, and trust, and hence for the flourishing of social groups. (shrink)

Animal Suffering: Philosophy and Culture explores the multifaceted moral meanings allocated to non-human suffering in contemporary Western culture.

When people suffer they always suffer as a whole human being. The emotional, cognitive and spiritual suffering of human beings cannot be completely separated from all other kinds of suffering, such as from harmful natural, ecological, political, economic and social conditions. In reality they interact with each other and influence each other. Human beings do not only suffer from somatic illnesses, physical pain, and the lack of decent opportunities to satisfy their basic vital, social and emotional needs. They (...) also suffer when they are not able to experience and grasp any meaning of life even if such suffering is not quite as obvious as most forms of physical, social and emotional suffering. Suffering from the lack for the sense of the meaning of life is a special form of emotional, cognitive, and spiritual suffering. Although all human beings share the same basic human need for some meaning of life, the fulfilment of this need is highly individual and personal. Although all forms of human suffering can be a challenge to the meaning of life, the personal conditions of suffering usually are a stronger challenge for the meaning of life. Among the personal conditions of human suffering, the Grenzsituationen cannot be cancelled or raised at all, but only accepted and coped with as existential aspects of the conditio humana. According to Karl Jaspers these are: death, suffering, struggling, guilt, and failing. The challenge for human beings to cope with these Grenzsituationen is a way to move from the mere Being-there to true human Existence. (shrink)

In this work, Jamie Mayerfeld undertakes a careful inquiry into the meaning and moral significance of suffering. Understanding suffering in hedonistic terms as an affliction of feeling, he claims that it is an objective psychological condition, amenable to measurement and interpersonal comparison, although its accurate assessment is never easy. Mayerfeld goes on to examine the content of the duty to prevent suffering and the weight it has relative to other moral considerations. He argues that the prevention of (...) suffering is morally more important than the promotion of happiness, and that the duty to relieve suffering is much stronger than most of us acknowledge. (shrink)

The paper aims at clarifying the distinctions and relations between pain and suffering. Three negative theses are defended: 1. Pain and suffering are not identical. 2. Pain is not a species of suffering, nor is suffering a species of pain, nor are pain and suffering of a common (proximate) genus. 3. Suffering cannot be defined as the perception of a pain’s badness, nor can pain be defined as a suffered bodily sensation. Three positive theses (...) are endorsed: 4. Pain and suffering are categorically distinct: pain is a localised bodily episode, suffering is a non-localised affective attitude. 5. Suffering can be expressed, pains cannot. As a consequence, we can have compassion for the suffering of others, not for their pains. 6. The relation between pain and suffering is akin to the relation between danger and fear, injustice and indignation, wrongdoing and guilt: suffering is the correct reaction to pain. One upshot is that both the influential view that the experience of pain is incorrigible and the influential view that the ordinary conception of pain is paradoxical are false. (shrink)

In this chapter we suggest that many experiences of suffering can be further illuminated as forms of transformative experience, using the term coined by L.A. Paul. Such suffering experiences arise from the vulnerability, dependence, and affliction intrinsic to the human condition. Such features can create a variety of positively, negatively, and ambivalently valanced forms of epistemically and personally transformative experiences, as we detail here. We argue that the productive element of suffering experiences can be articulated as transformative, (...) although suffering experiences are not the type mostly discussed in the transformative experience literature. We correct for this here by developing a taxonomy of negatively valenced transformative experiences. We suggest three features that make such experiences ones of suffering, following Michael Brady’s definition: intensity, novelty, and attentional focus. Finally, we suggest that one possible explanation for the edifying capacity of suffering comes from it requiring more transformation than positive experiences. (shrink)

This article offers a new theory of suffering as significantly disrupted agency. In presenting it, I here make three significant contributions. First, I subject the leading account of suffering as undesired unpleasant experience (Brady, 2018) to its first dose of sustained scrutiny. Second and drawing on this discussion, I identify and liberate eight desiderata for any account of suffering. Third, I present the novel account of suffering as significantly disrupted agency and argue that it satisfies these (...) desiderata. Moreover, I argue that elaborating this proposal with a minimal model of agency allows us to capture both the suffering of a wide range of organisms and the complex dynamics of suffering as it is endured. I conclude by briefly highlighting some of the potential implications of the theory for further theoretical and practical inquiries. (shrink)

