Institute for the History and Philosophy of Science and Technology, University of Toronto, Toronto, Ontario, Canada.
Bioethics. 2020 Sep;34(7):695-702. doi: 10.1111/bioe.12748. Epub 2020 Jul 6.
Eric Cassell famously defined suffering as a person's severe distress at a threat to their personal integrity. This article draws attention to some problems with the concept of distress in this theory. In particular, I argue that Cassell's theory turns on distress but does not define it, which, in light of the complexity of distress, problematizes suffering in three ways: first, suffering becomes too equivocal to apply in at least some cases that Cassell nevertheless identifies as suffering; second, Cassell's account does not explain what sort of experience suffering is, resulting in theoretical and practical difficulties in distinguishing it from other medical conditions; third, there is good reason to believe that, in medical contexts, 'distress' just means 'suffering' or some cognate concept not yet distinguished from it, rendering Cassell's theory circular. I consider a rebuttal to my objections and reply, concluding that Cassell's theory of suffering needs a definition of distress to settle what the nature of suffering really is.
埃里克·卡塞尔（Eric Cassell）曾将痛苦定义为个人的严重困扰，这种困扰源自对个人完整性的威胁。本文提请关注该理论中困扰概念存在的一些问题。我认为，卡塞尔的理论虽然涉及困扰，但并没有对其进行定义，鉴于困扰的复杂性，这使得痛苦在三个方面产生了问题：首先，痛苦变得过于模棱两可，在卡塞尔确定为痛苦的某些情况下，无法应用；其次，卡塞尔的说法并没有解释痛苦是什么样的体验，这导致在区分痛苦与其他医疗状况方面存在理论和实践上的困难；第三，有充分的理由认为，在医学背景下，“痛苦”仅仅意味着“苦难”或一些与之相关的尚未与之区分的概念，从而使卡塞尔的理论变得循环。我考虑了对我的反对意见的反驳，并作出了回应，最终得出结论，卡塞尔的痛苦理论需要对困扰进行定义，以确定痛苦的本质到底是什么。
