Faculty of Education, University of Manitoba, Winnipeg, Canada.
Palliat Support Care. 2012 Mar;10(1):27-36. doi: 10.1017/S1478951511000551.
The notion of "suffering" is understood in very different ways in a variety of contexts. In palliative care, the relief and prevention of suffering is considered to be a fundamental goal (Pastrana et al., 2008). However, the avoidance of suffering has also been used as an argument by those campaigning for the legalization of euthanasia and assisted suicide (Finlay, 2009). In reflecting upon suffering in these two contexts, we were intrigued by Finlay's (2009) contention that to laypeople, the phrase "'unbearable suffering' conjures up images of patients on their deathbeds wracked with uncontrolled pain" (p. 1841).
This article explores how suffering is used and understood in an "everyday" discourse, by analyzing comments posted to a website debating assisted suicide in the context of the Canadian case of Sue Rodriguez.
Using a broad social approach to discourse analysis (Tonkiss, 2004), three themes emerged in our analysis: (1) when people suffer, (2) how people are understood to suffer, and (3) how suffering should be dealt with. We also examined what was not said in this discussion: there was little consideration of the more holistic goals of palliative care and how suffering might be understood and managed in ways other than within the frame of assisted suicide.
Paying attention to the everyday discourse of suffering is important because, as members of society, we all play a role in negotiating the meaning of suffering. Such meaning has a significant impact upon patients and palliative care professionals alike.
“痛苦”的概念在不同的语境中被理解为非常不同的东西。在姑息治疗中，缓解和预防痛苦被认为是一个基本目标（Pastrana 等人，2008 年）。然而，避免痛苦也被那些争取安乐死和协助自杀合法化的人用作论据（Finlay，2009 年）。在反思这两种情况下的痛苦时，我们对 Finlay（2009 年）的论点感到好奇，即对门外汉来说，“无法忍受的痛苦”这个短语“让人联想到临终患者在无法控制的痛苦中痛苦不堪的画面”（第 1841 页）。
本文通过分析在加拿大苏·罗德里格斯（Sue Rodriguez）案的背景下，一个网站上关于协助自杀的辩论中发布的评论，探讨了痛苦是如何在“日常”话语中被使用和理解的。
使用广泛的社会话语分析方法（Tonkiss，2004 年），我们的分析中出现了三个主题：（1）人们何时受苦，（2）人们如何被理解受苦，以及（3）如何处理痛苦。我们还研究了在这次讨论中没有提到的内容：几乎没有考虑姑息治疗的更全面目标，以及如何以不同于协助自杀框架的方式理解和管理痛苦。
关注痛苦的日常话语很重要，因为作为社会的一员，我们都在协商痛苦的意义方面发挥作用。这种意义对患者和姑息治疗专业人员都有重大影响。