This article advances some considerations that undermine the overall justification for what I call “beneficent interventions,” or interventions aimed at reducing the suffering of wild animals. I first appeal to Susan Wolf’s (2010) account of meaning in life to argue that wild animals can and do have meaning in their lives. I then argue that the meaning in animal lives can offset their suffering, making their lives more worth living. This source of positive value in the lives of (...) wild animals undermines some of the justification for those beneficent interventions that aim to reduce wild animal suffering by reducing the numbers of wild animals who either suffer or inflict suffering upon others. (shrink)

As ever more advanced digital systems are created, it becomes increasingly likely that some of these systems will be digital minds, i.e. digital subjects of experience. With digital minds comes the risk of digital suffering. The problem of digital suffering is that of mitigating this risk. We argue that the problem of digital suffering is a high stakes moral problem and that formidable epistemic obstacles stand in the way of solving it. We then propose a strategy for (...) solving it: Access Monitor Prevent (AMP). AMP uses a ‘dancing qualia’ argument to link the functional states of certain digital systems to their experiences—this yields epistemic access to digital minds. With that access, we can prevent digital suffering by only creating advanced digital systems that we have such access to, monitoring their functional profiles, and preventing them from entering states with functional markers of suffering. After introducing and motivating AMP, we confront limitations it faces and identify some options for overcoming them. We argue that AMP fits especially well with—and so provides a moral reason to prioritize—one approach to creating such systems: whole brain emulation. We also contend that taking other paths to digital minds would be morally risky. (shrink)

Does an affirmation of theistic evolution make the task of theodicy impossible? In this article, I will review a number of ancient and contemporary responses to the problem of evil as it concerns animal suffering and suggest a possible way forward which employs the ancient Jewish insight that evil—as resistance to God's will that results in suffering and alienation from God's purposes—precedes the arrival of human beings and already has a firm foothold in the nonhuman animal world long (...) before humans are ever tempted to go astray. This theological intuition is conferred renewed relevance in light of the empirical reality of evolutionary gradualism and continuity and in view of the recent findings of cognitive ethology. Consequently, I suggest that taking biological evolution seriously entails understanding “moral evil” as a prehuman phenomenon that emerges gradually through the actions and intentions of “free creatures” which—as evolutionary history unfolded—increasingly possessed greater levels of freedom and degrees of moral culpability. (shrink)

Before curing was a possibility, medicine was devoted to the relief of suffering. Attention to the relief of suffering often takes a back seat in modern biomedicine. This book seeks to place suffering at the center of biomedical attention, examining suffering in its biological, psychological, clinical, religious, and ethical dimensions.

This paper argues that it is possible for suffering to occur in the absence of phenomenal consciousness – in the absence of a certain sort of experiential subjectivity, that is. (Phenomenal consciousness is the property that some mental states possess, when it is like something to undergo them, or when they have subjective feels, or possess qualia.) So even if theories of phenomenal consciousness that would withhold such consciousness from most species of non-human animal are correct, this neednt mean (...) that those animals dont suffer, and arent appropriate objects of sympathy and concern. (shrink)

It is often accepted that we may legitimately speak about voluntary euthanasia only in cases of persons who are suffering because they are incurably injured or have an incurable disease. This article argues that when we consider the moral acceptability of voluntary euthanasia, we have no good reason to concentrate only on persons who are ill or injured and suffering.

