CoChat
Sign Up
Cited by 329Empathy and Medical EducationMedicine, History, and PhilosophyPatient-Provider Communication in Healthcare

The DOI matches its Crossref record; 13 of the 13 references it cites were found in a registry or an index.

Diagnosing Suffering: A Perspective

Cassell, Eric J.·1999·Annals of Internal Medicine
DOI 10.7326/0003-4819-131-7-199910050-00009
Open this paper in CoChat — free account

Abstract

The alleviation of suffering is crucial in all of medicine, especially in the care of the dying. Suffering cannot be treated unless it is recognized and diagnosed. Suffering involves some symptom or process that threatens the patient because of fear, the meaning of the symptom, and concerns about the future. The meanings and the fear are personal and individual, so that even if two patients have the same symptoms, their suffering would be different. The complex techniques and methods that physicians usually use to make a diagnosis, however, are aimed at the body rather than the person. The diagnosis of suffering is therefore often missed, even in severe illness and even when it stares physicians in the face. A high index of suspicion must be maintained in the presence of serious disease, and patients must be directly questioned. Concerns over the discomfort of listening to patients' severe distress are usually more than offset by the gratification that follows the intervention. Often, questioning and attentive listening, which take little time, are in themselves ameliorative. The information on which the assessment of suffering is based is subjective; this may pose difficulties for physicians, who tend to value objective findings more highly and see a conflict between the two kinds of information. Recent advances in understanding how physicians increase the utility of information and make inferences allow one to reliably use the subjective information on which the diagnosis and treatment of suffering depend. Knowing patients as individual persons well enough to understand the origin of their suffering and ultimately its best treatment requires methods of empathic attentiveness and nondiscursive thinking that can be learned and taught. The relief of suffering depends on physicians acquiring these skills.

Overview

Integrity signals

Registry

Crossref · 10.7326/0003-4819-131-7-199910050-00009

Cites

13 of 13 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Verification

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Citations

Cites

Show all 13 references

Cited by

Sorted by citations

Items 301–328 of 328

Related

See all

Metadata

Authors
Cassell, E. J.
Affiliations
Cornell University (US)
Corresponding author
Cassell, Eric J.
Venue
Annals of Internal Medicine
Publisher
American College of Physicians
Published
1999-10-05
Volume
131
Issue
7
Pages
531-534
ISSN
  • 0003-4819 (ISSN-L)
  • 1539-3704
DOI
10.7326/0003-4819-131-7-199910050-00009
OpenAlex
W2049646510
Cited by
329
References
13
Citations by year
2026: 4 · 2025: 9 · 2024: 13 · 2023: 9 · 2022: 11 · 2021: 17 · 2020: 21 · 2019: 11 · 2018: 15 · 2017: 20 · 2016: 8 · 2015: 11 · 2014: 11 · 2013: 12 · 2012: 16
FWCI
4.25
Type
journal article
Language
en
Open access
closed
Licence
www.acpjournals.org/journal/aim/text-and-data-mining (tdm)
Locations
  • Annals of Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • DigitalGeorgetown (Georgetown University Library) (submittedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Empathy and Medical Education
  • Social Sciences › Arts and Humanities › History and Philosophy of Science › Medicine, History, and Philosophy
  • Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
Keywords
suffering, palliative care, dying patients, patient distress, physician-patient communication, empathic listening, subjective information, fear, meaning of symptoms, physician empathy, patient-centered care
MeSH terms
Clinical Competence, Humans, Pain, Physician-Patient Relations, Stress, Psychological, Terminally Ill, Pain Management

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review