Rethinking suffering in palliative care

The concept of suffering remains elusive in its definition and has different meanings for different patients and their families. For example, at an intuitive level, suffering occurs when individuals find themselves in a difficult situation, for example, having COVID-19, which they would naturally prefer not to have; these are negative states that demand endurance. However, the subjective element in such experiences determines how each individual reacts and copes with the situation and, consequently, the suffering that is perceived. It is equally true that health professionals (including nurses, doctors, researchers, psychotherapists and allied health care professionals) hold different perspectives about suffering. It is because of these varying perspectives that approaches to prevent or manage suffering are diverse. In palliative care, the inevitability of death heightens the prospect of suffering and, with that, comes nursing and medical interventions. It is accepted that relief of suffering is a pre-requisite for all health professionals working in palliative and end-of-life care. However, Nyatanga (2005) argued that, while there remains a lack of consensus on what suffering is, it is not clear what nurses assess as suffering; nurses need to have an understanding first of the nature of suffering and then determine how they ensure that their interventions relieve patients' suffering. Palliative care practices in the UK draw from the principles of palliative care set forth by the World Health Organization (WHO) (1990), and this comment scrutinises the principle of not postponing or hastening death, while arguing that this principle is deeply aligned with preventing suffering.