We argue that some sports test athletes’ capacities to endure specific types of suffering, and in such cases the suffering is constitutive of the sport: the sporting contest would not be a good sporting contest if that capacity were not tested. We then argue that it is morally acceptable for athletes to experience pleasure (Schadenfreude) in response to the constitutive suffering of competitors insofar as that pleasure is compatible with pity or sympathy for non-constitutive suffering. We (...) use the case of morally acceptable pleasure in the constitutive suffering of a competitor to clarify the sense of Schadenfreude. We defend a little recognised distinction of Aristotelian provenance between benign and malignant Schadenfreude, and, in contrast to the prevailing scholarly assessment, we show that Schadenfreude is not necessarily a passive emotion. (shrink)

This article explores the defense Indian Buddhist texts make in support of their conceptions of lives that are good for an individual. This defense occurs, largely, through their analysis of ordinary experience as being saturated by subtle forms of suffering . I begin by explicating the most influential of the Buddhist taxonomies of suffering: the threefold division into explicit suffering , the suffering of change , and conditioned suffering . Next, I sketch the three theories (...) of welfare that have been most influential in contemporary ethical theory. I then argue that Buddhist texts underdetermine which of these theories would have been accepted by ancient Indian Buddhists. Nevertheless, Buddhist ideas about suffering narrow the shape any acceptable theory of welfare may take. In my conclusion, I argue that this narrowing process itself is enough to reconstruct a philosophical defense of the forms of life endorsed in Buddhist texts. (shrink)

In the current debate on theodicy, the problem of animal suffering is becoming increasingly relevant, as demonstrated by some recent books devoted to this topic. Such a problem is particularly challenging for a theistic theodicy, as its traditional arguments do not seem able to deal with it. In the first instance, the article aims to provide a brief overview of the main arguments sustained by theists regarding animal suffering, and secondly to provide an evaluation of such arguments which (...) might be useful for further research on this topic. (shrink)

Taking as its starting point a recent statement of the Goals of Medicine published by the Hastings Centre, this paper argues against the dualistic distinction between pain and suffering. It uses an Aristotelian conception of the person to suggest that malady, pain, and disablement are objective forms of suffering not dependent upon any state of consciousness of the victim. As a result, medicine effectively relieves suffering when it cures malady and relieves pain. There is no medical mission (...) to confront the spiritual condition of the patient. (shrink)

Suffering is a ubiquitous yet elusive concept in health care. In a field devoted to the pursuit of objective data, suffering is a phenomenon with deep ties to subjective experience, moral values, and cultural norms. Suffering’s tie to subjective experience makes it challenging to discern and respond to the suffering of others. In particular, the question of whether a child with profound neurocognitive disabilities can suffer has generated a robust discourse, rooted in philosophical conceptualizations of personhood (...) as well as the academic and experiential expertise of practiced health-care professionals. The issue remains unresolved because it is difficult, perhaps impossible, to ever truly know an infant’s lived experience. But what if this is not the best question? What if instead of asking “can this infant suffer?” the discourse is broadened to ask “is there suffering here?” This latter question demands attention to patients’ subjective experiences of suffering, but also to the web of relationships that envelop them. Without losing sight of the importance of patients’ experiences, consideration of their relationships may elucidate the presence of suffering when the patients themselves are unable to provide the same clarity. In this essay, care ethics frames an examination of how suffering manifests in the loving and caring relationships that surround an infant with profound neurocognitive disabilities, changing those relationships and affecting the individuals within them. Exploring suffering through these relationships may offer clarity on the presence and content of suffering for infants with profound cognitive disabilities, in turn offering moral guidance for responding to suffering and supporting flourishing in this context. (shrink)

Background One of the objectives of medicine is to relieve patients' suffering. As a consequence, it is important to understand patients' perspectives of suffering and their ability to cope. However, there is poor insight into what determines their suffering and their ability to bear it. Purpose To explore the constituent elements of suffering of patients who explicitly request euthanasia or physician-assisted suicide (EAS) and to better understand unbearable suffering from the patients' perspective. Patients and methods (...) A qualitative study using in-depth face-to-face interviews was conducted with 31 patients who had requested EAS. The grounded theory approach was used to analyse the data. Results Medical, psycho-emotional, socio-environmental and existential themes contributed to suffering. Especially fatigue, pain, decline, negative feelings, loss of self, fear of future suffering, dependency, loss of autonomy, being worn out, being a burden, loneliness, loss of all that makes life worth living, hopelessness, pointlessness and being tired of living were constituent elements of unbearable suffering. Only patients with a psychiatric (co)diagnosis suffered unbearably all the time. Conclusions Unbearable suffering is the outcome of an intensive process that originates in the symptoms of illness and/or ageing. According to patients, hopelessness is an essential element of unbearable suffering. Medical and social elements may cause suffering, but especially when accompanied by psycho-emotional and existential problems suffering will become ‘unbearable’. Personality characteristics and biographical aspects greatly influence the burden of suffering. Unbearable suffering can only be understood in the continuum of the patients' perspectives of the past, the present and expectations of the future. (shrink)

