abstract:This paper analyzes the phenomenon of suffering and its relationship to medical practice by focusing on the paradigmatic work of Eric Cassell. First, it explains Cassell’s influential model of suffering. Second, it surveys various critiques of Cassell. Next it outlines the authors’ concerns with Cassell’s model: it is aggressive, obscure, and fails to capture important features of the suffering experience. Finally, the authors propose a conceptual framework to help clarify the distinctive nature of subjective patient suffering. This framework contains two necessary conditions: (1) a loss of a person’s sense of self, and (2) a negative affective experience. The authors suggest how this framework can be used in the medical encounter to promote clinician-patient communication and the relief of suffering.

中文翻译：

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当我们谈论苦难时，我们的意思是什么——以及为什么埃里克·卡塞尔不应该有最后的话

摘要：本文着眼于埃里克·卡塞尔（Eric Cassell）的范式工作，分析了痛苦现象及其与医疗实践的关系。首先，它解释了卡塞尔有影响的痛苦模型。其次，它调查了对卡塞尔的各种批评。接下来，它概述了作者对卡塞尔模型的担忧：它咄咄逼人、晦涩难懂，并且未能捕捉到痛苦经历的重要特征。最后，作者提出了一个概念框架，以帮助阐明主观患者痛苦的独特性质。这个框架包含两个必要条件：（1）一个人的自我意识的丧失，（2）消极的情感体验。作者建议如何在医疗会诊中使用该框架来促进临床医患沟通和减轻痛苦。