Suffering Art Gladly is concerned with the ostensibly paradoxical phenomenon of negative emotions involved in the experience of art: how can we explain the pleasure felt or satisfaction taken in such experience when it is the vehicle of negative emotions, that is, ones that seem to be unpleasant or undesirable, and that one normally tries to avoid experiencing? The question is as old as philosophical reflection on the arts, beginning with Plato and Aristotle, and subsequently addressed by Hume, Burke, (...) Diderot, Kant, and Schopenhauer, among others. Moreover, it is still an important and unresolved question in contemporary philosophy of art, where the discussion has been notably enlivened by recent research on the nature of imagination, cognition, and the emotions. Suffering Art Gladly comprises essays of two kinds, though the division between them is not airtight. The first kind are essays with a primarily historical focus, examining the problem of negative emotion from art as treated by important figures in the history of aesthetic thought, including Aristotle, Hume, Diderot, Kant, and Schopenhauer. The second kind are essays with a primarily contemporary focus, in which the methods and tools of contemporary analytic philosophy are much in evidence. In addition to the thirteen essays forming the heart of the book there is a general introduction by the editor, motivating the basic problem with which the essays are variously concerned and identifying the presuppositions or assumptions that are involved in different solutions to the problem. The individual essays are wide-ranging, dealing with a variety of artforms, negative emotions, and specific works of art, and the contributors, all recognized scholars in the field of aesthetics, are a mixture of junior and senior figures representing seven nationalities. (shrink)

Whence comes suffering? If the divine reality is a reality of bliss, and all is derived from this divine reality, how can suffering arise? Does the reality of God contain suffering? Might suffering be understood as a mode of bliss? These are the questions I take up in this essay. I suggest that the various states of suffering may best be understood as fragments of bliss, progressively resolved as fragmentation is overcome. Spiritual life is the (...) progressive movement from the suffering of ontological fragmentation toward the bliss of reunion. (shrink)

John R. Schneider explores the problem that animal suffering, caused by the inherent nature of Darwinian evolution, poses to belief in theism. Examining the aesthetic aspects of this moral problem, Schneider focuses on the three prevailing approaches to it: that the Fall caused animal suffering in nature, that Darwinian evolution was the only way for God to create an acceptably good and valuable world, and that evolution is the source of major, God-justifying beauty. He also uses canonical texts (...) and doctrines from Judaism and Christianity - notably the book of Job, and the doctrines of the incarnation, atonement, and resurrection - to build on insights taken from the non-lapsarian alternative approaches. Schneider thus constructs an original, God-justifying account of God and the evolutionary suffering of animals. His book enables readers to see that the Darwinian configuration of animal suffering unveiled by scientists is not as implausible on Christian theism as commonly supposed. (shrink)

In this chapter we suggest that many experiences of suffering can be further illuminated as forms of transformative experience, using the term coined by L.A. Paul. Such suffering experiences arise from the vulnerability, dependence, and affliction intrinsic to the human condition. Such features can create a variety of positively, negatively, and ambivalently valanced forms of epistemically and personally transformative experiences, as we detail here. We argue that the productive element of suffering experiences can be articulated as transformative, (...) although suffering experiences are not the type mostly discussed in the transformative experience literature. We correct for this here by developing a taxonomy of negatively valenced transformative experiences. We suggest three features that make such experiences ones of suffering, following Michael Brady’s definition: intensity, novelty, and attentional focus. Finally, we suggest that one possible explanation for the edifying capacity of suffering comes from it requiring more transformation than positive experiences. (shrink)

SUFFERING HUMAN AND DIVINE INTRODUCTION I KNEW when I asked Dr. H. Wheeler Robinson to write this volume on Suffering that I was giving him the most difficult ...

This essay explores the experience of suffering in order to see to what extent it can be understood within the context of the human condition without diverting the reality of suffering or denying the meaning of human existence and divine reality. Particular attention is given to describing and interpreting what I call the transcendent dimensions of suffering with the intent of showing that in the experience of suffereing persons come up against the limits of what can be (...) accounted for in ordinary terms and point towards transcendent reality. In religious faith the transcendent dimensions of suffering may be understood to come together with other transcendent dimensions of experience in a more distinctive or focused encounter with transcendent reality. The conception of God that is suggested by the transcendent dimensions of suffering, however, differs from the model of God in western theism as an absolutely transcendent, all powerful, immutable and impassible being. (shrink)

Despite the central place of suffering in medical care, suffering in infants and nonverbal children remains poorly defined. There are epistemic problems in the detection and treatment of suffering in infants and normative problems in determining what is in their best interests. A lack of agreement on definitions of infant suffering leads to misunderstanding, mistrust, and even conflict amongst clinicians and parents. It also allows biases around intensive care and disability to affect medical decision-making on behalf (...) of infants. In this paper, I propose the concept of suffering pluralism, which is a novel multidimensional view of infant suffering based on subjective and objective components. The concept of suffering pluralism is more inclusive of the multiple ways in which infant suffering can occur. It acknowledges and defines a subjective component to infant suffering, while also focusing moral attention on objective well-being by describing it using the language of suffering. This concept allows us to better weigh up subjective and objective components of well-being. It also encourages clarity and consistency in claiming suffering, which is likely to improve communication and reduce conflict in medical decision-making for unwell infants and children. I will end by exploring possible critiques and limitations of this concept. (shrink)

In the end‐of‐life context, alleviation of the suffering of a distressed patient is usually seen as a, if not the, central goal for the medical personnel treating her. Yet it has also been argued that suffering should be seen as a part of good dying. More precisely, it has been maintained that alleviating a dying patient’s suffering can make her unable to take care of practical end‐of‐life matters, deprive her of an opportunity to ask questions about and (...) find meaning in and for her existence, and detach her from reality. In this article, I argue that the aims referred to either do not support suffering or are better served by alleviating it. When the aims would be equally well served by enduring suffering and relieving it, the latter appears to be the preferable option, given that the distress a patient experiences has no positive intrinsic value. Indeed, as the suffering can be very distressing, it may not be worth bearing even if that was the best way to achieve the aims: the distress can sometimes be bad enough to outbalance the worth of achieving the goals. Having considered an objection to the effect that a patient can have a self‐regarding moral duty to endure the distress she faces at the end of life, I conclude that the burden of proof is on the side of those who maintain that the suffering experienced at the end of life ought to be endured as a part of dying well. (shrink)

Invertebrate animals are usually seen as a kind of “aliens” which do not deserve any moral consideration. However, there is a growing amount of evidenceindicating that many of them do have the capacity to experience pain. The samecriteria that are usually applied in order to infer that vertebrates are sentient beings (behavioral response, learning capacity, memory, a certain specific neurophysiological structure…) lead to the idea that many invertebrates aresentient as well. Therefore, under the skeptical premise that we have no directevidence (...) of the experience of pain in vertebrates, we are forced to hold that itexists in both vertebrates and invertebrates. (shrink)

The suffering of nonhuman animals has become a noted factor in deciding public policy and legislative change. Yet, despite this growing concern, skepticism toward such suffering is still surprisingly common. This paper analyzes the merits of the skeptical approach, both in its moderate and extreme forms. In the first part it is claimed that the type of criterion for verification concerning the mental states of other animals posed by skepticism is overly (and, in the case of extreme skepticism, (...) illogically) demanding. Resting on Wittgenstein and Husserl, it is argued that skepticism relies on a misguided epistemology and, thus, that key questions posed by it face the risk of absurdity. In the second part of the paper it is suggested that, instead of skepticism, empathy together with intersubjectivity be adopted. Edith Stein’s take on empathy, along with contemporary findings, are explored, and the claim is made that it is only via these two methods of understanding that the suffering of nonhuman animals can be perceived. (shrink)

It is the persistence of social suffering in a world in which it could be eliminated that for Adorno is the source of the need for critical reflection, for philosophy. Philosophy continues and gains its cultural place because an as yet unbridgeable abyss separates the social potential for the relief of unnecessary human suffering and its emphatic continuance. Philosophy now is the culturally bound repository for the systematic acknowledgement and articulation of the meaning of the expanse of human (...) suffering within technologically advanced societies that are already committed to liberal ideals of freedom and equality. (shrink)

Ng :255–285, 1995. https://doi.org/10.1007/bf00852469) models the evolutionary dynamics underlying the existence of suffering and enjoyment and concludes that there is likely to be more suffering than enjoyment in nature. In this paper, we find an error in Ng’s model that, when fixed, negates the original conclusion. Instead, the model offers only ambiguity as to whether suffering or enjoyment predominates in nature. We illustrate the dynamics around suffering and enjoyment with the most plausible parameters. In our illustration, (...) we find surprising results: the rate of failure to reproduce can improve or worsen average welfare depending on other characteristics of a species. Our illustration suggests that for organisms with more intense conscious experiences, the balance of enjoyment and suffering may lean more toward suffering. We offer some suggestions for empirical study of wild animal welfare. We conclude by noting that recent writings on wild animal welfare should be revised based on this correction to have a somewhat less pessimistic view of nature. (shrink)

BackgroundThis article aims to contribute to a better conceptualization of pain and suffering by providing non-essential and non-naturalistic definitions of both phenomena. Contributions of classical evidence-based medicine, the humanistic turn in medicine, as well as the phenomenology and narrative theories of suffering and pain, together with certain conceptions of the person beyond them are critically discussed with such purpose.MethodsA philosophical methodology is used, based on the review of existent literature on the topic and the argumentation in favor of (...) what are found as better definitions of suffering and pain.ResultsPain can be described in neurological terms but cognitive awareness, interpretation, behavioral dispositions, as well as cultural and educational factors have a decisive influence on pain perception. Suffering is proposed to be defined as an unpleasant or even anguishing experience, severely affecting a person at a psychophysical and existential level. Pain and suffering are considered unpleasant. However, the provided definitions neither include the idea that pain and suffering can attack and even destroy the self nor the idea that they can constructively expand the self; both perspectives can b e equally useful for managing pain and suffering, but they are not defining features of the same. Including the existential dimension in the definition of suffering highlights the relevance of suffering in life and its effect on one’s own attachment to the world. An understanding of pain and suffering life experiences is proposed, meaning that they are considered aspects of a person’s life, and the self is the ever-changing sum of these experiences.ConclusionsThe provided definitions will be useful to the identification of pain and suffering, to the discussion of how to relieve them, and to a better understanding of how they are expressed and experienced. They lay the groundwork for further research in all these areas, with the twofold aim of a) avoiding epistemological mistakes and moral injustices, and b) highlighting the limitations of medicine in the treatment of suffering and pain. (shrink)

This paper aims to clarify Schopenhauer’s a priori argument for pessimism and, to an extent, rescue it from standard objections in secondary literature. I argue that if we separate out the various strands of Schopenhauer’s pessimism, we hit upon problems and counterexamples stemming from psychology. For example, instances where striving does not appear to equate to suffering, which puts pressure on the Schopenhauerian claim that human life, qua instantiation of the will, is painful. Schopenhauer’s sensitivity to the complexities of (...) human psychology means that he may be able to stave off such concerns. However, this reveals that true force of Schopenhauer’s argument lies in the manner in which he combines an a priori formulation with empirical observation. I conclude that, though not unproblematic, Schopenhauer’s argument in its most refined forms offers a deep articulation of the human condition, and warrants serious consideration. (shrink)

While there is a great deal to agree with in the essay Expanded Terminal Sedation in End-of-Life Care there is, we think, a need to more fully appreciate the humanistic side of both palliative and end-of-life care.1 Not only does the underlying philosophy of palliative care arguably differ from that which guides curative medicine,2 dying patients are in a uniquely vulnerable position given our cultural disinclination towards open discussions of death and dying. In this brief response, we critically engage Gilbertson (...) et al ’s essay and seek to contextualise the perspective they put forward. According to Cassell, we should distinguish between pain and suffering.3 The former often gives rise to the latter, but suffering has other causes. This includes existential distress, indicating that, unlike pain, suffering is not simply physiological phenomena. Suffering involves the disintegration of the person, meaning that it can impact patient autonomy. Certainly, that a patient is suffering does not equate to a lack autonomy. Nevertheless, we should take care when making decisions in circumstance where the integrity of our embodied personhood is under threat, something that is clearly the case for those who are dying, particularly those who have refractory symptoms while doing so. Generally speaking, refractory symptoms are those which are intractable. They persist despite attempts at palliation. While this implies that such symptoms—and the suffering they cause—cannot be reversed this is not necessarily the case. Not only can the symptoms experienced by dying patients change …. (shrink)

Kant claims that animal suffering only matters if it affects us indirectly by making us more callous toward other persons. This seems inconsistent with Kant’s formal moral theory, and it seems to entail that we are morally better off if we remain willfully ignorant of animal suffering. In defense of Kant’s indirect view, I explain how psychological facts should play a role in the application of the categorical imperative. I then give three responses to the objection that Kant (...) encourages willful ignorance. First, supporting practices of animal exploitation facilitates a system that harms workers. Second, moral ignorance as a habit of mind makes us more likely to ignore morally relevant harm to other persons. Third, remaining intentionally ignorant is not in keeping with our capacity for intellectual self-determination. (shrink)

Suffering, defined as a state of undergoing pain, distress or hardship, is a multidimensional concept; it can entail physical, psychological and spiritual distress that prompts the sufferer to seek medical attention. As a construct originating from and unique to each patient, no patient’s suffering is equal to another’s or completely reducible to any generalizable frame of understanding. As it happens in a common medical encounter, the suffering patient requires an anamnesis provided by attentive and comprehensive listening to (...) both the said and unsaid parts of his or her discourse interpreted through the hermeneutical skills of the physician. Suffering can then be decoded into a complex construct, which can guide the formulation of a strategy to help patient coping by attempting to find meaning in it. To help this search for meaning, one may employ philosophic therapy, bibliotherapy and counseling, among other approaches. Suffering-based medicine (SBM) thus circumvents the limitations of the reductionistic Allopathic medical frame of understanding of disease. Such an attitude should be a common goal for all scientific medicine practitioners, as it complements and does not conflict with any of its therapeutic modalities. Furthermore, medical education should include humanistic disciplines to empower physicians to better understand their patients’ experience of suffering. (shrink)

Several countries have legalized euthanasia on the basis of medically diagnosable suffering over the last decennial; the criteria to which they adhere differ. The topic of this article is euthanasia on the basis of existential suffering. This article presents a recent proposal to legalize euthanasia for people who experience such suffering and then discusses the issue of what the value of life may be, and whether the standard that life is normally something positive should be accepted. This (...) provides the foundation to answer the question of whether euthanasia on the basis of existential suffering should be allowed. (shrink)

This is the first English-language translation of an important book that contributes to contemporary debates about social suffering in sociology, social psychology, political theory and philosophy. Renault provides a systematic account of the ways in which social suffering could be conceptualised.

Many people think we should refrain from intervening in nature as much as possible. One of the main reasons for thinking this way is that the existence of nature is a net positive. However, population dynamics teaches us that most sentient animals who come into existence in nature die shortly thereafter, mostly in painful ways. Those who survive often suffer greatly due to natural causes. If sentient beings matter, this gives us reasons to intervene to prevent such harms. This counterintuitive (...) conclusion can be opposed by arguing that we should not care about nonhuman animals; that other values, such as the existence of certain ecosystemic relations or of untouched wild areas, count for more than the interests of sentient beings; or that intervention in nature cannot succeed. There are, however, strong reasons to reject these claims and to support significant intervention in nature for the sake of animals, despite our deep-rooted intuitions to the contrary. (shrink)

This paper examines the moral significance of guilt in the context of how students confront the suffering of another. Within social-justice education, such confrontations are often staged in pedagogical efforts to encourage students to assume social responsibility. Frequently, however, the guilt that students claim to endure as a result of these pedagogical encounters is not perceived to be of much ethical import. By exploring the psychoanalytic work of Melanie Klein and the ethical philosophy of Emmanuel Levinas, this essay argues (...) that guilt arises out of our susceptibility to another’s pain and that it plays a crucial role both in ‘making reparation’ (Klein) and in the very formation of responsibility itself (Levinas). (shrink)

Background How often does refractory suffering, which is suffering due to symptoms that cannot be adequately controlled, occur at the end of life in modern palliative care? What are the causes of such refractory suffering? Should euthanasia be offered for refractory suffering at the end of life? We sought to shed light on these questions through interviews with palliative care specialists. Methods Semi-structured interviews with six nurses and six doctors working in palliative care in five Norwegian (...) hospitals. Transcripts were analysed with systematic text condensation, a qualitative analysis framework. Results Informants find that refractory suffering is rare, and that with palliative sedation satisfactory symptom control can nearly always be achieved at the end of life. However, the process of reaching adequate symptom control can be protracted, and there can be significant suffering in the meantime. Both somatic, psychological, social and existential factors can contribute to refractory suffering and potentiate each other. However, informants also place significant weight on factors pertaining to the organization of palliative care services as contributing to insufficient symptom control. Conclusions If refractory suffering is indeed rare, then this arguably weakens a common prima facie argument for the legalization of assisted dying. However, the process of reaching adequate symptom control can be protracted and involve significant suffering. The experiences of palliative care clinicians constitute important empirical premises for the assisted dying debate. The study points to several areas in which palliative care can be improved. (shrink)

We attempt to bring the concepts of pain, suffering, and anxiety into sufficient focus to make them serviceable for empirical investigation. The common-sense view that many animals experience these phenomena is supported by empirical and philosophical arguments. We conclude, first, that pain, suffering, and anxiety are different conceptually and as phenomena, and should not be conflated. Second, suffering can be the result — or perhaps take the form — of a variety of states including pain, anxiety, fear, (...) and boredom. Third, pain and nociception are not equivalent and should be carefully distinguished. Fourth, nociception can explain the behavior of insects and perhaps other invertebrates (except possibly the cephalopods). Fifth, a behavioral inhibition system associated with anxiety in humans seems to be present in mammals and most or all other vertebrates. Based on neurochemical and behavioral evidence, it seems parsimonious to claim that these animals are capable of experiencing anxious states. (shrink)

Interdisciplinary in approach, this book combines philosophy, sociology, history and psychology in the analysis of contemporary forms of suffering. With attention to depression, anxiety, chronic pain and addiction, it examines both particular forms of suffering and takes a broad view of their common features, so as to offer a comprehensive and parallel view both of the various forms of suffering and the treatments commonly applied to them. Highlighting the challenges and distortions of the available treatments and identifying (...) these as contributory factors to the overall problem of contemporary suffering, Empty Suffering promises to widen the horizon of therapeutic interventions and social policies. As such, it will appeal to scholars across the social sciences and humanities with interests in mental health and disorder, social theory and social pathologies. (shrink)

"This book focuses on arguments from suffering against the existence of God and on a variety of issues concerning agency and value that they bring out. The central aim is to show the extent and power of arguments from evil. The book provides a close investigation of an under-defended claim at the heart of the major free-will-based responses to such arguments, namely that free will is sufficiently valuable to serve as the good, or prominently among the goods, that provides (...) a God-justifying reason for permitting evil in our world. Offering a fresh examination of traditional theodicies, it also develops an alternative line the author calls a divine intimacy theodicy. It makes an extended case for rejection of the position of skeptical theism. The book expands upon an argument from evil concerning a traditional doctrine of hell, which reveals a number of interesting issues concerning fault, agency, and blameworthiness. In response to recent work contending that the problem of evil is defanged since God's baseline attitude toward human beings is indifference, the book defends the essential perfect moral goodness of God. Finally it takes up the question of whether or not it makes sense to live a religious life as an agnostic or as an atheist"--. (shrink)